From Where I Sit Page 2
Weekly Biological Testing Page 4
SBIRT & Caries Risk Assessment Page 6
Changes to HIPPA Page 8
OHP Provider News Page 10
Commercial Provider News Page 12
CCO News Page 13
Regions & Representatives Page 13
Dental Outcomes & Performance Metrics Page 14
BMI Page 15
New Providers Page 16
Social Networking Page 17
Classifieds Page 18
Calendar of Events Page 20
I N S I D E T H I S I S S U E :
O U R M I S S I O N : To provide dental leadership, service and access to care to our communities in a professional, entrepreneurial and sustainable manner
It’s a New World page 2
The AdvantageThe Advantage Community Newsletter
From Where I Sit:
3rd Quarter 2013
2 | The Advantage 3rd Quarter 2013 | 3
I have written many times about the new
healthcare world that is being envisioned
by the government through the Affordable
Care Act (ACA) and the Oregon Health
Care delivery system transformation
legislation (HB3650, SB1580, & HB 2009)
among others
As I talked before; Government, (city,
county, state, Federal, Medicaid, Medicare,
military, the VA and Tribes), pays for over
60% of the cost of Health Care in this
country Because of this, they would like to
change the Healthcare delivery system—
which is really a ‘sick care’ system The new
world is about a group of providers taking
on the financial risk for a group of patients
and promising certain outcomes Rather
than providers waiting in their offices for
people to show up with problems—then
getting paid a fee for service to fix the
problem; having to arrange with some
third party payer to pay the bill and being
frustrated by the fact that our ability to
fix the problem out strips the patients’
ability to pay and the third party payer’s
willingness to pay—the practice will be
paid a fixed rate to take care of a number
of patients; taking on a substantial fiscal
risk that the patients they are seeing will
need more care because of poor health
and/or health habits
The problem is, now that government pays
the majority of the bill, they do not want
to buy what we have to sell What they
want now, is to buy healthy people who
do not need their expensive problems
fixed Because the government cannot
really assess quality of work (because they
are not dentists) they will want to find
quantitative ways to measure how well
we are taking care of the patient’s needs
They may want to track documentation,
patient satisfaction, spending on services
such as; hospital ER, prescriptions, number
of procedures such as sealants done,
permanent molars, or even the number of
people with a dental visit of any kind
So if the government is not paying for
procedures, what do they want us to
do? They want us to become involved
with our communities and help the
community to help its citizens achieve
overall better health—which includes
oral health The problem is that people
have become convinced that the solution
is to have their teeth fixed when they
have a problem; and, as an industry, the
incentives for payment minimized the idea
that prevention can be the better (less
expensive) solution
This entire process is starting with
Medicaid—which the majority of you
reading this newsletter do not treat Some
of you are desperately trying to avoid the
system used in Medicaid dentistry in your
commercial work This group of Dentists
may find that they cannot avoid it much
longer Government is starting to ask why
so much dentistry needs to be done on
the people with commercial insurance
They are looking at how their employees
can have less disease, thus fewer repairs, as
well An article about this was in the ADA
Journal The article, by Dr. Christensen, is
It’s a New WorldChange is inevitable, but everyone still needs Teeth
By R. Mike Shirtcliff, DMD
From Where I Sit:
questioning the need for so many crowns
My prediction is that you will see more
and more articles in the future about
the concept of disease prevention and
finding ways to avoid expensive restorative
procedures The ADA newsletter has
published a series on this subject with
titles such as, “The New Normal”
Also, you will begin to see a lot of articles
about government programs such as
spore testing for autoclaves Please read
them and do what it takes to stay current
As a subcontractor to Advantage Dental,
Advantage Dental will also have to do
some auditing to prove to our government
masters that we are all complying with
the law
Advantage Dental and PacificSource are
rolling out a new commercial product
in January that will pay dentists who
participate on a monthly capitated
payment, plus co-pays, for certain
procedures At first, only those providers
that take a large enough block of
Oregon Health Plan (OHP) patients to
minimize the risk, and are familiar with
how capitation works, will be afforded
the opportunity to participate This new
product will be offered only to large
groups that want dual choice; similar
to what ODS & Willamette is offering
This will be a limited offer at first; so if
you are interested please let Advantage
Dental Customer Service know at
As always, thank you all for what you do
to serve the citizens of your respective
communities The world is changing, but
some things remain the same All people
have and need teeth
Government is starting to ask why so much dentistry needs to be done...
4 | The Advantage 3rd Quarter 2013 | 5
L���� � C�n����
$6,000 �ne + 40 hours Community Service1 Missed Test = 1 Fail
0 20 5
Within this past year all Board
investigations have included inquiry into
sterilization practices Those investigations
have determined that nearly 75% of
practicing dentists have been less than
diligent in undertaking weekly biological
testing of heat sterilizing devices
The requirement of undertaking weekly
testing is established by Oregon
Administrative Rule 818-012-0044(4),
(See opposite page for rule text) This
rule has been in place for many years,
but has not been a point of awareness
for many dentists or the Board until the
recent sterilization failures in Oklahoma
that made national news (Note that the
events in Oklahoma involved the complete
and actual disregard for sterilization, as
opposed to the failure to perform a weekly
test on sterilization equipment)
In response to the poor testing compliance
in Oregon , the Board has crafted a tiered
disciplinary system Each missed weekly
test is deemed a failure If a dentists has
0-5 failures, the board may issue a letter
of concern If the dentist has 6 or more
failures, the Board may issue discipline
on a tiered scale The highest level on the
scale is for 20 or more failures; for which
the Board may impose a $6,000 fine and 40
hours of community dental service or more
By virtue of the tiered system, the
highest level of discipline incorporates
those individuals who may have been
testing every other week as apposed to
every week The lesser disciplinary levels
incorporate those dentists who may have
had staff turnover of similar administrative
lapses In all circumstances, however, the
ending Consent Orders are discipline that
is publicly published by the Board and
reported to the National Practitioners
Data Bank
In the vast majority of cases, the testing
failures have been due to a minor
administrative lapse or failure of a dentist
to fully appreciate that weekly testing
was mandated Given that the failure
rate nears 75% of all practicing dentists,
the failures include some of the best and
most conscientious of providers This
includes former Oregon Dental Board
Members as well as former Presidents of
local Dental Societies; all people who have
dedicated themselves to dental excellence
and would not knowingly violate a
sterilization mandate In addition, in some
Weekly Testing Is MANDATED by the Oregon Board of Dentistry
Penalties for not conducting weekly biological testing of sterilizing devices can be costlyIs YOUR Office testing bi-weekly?
…the failure rate nears 75%
of all practicing dentists, the
failures include some of the
best and most conscientious
of providers. r
Watkinson Laird Rubenstein
Baldwin & Burgess, P.C. Announces the Addition of
New Shareholders:
James R. Dole
John J. Christianson
Jane M. Yates
New Offices In:
Portland and Grants Pass
Providing legal services to healthcare practices,
individuals, and businesses throughout Oregon
in the areas of:
• Health Law
• Employee Benefits and Personnel Issues
• Real Estate and Business Transactions
• Estate Planning and Asset Protection
• Litigation and Family Law
Eugene Roseburg Redmond
Portland Grants Pass
www.WLRLaw.com (800) 270-7418
Oregon Board of Dentistry Infection Control Guidelines 818-012-0040
In determining what constitutes unacceptable patient care with respect
to infection control, the Board may consider current infection control
guidelines such as those of the Centers for Disease Control and Prevention
and the American Dental Association Additionally, licensees must comply
with the following requirements:
(1) Disposable gloves shall be worn whenever placing fingers into the
mouth of a patient or when handling blood or saliva contaminated
instruments or equipment Appropriate hand hygiene shall be
performed prior to gloving
(2) Masks and protective eye wear or chin-length shields shall be worn
by licensees and other dental care workers when spattering of blood
or other body fluids is likely
(3) Between each patient use, instruments or other equipment that come
in contact with body fluids shall be sterilized
(4) Heat sterilizing devices shall be tested for proper function on a
weekly basis by means of a biological monitoring system that
indicates micro-organisms kill.
(5) Environmental surfaces that are contaminated by blood or saliva shall
be disinfected with a chemical germicide which is mycobactericidal
at use
(6) Impervious backed paper, aluminum foil, or plastic wrap may be used
to cover surfaces that may be contaminated by blood or saliva and
are difficult or impossible to disinfect The cover shall be replaced
between patients
(7) All contaminated wastes and sharps shall be disposed of according to
any governmental requirements
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circumstances contract dentists or employed dentists are receiving Consent
Orders due to the administrative failings of their employers
Earlier this year, the Dental Board issued notice to all providers reminding
them of their testing requirements This effort at education is working as
awareness for the weekly requirement is increasing However, while the effort
to inform is beneficial, there has been no concurrent effort to raise awareness
regarding the level of discipline that is being issued
6 | The Advantage 3rd Quarter 2013 | 7
Poverty is a risk factor that impacts many areas of our
communities and citizens – education, health, and child safety
are just a few of these areas In terms of health, Bridges Out Of
Poverty says, “The poorer you are the sicker you are ” Apply that to
the Oregon Health Plan population, most of whom live in poverty,
and we health professionals will see more individuals with
comorbid interrelated health issues For example, dental patients
with obesity, high blood pressure, substance abuse, tobacco
addictions and a mental health diagnosis
The day-to-day lives of these individuals make engaging in dental
care difficult Scrambling from one agency to another to find
the resources to meet their basic needs might make their lives
look like tornadoes They tend to be focused on the crisis of the
moment with little time or energy to focus on tomorrow, next
week or next month Survival needs of food, utilities, housing,
keeping a car running, or needs of family members in the same
situation often take priority over keeping dental or medical
appointments A lack of education about how good oral health
affects overall health or the importance of baby teeth in children
can keep parents from accessing dental care
As Advantage Dental transitions into contracting with 16
Coordinated Care Organizations (CCO) the view of dentistry
will need to shift to assisting in coordinating care, which will be
outlined in this article Topics to be discussed are SBIRT (Screening,
Brief Intervention and Referral to Treatment), Caries Risk
Assessment, Prevention strategies, and Bridges Out of Poverty
SBIRT (SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT)
Integrating dental into the global budget of the CCOs will require
the dental team to help meet the measures of each CCO The
Oregon Health Authority has identified SBIRT as an incentive
funding measure for Oregon’s Coordinated Care Organizations
SBIRT is evidence based and determined to be an effective
method to intervene in alcohol and drug misuse In the past it
has been underutilized in the primary care setting Research has
shown that patients tend to show up in the dental office more
often than the primary care office Given this, dentistry has the
ability to reach a subset of folks with this intervention that may
otherwise go unscreened and without intervention
Oregon SBIRT Primary Care Residency Initiative, sited at OHSU, is
one of the largest training programs with the goal to teach SBIRT
method to primary care physicians Advantage Dental would like
to take this a step further by training the dental team as well For
more information on SBIRT and the Oregon training program visit:
www.SBIRToregon.org
When the simple act of putting food on the table for your family becomes the focus of your daily life and Oral Health looks like an impossible luxury
The view of Dentistry will need to shift:
— Cindy Shirtcliff, LCSW and Sharity Ludwig, BS, RDH, EPP
CARIES RISK ASSESSMENT
The American Dental Association has completed some revisions
that will be coming into effect January 2014 The ones of
most interest to Advantage Dental will be the new Caries Risk
Assessment codes, which will provide a standard means of
reporting Caries Risk for dental professionals These codes will
allow the opportunity for dental insurers to start paying for
different levels of care based on the identified risk of an
individual patient
Advantage Dental expects that a Caries Risk Assessment will
be an initial part of treatment on every individual with the
expectations to provide treatment according to risk status For
example, according to the ADA Evidence Based Guidelines, a
low risk patient would not benefit from receiving an in office
fluoride treatment It is recommended that daily use of fluoride
toothpaste is adequate The patient identified as High Risk would
require 2-4 applications per year
Dental prevention without using caries risk is not cost effective
and is actually cost prohibitive It is necessary to identify those at
high risk and work toward moving them to a lower risk category
and keeping those at low risk stable Advantage Dental recently
partnered with DHS’s Self-Sufficiency Program in doing outreach
home visits to parents who had not accessed dental care for
their children after school screenings had deemed them needing
urgent or emergent dental care This outreach began with 5
families Interestingly, 2 families out of the 5 were homeless As
a family attending to survival needs of shelter, food and keeping
a car running, it seems it was hard to put dental care at the top of
the list One single mom works 12 hours a day during the week
Another had a phobia of going to the dentist she did not want
to impart to her young child Not knowing how to get help, she
avoided taking him to the dentist
Let’s face it, missing appointments or not seeking free dental
care or health care can frustrate all of us as providers We
have all used terms like “resistant,”, “unmotivated,” and “non-
compliant” to describe our patients who don’t show up or change
behaviors Advantage Dental is training its providers and staff
in the understanding of the Culture of Poverty The hope is that
with understanding will come more empathy and less judgment,
thus reducing a barrier to care We are helping staff to remember
that our societal experiences may be different than those of our
patients
Living without adequate resources will place many OHP patients
in the “high risk” category on the Caries Risk Assessment
Therefore, Advantage Dental will be promoting individualized
preventative treatment plans to address the level of risk For
a younger child at high risk it would include 4 betadyne and
fluoride varnish treatments before the age of 30 months Another
example would be early dental care for a pregnant woman and
the use of Xylitol products
In the next few months an Advantage team will be conducting
trainings around the topics of Prevention, Caries Risk Assessments,
SBIRT and the Culture of Poverty These will initially be webinars
for the convenience of staff to attend from their offices and
minimal loss of work time
The new codes for 2014 will be:
D0601 caries risk assessment and documentation, with a
finding of low risk using recognized assessment
tools
D0602 caries risk assessment and documentation,
with a finding of moderate risk using recognized
assessment tools
D0603 caries risk assessment and documentation,
with a finding of high risk using recognized
assessment tools
For more information on Caries Risk Assessment:https://secure.advantagedental.com/images/files/
PreventionManualSec1.pdf
http://www.ada.org/sections/professionalResources/pdfs/
topics_caries_under6.pdf
http://www.ada.org/sections/professionalResources/pdfs/
topic_caries_over6.pdf
http://www.cdafoundation.org/learn/education-training/
cambra
http://ebd.ada.org/ClinicalRecommendations.aspx
8 | The Advantage 3rd Quarter 2013 | 9
There have been substantial recent
changes made to HIPAA which required
compliance by September 23, 2013
To ensure that your office has met the
compliance requirements, we recommend
that you consult with your attorney and/
or HIPAA specialist For your information
only, below is a list of resources that you
may find useful
Resources:
¾ HIPAA Administrative Simplification Regulation Text provided by the Department of Health and Human Services Office for Civil Rights
� http://www.hhs.gov/ocr/privacy/hipaa/administrative/combined/hipaa-simplification-201303.pdf
� This document includes information related to the new HIPAA provisions
¾ HIPAA Privacy and Security web page provided by the American Dental Association
� http://www.ada.org/8753.aspx
� This website provides an overview of the new HIPAA provisions and explains how such provisions could affect dental offices
¾ Department of Health and Human Services website
� http://www.hhs.gov/ocr
� This website provides detailed information regarding the new HIPAA provisions as well sample Business Associate Agreements
¾ HIPAA training materials from the Department of Health and Human Services
� http://www.hhs.gov/ocr/privacy/hipaa/understanding/training/index.html
� This website includes links to two
videos and a handout, all which review the new HIPAA provisions The first video, “Patient Privacy” is geared toward doctors and healthcare providers; the second video, “HIPAA and You” is geared toward healthcare providers in general; and, the handout, “Examining Compliance with the HIPAA Privacy Rule” is geared toward healthcare providers who regularly interact with PHI
Please Note: Advantage Dental in no
way guarantees the accuracy of the
information contained in these resources
and Advantage Dental does not intend
any of the resources to constitute or
take the place of legal advice from your
own attorney Furthermore, Advantage
Dental does not endorse and will not
take responsibility for the accuracy of the
information provided by these resources
PAC-078_DENTAL_AdvantageDentalNewsltr_4.625x3.5_Q2-2013.indd 1 4/24/13 3:52 PM
Changes to HIPAA
The Good Shepard event was a great time for the Hermiston, Heppner and Boardman clinic staff. They did 85 dental screening and put the new Eastern Oregon Advantage Communities brochure in hundreds of hands.
Wondering why you should be an Advantage Dental Provider?Call us at:
866-268-9616or e-mail
Super Advantage Smiles for Kids (ASK) Donation OpportunityOnline shopping for the Holidays? Amazon com just launched AmazonSmile:
Go to AmazonSmile through your online Amazon account
Be sure to type in Advantage Smiles for Kids as your charity of choice
5% of every dollar you spend will be donated to ASK!
Happy Shopping!
Oregon Health Plan Provider News
10 | The Advantage 3rd Quarter 2013 | 11
Help us, help your patients by following
these guidelines when Submitting your preauthoraiztionfor third molar extractions.EVIDENCE OF INFECTION: The most
important thing looked for is evidence
of acute infection or abscess If there
is good evidence of acute infection
or abscess, it’s usually approved
Unfortunately, documentation to
evaluate for acute infection is usually
lacking There is a lot of documentation
for pericoronitis but, technically, this
only means inflammation and it does not
necessarily mean there is an infection
Pericoronitis was the most common
dental emergency seen in the Army
because most young soldiers enlisted
before they had their third molars
removed Pericoronitis can often be
treated by debridement, irrigation, anti-
inflammatory medication and home care
instructions It should not be necessary
to extract third molars because of one
episode of pericoronitis
PAIN: Pain is the most subjective and
the most difficult symptom to evaluate
because some discomfort is expected
for erupting third molars and tolerance
for pain differs from one person to the
next If the tooth is confined within the
bone, incompletely formed and appears
to be causing pressure symptoms rather
than pain from infection, the patient’s
complaint of pain cannot be relied on
as the sole reason for extraction The
OHP rulebook states the pain must be
“severe”
SWELLING: Swelling is also difficult
to evaluate because, like pain, mild to
moderate swelling is common with
erupting third molars (the tooth pushes
the gum tissue up as it tries to erupt
– this is normal “swelling”) The OHP
rulebook states that there must be
“unusual swelling of the face or gums”
CARIES: Caries is not addressed in the
OHP rules as a reason for extraction, but
will be allowed when there is deep decay
and the tooth is clearly non-restorable,
even if it’s not symptomatic because it
will become a problem eventually If
there is only early decay extractions are
not normally approved because they are
not listed by OHP as one of the criteria
DOCUMENTATION: Other
documentation that helps determine
if acute infection is present includes
suppuration from beneath the
operculum or around the tooth,
regional lymphadenopathy, elevated
temperature, trismus and history of
antibiotic prescriptions
POTENTIAL FOR INFECTION: Another
consideration is the potential for
infection in medically compromised
or pregnant patients If there are deep
perio pockets behind the second molars
with a partially erupted third molar, I
usually approve the extraction rather
than put a medically compromised or
pregnant patient at risk for infection
This is not a consideration in healthy
patients
EXTRACTIONS OF THIRD MOLARS IS SURGERY
Something you should remind your
patients of is that extraction of third
molars is surgery and it has risks
for operative and post-operative
complications including infection,
bleeding, and nerve dysfunction These
complications are uncommon but
they should be considered As with
any other invasive medical or dental
procedure, surgical removal of impacted
third molars should be done only when
necessary and it should be after a risk:
benefit analysis
Regarding Approvals and Denials of Preauths for Third Molar Extractions
ARE YOU PRESCRIBING XYLITOL GUM or MINT KITS FOR YOUR OHP PATIENTS?
Part of Advantage Dental’s Caries Protocol for the high-risk patient is to have a preventative
protocol in place to reduce the level of dental disease Because of this, Advantage is offering
xylitol products to patients Patients who are pregnant* and with special heath care needs**
will be provided a 90-day kit at no out of pocket expense (Bill out D9630) Those who do not fall
into either of those categories can purchase the kits for $28 In this case the kit will be mailed
out once payment is received by Advantage Dental Administration
* All patients who are pregnant or less than 3 months postpartum should be given a 90-day
supply of xylitol with instructions to use for 3 months after delivery If patient has rampant
decay then the patient should be put on xylitol protocol for 6 months after delivery
** Patients with developmental, physical, medical, or mental disabilities that prevent or limit
performance of adequate oral health care by themselves or caregivers Provide patient xylitol
until dental disease is under control
Did You Know, You can purchase kits too!Xylitol: Nature’s Cavity Fighter, $28.00 per kit
Gum Kit:
• 1 bottle (50 pieces each) of Xylitol Gum and one bulk bag (500 pieces) of Gum Your choice of Cinnamon, Fruit, or Peppermint
• 1 Tube of Xylitol Toothpaste
• Informational Brochure
Mint Kit:
• 1 bottle (200 mints each) of Xylitol Mints, and one bulk bag (1,000 pieces) of mints Your choice of Cinnamon, Fruit, or Peppermint
• 1 Tube of Xylitol Toothpaste
• Informational Brochure
—Gary Allen, DMD Dental Consultant
To order a 90-day xylitol kit or toothpaste call the Customer Service Provider Only Line (Please DO NOT share this number with your patients) 1-888-480-4478 Have patient’s recipient ID#, Last name, First name, and whether patient is pregnant, special health care needs, or OTHER and who will be paying the $28 for the kit
12 | The Advantage 3rd Quarter 2013 | 13
Your Representatives
Advantage Consolidated, LLC Board of Managers Region 1:
Dane Smith, DDS of North Bend, ORRon Tribble, DMD of Winston, OR
Region 2:
Greg Bigelow, DMD of Grants Pass, ORDon Lanahan, DMD of Grants Pass, OR
Region 3:
J Kyle House, DDS of Hood River, ORJames Petersen, DMD of Prineville, OR
Elected At Large Region (Entire State of Oregon):
John “Jack” Bauer, DMD of Burns, ORThomas Tucker, DMD of Klamath Falls, OR
Appointed At Large Region (Entire State of Oregon):
Cedric “Ced” Hayden, DDS of Springfield, ORMatthew Hayden, DDS of Hermiston, OR
Lay Managers:
Bruce Hanna of Roseburg, ORMike Gordon of Coos Bay, ORRob Keith of Lebanon, ORJohn Thomas of Eugene, OR Jerry Duncan of Roseburg, OR
B Unit Non-Voting Manager:
Sylvia Goedeck of Prineville, OR
President/CEO Non-Voting Manager:
R Mike Shirtcliff, DMD of Redmond, OR
Representatives for each region
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Are you treating Healthy Kids Connect patients through PacificSource? Healthy Kids Connect has been a traditional insurance program with a subsidy available that helped to pay the premiums to those that qualify. Since it was traditional insurance patients were able to see any provider that was contracted with Advantage to be a network provider for PacificSource. With the changes in health care, and Oregon’s reform process, the Healthy Kids Connect program will be changing as of January 1, 2014.
Healthy Kids Connect will become part of the Oregon Health Plan benefit offered through the Cover Oregon Marketplace. With this change, only providers that are contracted OHP providers will be eligible to treat these patients.
Please make sure your staff knows that for dates of service on or after January 1, 2014 you will not receive payment on any treatment of a Healthy Kids Connect patient, unless you are an OHP contracted provider.
Should you have any questions regarding this change, please feel free to contact Customer Service at 1-866-268-9631.
Commercial Provider News
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PacificSource Has OnLine ResourcesPacificSource has some great resources on-line. Besides their provider bulletin they also have a page dedicated to news of interest to Dental providers specifically. Here are some links to PacificSource resources to help you:
Provider Information Page
http://www.pacificsource.com/providers/
Provider Bulletin
http://www.pacificsource.com/provider/provider-newsletters/
Dental Providers Information Page
http://www.pacificsource.com/DentalProviders/
14 | The Advantage 3rd Quarter 2013 | 15
See more information on SBIRT in the article on page 6
You don’t need any special equipment or skill to assess BMI, so why not start screening your patients by calculating their BMI then counseling them to see their physician when needed BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems
The BMI ranges are based on the relationship between body weight and disease and death Overweight and obese individuals are at increased risk for many diseases and health conditions, including the following:
Body Mass Index (BMI) is a number calculated from a person’s weight and height BMI is a fairly reliable indicator of body fatness for most people BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat To calculate BMI you only need to have the patient’s weight and height There are many on-line BMI calculators that you may use, but we recommend the one found on the Centers for Disease Control (CDC) website View the CDC Adult BMI Calculator go to: www.cdc.gov
For adults 20 years old and older, BMI is interpreted using standard weight status categories that are the same for all ages and for both men and women For children and teens, on the other hand, the interpretation of BMI is both age- and sex-specific
For more information about interpretation for children and
teens, visit Child and Teen BMI Calculator at: www.cdc.gov
For more information about these and other health problems associated with overweight and obesity, visit Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults on the CDC website at: www.cdc.gov
Performance metrics have always been
part of Advantage Dental’s OHP contract
with the state These metrics have
primarily focused on preventive services
for children and pregnant women and
provided benchmarks and trending data
to monitor quality improvement projects
Until now, they carried no penalties for
poor performance and no incentives for
improvement With implementation of
healthcare reform and integration into
Coordinated Care Organizations (CCOs),
new metrics will be developed to monitor
dental plan performance and financial
incentives will be added to improve
quality and outcomes
Recommendations for appropriate dental
performance metrics will be made by
a Dental Quality Metrics Workgroup
appointed by the Director of the Oregon
Health Authority (OHA) The workgroup
consists of 11 members—three from CCOs,
four from DCOs and four individuals with
expertise in oral health Dr Mike Shirtcliff is
one of the four DCO members appointed
to the Dental Quality Metrics Workgroup
The workgroup has already met several
times to review and discuss a variety of
dental metric sets
The Dental Quality Metrics Workgroup
will recommend up to five measures for
adoption by the OHA Metrics and Scoring
Committee no later than November 2013
Two of the measures will be selected
for inclusion in the set of CCO financial
incentive measures Criteria used by
the workgroup to select dental quality
measures include:
1 Representative of the services provided and beneficiaries served by the CCOs
2 Use valid and reliable performance measures
3 Rely on national measures whenever possible
4 Focus on outcomes to the extent possible
5 Exclude measures that would be expected to be heavily influenced by the patient case mix
6 Control for the effects of random variation (e g , measure type, denominator size)
7 Focus on the right care, at the right time, in the right place
Following implementation of the dental
performance measures, Advantage Dental
will be at risk to achieve quality goals
defined by OHA and CCOs While this
will be an important area of emphasis
for Advantage Dental as a dental plan, it
should not be our only focus Advantage
can show value added to its CCO partners
by helping them reach overall healthcare
quality measures OHA has identified
17 incentive measures where CCOs will
be expected to show improvement
Among these are several where oral
health providers can be trained to deliver
appropriate interventions to improve
overall health quality One of these is
alcohol and drug misuse Screening, Brief
Intervention and Referral for Treatment
(SBIRT) Some CCOs are sponsoring
SBIRT training throughout the state
and Advantage dentists and offices are
encouraged to attend
Other CCO measures, where dental
providers and dental plans have a role in
helping achieve better health outcomes
for Oregonians, include checking and
controlling high blood pressure, helping
control HbA1c levels in diabetics, reducing
tobacco use and reducing avoidable
emergency department (ED) visits This
new era of coordinated and integrated
health care offers opportunities and
challenges for all health care provider
types to step up and use their training,
knowledge and expertise to improve the
health of all Oregonian through a seamless
delivery system
BMI Weight Status
Below 18 5 Underweight
10 5–24 9 Normal
25 0–29 9 Overweight
30 0 and Above Obese
BMI ranges
Dental Outcomes and Performance Metrics
Let’s Talk AFS• Credit Reports• Patient Financing Consulting
(through Credit Matrix)• Patient Appointment Reminder Calls• Patient Payment Reminder Calls• Patient Reactivation Calls• Patient Hygiene Reminder Calls• Insurance Follow-up Calls
Would you like to improve your ability to provide patient financing and increasing the efficiency of your practice? Why not take a look at what Advantage Dental’s financial services can offer—starting at only $200 per month.
Become an Advantage Dental Contracted Provider and be eligible to participate in AFS, one of many Member Benefit programs available to our contracted Dentists.
Call 866-268-9616 or e-mail: [email protected]
• Hypertension• Dyslipidemia• Type 2 diabetes• Coronary heart disease• Stroke
• Gallbladder disease• Osteoarthritis• Sleep apnea and
respiratory problems• Some cancers
16 | The Advantage 3rd Quarter 2013 | 17
CCO News
No Matter Where You Are...Brad visits practices from Central Oregon all the way to the coast. His unsurpassed commitment and personable style is welcomed by all. If you are looking for a bank that goes the distance, give Brad a call.
www.columbiacommunitybank.com
Brad Volchok 503-924-2320Email: [email protected]
Advantage Dental ad_5-13-13_F.pdf 1 5/15/2013 10:22:13 AM
ALLCARE and Western Oregon Advanced Health are now sending a pre-auth for pain medication AllCare has stated that either the pharmacy or the office can call AllCare at 541-471-4106 and advise that the script is for dental and request for an “acute fill override” which will be approved
Advantage Dental Services, LLC is now contracted with the following CCOs:Western Oregon Advanced Health (WOAH), July 1, 2013Intercommunity Health Network (IHN), October 1, 2013Primary Health of Josephine County (PHJC), October 1, 2013
Coming Soon:Trillium, January 1, 2014JCC (Jackson Care Connect), January 1, 2014
What Can the Social Network Do For Your Practice?
Social Media Do’s and Don’ts for the Dental Practice
We are bombarded with the message to
used social medial but most dentists are
still asking, “what is social media and what
can it do for my practice?” Why spend the
time and resources to interact with your
current and future patients this way?
Measuring the value of any social media
activity is tough There isn’t a lot of
quantitative data that can be examined to
show how affective or ineffective a social
media campaign is Not unlike the design
of your letterhead or website, the response
to social media is somewhat subjective and
often indirect
It’s difficult to put a hard value on that
positive comment posted to your facebook
page, but you know that there is value in
positive reviews & referrals that lead to new
patients
GONE ARE THE DAYS OF SHOTGUN ADVERTISING
People have become more sophisticated
in the process of making purchasing
decisions The information age has made
it possible for the customer to quickly and
easily research a product or service They
can now view reviews and comments with
a click on of a mouse or swipe of a finger
And people are making decisions based
on what they see online
Engaging your customer through social
media can lead to a drastic increase in
business The more relationships you can
build, the more your current customers
will talk and recommend you to their
friends, family and acquaintances Social
Media gives you a new tool to build trust,
loyalty and respect in your community
YOU CAN’T FAKE IT
Social Media may not be right for every
dentist People must engage with these
communities in a real way You will need
to be diligent in the management of your
on-line reputation Social Media can open
you up to criticism and it can be difficult to
deal with negative feedback
Many have decided that Social Media is
worth the risk For example; the father of
the creator of facebook, Mark Zukerberg,
advocates for Dentists to use facebook to
build their practice, (Read more about Dr
Zuckerberg at: http://articles.latimes.
com/2011/mar/30/business/la-fi-
zuckerberg-father-20110330)
THE NUMBERS ARE COMPELLING
More than 80% of American adults use
an online social network 23% of the
time an average user spends online is on
a social media platform With over one
billion facebook users—and close to as
many users on Twitter, Pinterest, LinkedIn,
MeetUp, Google+, and more—connecting
every minute of every day; why not take
advantage of the opportunity?
How are you going to use social media to engage with current
and future patents online? Here are some quick tips to help get
you started in your practice’s online marking strategy
1 Do Create Quality Content Social media presents the
opportunity disseminate engaging and information content
about your practice; and social media users demand it
2 Listen: Take the time to listen and find out what patients are
saying online Make time every week to read and respond to
patient feedback
3 Get Outside Help When Needed: Social Media takes time to
manage effectively If you think you may not be able to keep up,
don’t take the chance of dropping the ball Hire outside help
Advantage Dental’s preferred partner LocalFresh is one great
resource for this kind of help
—Kimberly Krueger, BA Graphic Design
3rd Quarter’s Newly Contracted Providers
Jeffrey Anderson, DDS Tigard, ORCole Anderson, DDS, MS Boise, IDN. Thomas Capsey II, DMD Medford, ORTravis McFee, DDS Salem, ORHamid Zehtab, DMD Lake Oswego, ORJason Bajuscak, DMD Portland, ORTyler Reading, DMD West Jordan, UTThomas Flath, DMD Portland, ORPeter Tommerup, DDS Grants Pass, ORGraham Hill, DDS Meridian, IDBradley Robertson, DDS Boise, IDScott Allen, DDS Idaho Falls, IDJay Harris, DDS Idaho Falls, IDMichael Elison, DMD Idaho Falls, IDJennifer Frankel, DMD Keizer, ORRiley Hicks, DDS Idaho Falls, IDJonathan Smith, DDS Spokane, WAJeffrey Travelstead, DMD Corvallis, ORH. James Clark, DDS Boise, IDEric Jacobsen, DDS Oregon City, OR
Please welcome the newest providers to the Advantage Dental Community.
“Intelligence without
ambition is like a
bird without wings.”
—Salvador Dali
18 | The Advantage 3rd Quarter 2013 | 19
VARIOUS LOCATIONS IN OR & WAPediatric Dentist: A Kidz Dental Zone/Advanced Pediat-ric Dentistry, a multi-site group practice in the Pacific Northwest, is looking for compassionate and motivated pediatric den-tists interested in opportunities to provide care focusing on prevention and community involvement We provide all the support our doctors need so that they can focus on building their community reputation and de-livering quality care in our state of the art clinical environments With us, a pediatric dentist can concentrate on patient care and patient care alone We offer a competitive salary with quarterly bonus potential, Health Savings Account, 401(K) retirement plan, company paid professional liabil-ity insurance, paid vacations and continuing education reimburse-ment The opportunity for future partnership is an option as well We currently have openings in Hood River, The Dalles and Herm-iston, Oregon and the Tri-Cities, Washington For inquiries please contact Dr J Kyle House at (541) 387-8688 or send resume to [email protected]
Orthodontist: Advanced Pedi-atric Dentistry, a rapidly growing Pediatric dental clinic currently
located in Pasco, Washington with a pending expansion to Richland, Washington, has an excellent opportunity for an or-thodontic provider Our practice is fully outfitted with state of the art equipment, a pediatric facility on one side of the facility and a dedicated orthodontic facility on the other The Orthodontic Practice is comprised of a ded-icated digital pan/ceph, 5 chair bay with a 6th chair in the exam/consult office, separate steriliza-tion facility and fully integrated computer network with Dolphin practice management software The clinics do share their lab, server, equipment and waiting rooms to decrease overhead This is an opportunity to practice fully integrated early and adolescent orthodontic care while building an adult base Our ideal candi-date should possess excellent clinical skills, a collaborative personality, have a community oriented practice philosophy and be licensed in both Washington and Oregon We offer a compet-itive salary based on experience with quarterly bonus potential, Health Savings Account, 401(K) retirement plan, company paid professional liability insurance, paid vacations and continuing education reimbursement To apply, please contact Dr J Kyle House at (541) 387-8688 or send resume to [email protected]
Classifieds
//STEP 1: INNOVATION IN SHAPING.
//STEP 2: INNOVATION IN IRRIGATION.
//STEP 3: INNOVATION IN OBTURATION.
© 2012 DENTSPLY International, Inc. ADENDO2 4/12 Rev. 1
IRRIGATING SOLUTION
//STEP 1: INNOVATION IN SHAPING.
//STEP 2: INNOVATION IN IRRIGATION.
//STEP 3: INNOVATION IN OBTURATION.
© 2012 DENTSPLY International, Inc. ADENDO2 4/12 Rev. 1
IRRIGATING SOLUTION
//STEP 1: INNOVATION IN SHAPING.
//STEP 2: INNOVATION IN IRRIGATION.
//STEP 3: INNOVATION IN OBTURATION.
© 2012 DENTSPLY International, Inc. ADENDO2 4/12 Rev. 1
IRRIGATING SOLUTION
Practices For SaleWHEELER, OR—Cash prac-tice with very low overhead and growing collections This 2 oper-atory practice shares the build-ing with a long-term care center, medical clinic, compounding pharmacy, physical therapist, and chiropractor
For more information, please contact Michelle Lauerman at [email protected]
AssociateshipsBROOKINGS, OR–Full-Time on the beautiful Oregon Coast
Brief Job/Practice Description: We are a private office looking for a full time (4 days per week) dentist You will work with a well seasoned staff with two hygienists, 2 front office, and 2 - 3 assistants You will perform all aspects of general dentistry that you wish This is a fee for service office with no OHP You will be able to perform dentistry at the highest quality level Salary starts at $10,000 per month or 30% of production (not collection), whatever is greater The guaran-teed salary goes up depending on experience There is enough patient flow for you to earn more than $20,000 per month! There is also a signing bonus of $5,000, and a generous stay-on bonus after the first year and after the 2nd year There is the ability for frequent 4 day weekends If you wish, you can have every 5th week off (unpaid, however) To apply or receive more informa-tion contact:
Devin Brice DMD 1090 south 8th street, Coos Bay, Or 97420
Phone: 503-989-2921 Fax: 541-756-0760
Email: [email protected]
Equipment For SaleDENTAL EQUIPMENT FOR SALE:Local offers are preferred due to shipping costs If interested please call the Middle Creek Dental clinic in Nampa, ID at 208 466 7424 during normal busi-ness hours; or call Dr Christensen directly at 208 466 7424; e-mail at: [email protected]
(1) ADEC 12 o’clock cabinets, $1, 000 ea
DENTAL EQUIPMENT FOR SALE—2 each, 2008 Forrest Dental Delivery Carts for Sale Used 1 year 5 hole instrument hose Self contained clean water system, Kavo fiber optics, heated syringes Cart features new U shape stand that is height adjust-able
$1500 or BO
1-2008 Forrest Dental Hygiene Delivery Cart: Used 1 year 5 hole instrument hose Self contained clean water system with heated syringe High speed suction and saliva Adjustable shelf
$1700 or BO
For for more information contact Sandy at Timm Family Dentist-ry at 541-382-1991 or [email protected].
FOR SALE-BIOLASE ILASE LASER—The personal Laser for everyday soft tissue procedures
New Never Used, full warranty: Retail Value $4, 995
Offered at $4, 500
To inquire about this item cocn-
professionally maintained and uninstalled, $7500 or best offer Please contact [email protected] for more information
FOR SALE:—Dentrix Im-ageCAM intraoral camera for sale: Unit is in perfect working order and takes great images Includes:
Camera Docking Station PC capture card and wireless foot pedal
$1500 or best offer
Additional docking stations are available for $500 or best offer per unit
Please contact [email protected] for more information
tact Dr Igor Shishkin at 541-326-8882 or email him at [email protected]
DENTAL EQUIPMENT NEEDED (1) Mid Mark 11 auto clave,
(3) X-Rays 097Bel-Ray intra oral 31” arm with three pass through mounts,
(2) 1040 ADEC Radius Cascade chairs with 6300 radius lights with assistance radius arm
(1) Air Techniques A/T 2000 XR film processor,
(2) Bel-Med 5142-S Nitrous Oxide flowmeters with 4 yoke stand with rubber goods,
doctor stools assistance chairs and assistance tables
Please contact: [email protected]
FOR SALE—Velopex Exra-X, x-ray Processor/developer (Day-light loader included): Unit is in perfect working order Processes and develops all types and sizes of dental films $1850 or best offer Please contact [email protected] for more information
FOR SALE—2002 Belmont EX2000 Panoramic/Cepha-lometric X-ray unit: Unit is in perfect working order and was
Classifieds
NOTICE: Beginning September 1, 2013 Advantage Dental will no longer accept faxed, mailed, or emailed attachments for preauthorizations or referrals These attachments will need to be submitted, with the referral or preauthorization, through
ADIN If you do not have a scanner for this purpose in your office, Advantage Dental’s IT Department recommends the Epson v700 The cost is between $550-$700 These scanners can be found online at CDW or Newegg
Beautifully versatileto meet the needs of your practice.
Filtek™ Supreme UltraUltra Universal Restorative
Scotchbond™ UniversalAdhesive
www.3MESPE.com/Filtekwww.3MESPE.com/Scotchbond
Customer Care Center: 1-800-634-22493M, ESPE, Filtek and Scotchbond are trademarks of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2012. All rights reserved.
One composite can really do it all.
If only we could bottle versatility. Wait, we just did.
20 | The Advantage
January 2014
Poverty, SBIRT, Tobacco, and Prevention Training WebinarsJanuary 9th, 2014 from 12-1:30: Overview
January 30, 2014 from 12-1:30: The Culture of Poverty, Cindy Shirtcliff
February 6, 2014 from 12-1:30: SBIRT, Instructor TBA
February 27, 2014 from 12-1:30: Tobacco, Sharity Ludwig
March 6, 2014 from 12-1:30: Prevention, Gary Allen, Sharity Ludwig, and Cindy Shirtcliff
Calendar of Events
To Advertise in The Advantage Classifieds
Submit your ad for review to [email protected] no later than 2pm the last Friday of the month prior to the end of the
quarter If you have any questions about advertising please call us at 866-268-9616
April 3rd and 5thOregon Dental ConferenceConvention Center Portland, OR
April 25th and 26thOregon Medical Association Annual MeetingThe Nines Hotel Portland, OR
August 1st & 2nd
Advantage Dental Summer MeetingEagle Crest Resort Redmond, OR
ACCOMODATIONS
503-644-3340Debbie Kutnyak, Beatty Group Int’l
REGISTER FOR CE
866-268-9616Kimberly Krueger, Advantage Dental
Presents
The CE is free for Advantage Dental Owners and their Staff and only $150 per office for all others.
Accommodations are at the Hyatt Regency Maui; 7 night double occupancy packages �art at $3,000 and include a mid-sized car, partial ocean view rooms with breakfa�.