Coverage Assistance Fund Reimburses for Vaccine-Incurred Costs to Practices. The Coverage Assistance Fund (CAF), a new program of the Health Resources & Services Administration (HRSA), is now available to reimburse practices for rejected claims to providers who are administering the COVID-19 vaccine to patients whose health insurance plans lack vaccine coverage, and for coverage of patients who are normally required to cover part of the cost of vaccination. (A separate program called the HRSA COVID-19 Uninsured Program is available for reimbursement of vaccine-related fees for patients who aren’t covered by a health plan.) To get a claim reimbursed through the CAF, apply electronically in the CAF portal after the patient’s insurance plan denies payment to the practice. Click here to learn more.

EIDL Supplemental Targeted Advance Funds Available to Eligible Small Businesses. The newest program from the Small Business Administration (SBA) is offering additional forgivable loans up to $5,000 to recipients of the EIDL Advance or Targeted EIDL Advance. Eligibility depends on if the business is located within a low-income community, has experienced a 50% financial loss, and has 10 or fewer employees. Small businesses who haven’t applied for an EIDL loan yet can still submit an application through December 31, 2021 while funds are still available. Click here to visit the COVID-19 Economic Injury Disaster Loan (EIDL) webpage. To view Frequently Asked Questions about the COVID-19 EIDL loan, click here.

Offer Paid Leave to Your Employees for COVID-19 Vaccination, Get a Tax Credit.  Starting April 1, 2021, employers with fewer than 500 employees are eligible for a tax credit for offering paid time off to employees for COVID-19 related time away from work. According to the Department of the Treasury, the tax credit also covers pay for days missed for illness, quarantine, testing, and caregiving related to COVID-19. Businesses can file for the credit until September 30, 2021. To read more about the program highlights, click here. To learn how to claim the credit here

SBA EIDL Program Extends Loan Payment Deferrals. Small businesses or organizations who received or will be receiving loans through the U.S. Small Business Administration (SBA) Economic Injury Disaster Loan program (EIDL) now have until 2022 to start making payments. First payment requirements depend on the year of the loan application. The first payment for 2020 recipients of the loan has been extended to two years while they are extended to 18 months for 2021 recipients. Click here to learn more about the EIDL loan program.

Report on Pediatric Dental Care and COVID-19. The AAPD Pediatric Oral Health Research and Policy Center is proud to offer Re-emergence: A Report on Pediatric Dental Practice Re-entry into Practice During the COVID-19 Pandemic. This visually appealing report is based on a survey to members of the AAPD Public Policy Advocate Initiative during the first wave of the COVID-19 pandemic. Intended to assess the pandemic’s impact on pediatric dental care, the survey honed in on significant questions of the moment to inform us on what we can expect looking forward. Click here to read.

Common COVID-19 Citations: Helping Employers Better Protect Workers and Comply with OSHA Regulations. Keep up with workforce regulations during the COVID-19 pandemic with this user-friendly document from OSHA. This resource helpfully identifies common unsafe and costly practices and what you can do about them. Click here to view.

Learn How Consumers Feel About Going to the Dentist in a Pandemic. The ADA’s Health Policy Institute now offers an on-demand webinar featuring new data from its COVID-19 Economic Impact poll and what it suggests about the next few months of patient volume at dental practices. No need to register, just click here to access the information.  

IHI Psychological PPE (August 12, 2020) This document from the Institute for Healthcare Improvement provides evidence-based practices to protect staff mental health during the COVID-19 pandemic. Designed for healthcare leaders, it features examples of effective strategies and the science behind the recommendations. View the document here.

AAPD Billing Guidance for Personal Protective Equipment (PPE) .The American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) have recently released guidance for dental practices regarding the use of COVID 19-related Personal Protective Equipment (PPE) as outlined by the Centers for Disease Control (CDC). With these new CDC recommendations comes a rise in expenses for your dental practice. Historically, normal costs related to PPE, sterilization procedures and overall universal precautions have been considered inclusive of the procedure – a practice business expense. 

The AAPD recommends reporting D1999 – unspecified preventive procedure by report – as an interim solution to reporting the required additional PPE. As with all CDT codes that include “by report” in the nomenclature, a narrative is required. For more information click here

Medicaid Updates Allow States to Recognize Increased Costs for PPE. One June 30, the Centers for Medicare & Medicaid Services (CMS) released an update to its COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies. The update can be viewed here.

Of particular interest in the updates, states may increase Medicaid and CHIP service payment rates to recognize increases in costs associated with personal protective equipment (PPE). States have the option of increasing service rates to incorporate PPE costs or paying an add-on to a service rate for PPE costs. However, Medicaid regulations prohibit providers from charging beneficiaries for the cost of PPE and require providers to accept as payment in full the amount paid by the agency plus any deductible, coinsurance or copayment required by the plan to be paid by the individual. 

The new FAQs have been integrated into the previously released COVID-19 FAQ document, found here.

ADA Poll on Practice Impact of COVID-19. The ADA Health Policy Institute continues to poll a large sample of ADA members to examine the impact of COVID-19 on dental practices nationwide. The results show breakdowns by state, age, practice size and more. This survey has weekly updated polling data. Click here to view the latest.

In a new ADA Health Policy Institute research brief, the latest projections for U.S. dental care spending are more optimistic. Spending is now projected to decline 31 to 38 percent in 2020, and up to 20 percent in 2021. Read the brief here.

Advocacy for Business Interruption Insurance. The AAPD joined the Academy of General Dentistry and a collective of other dental organizations in a letter to Capitol Hill requesting that the issue of shutdown or viral-related exclusions in commercial business interruption insurance policies be addressed in the next COVID-19 relief package. The comprehensive, strongly worded missive was sent to the Majority and Minority Leaders of the House and Senate, as well as House Financial Services and Senate Banking. Read the letter here.

ADA COVID-19 Coding and Billing Interim Guidance: PPE. Recognizing the significant financial challenge posed by the rising cost of infection control procedures, the ADA provides guidance regarding coding and billing for PPE, as well as programs and policies of major dental benefit carriers. Learn more here. 

Paycheck Protection Program Flexibility Act Becomes Law. On June 5, the President signed into law the Paycheck Protection Program Flexibility Act, which will reform the Paycheck Protection Program (PPP) to give small businesses more time and flexibility to use their funds. Advocated by the AAPD and the Organized Dentistry Coalition, the bipartisan legislation passed the House on May 28 and the Senate on June 3. The new act applies to pediatric dentists who have or will receive funds from the PPP — a loan established by the Coronavirus Aid, Relief, and Economic Security Act. This act will extend the following benefits: 

  • Increase the Paycheck Protection Program loan forgiveness coverage period from eight weeks to 24 weeks
  • Defer payroll tax for borrowers
  • Deferring Paycheck Protection Program loan repayment for 10 months instead of 6 months
  • Allowing borrowers to use 40 percent of PPP funds to pay for non-payroll expenses
  • Extending the rehiring deadline for dental practice employees

Patient Communications Materials. Brighten the day for your patients by sending them this new “stay home, stay healthy” poster from the AAPD – or posting it on your practice Facebook page. This poster can also be accessed in Spanish here. For more free downloads of positive patient materials based on sound science, visit the AAPD parent and caregiver website.

New COVID-19 FAQ from Medicaid. Items of particular interest in the updated Medicaid COVID-19 document include teledentistry (page 30), a greatly expanded section on financing flexibilities, including advance and retainer payments (page 40) and information on payment rates and methodologies (starting on page 42). Learn more here.

If you prefer to view a document that has only the new items, rather than the full document, click here.

New Dental Benefit Guides from the ADA. The American Dental Association recently released two new dental benefit guides to address common hurdles anticipated when reopening practices

  • Dental Benefits: Handling Eligibility
    With high rates of unemployment, it is likely that patients reporting for dental appointments may have recent changes in their employment situation. Often dental offices face recoupment situations because of retroactive changes to eligibility. Third-party payers are able to reflect eligibility changes retroactively, and clauses within the participating provider contracts allow them to recoup funds from the participating dentist when treating a patient who has lost benefit coverage. It is essential that dental offices ask the patient specific questions and verify eligibility on the date of service to avoid recoupment requests in the future.
  • Dental Benefits: Handling Contract Negotiations 
    Dentistry faces increasing standards for infection control following the COVID-19 pandemic. It is anticipated that the cost of care will substantially increase for dental procedures. Under these circumstances, dental offices may see the need to readjust their fee schedules and renegotiate their participating contracts. 

Personal Well-Being and Mental Health. Taking good care of yourself – as well as your family and staff – is invaluable in times of stress and uncertainty. Here are resources to help.

  • COVID-19 Mental Health Resources. This ADA web page provides a variety of resources, including informational websites, podcasts, videos, online courses and hotlines. 
  • COVID-19 Information and Resources. This publication from the National Alliance on Mental Illness (NAMI) provides information from reputable sources on managing stress and anxiety, helpfully organized in a Q and A format. 
  •  Coping with Stress from the CDC. This online resource covers the various issues related to stress, including worry about your own health and the health of your loved ones, changes in sleep or eating patterns, difficulty sleeping or concentrating, and worsening of health problems. Click here to learn more.
  •   Head Space Mindfulness App. This highly rated app and website offer hundreds of articles on such topics as sleep, stress, meditation, exercise and healthy living. 
  •  Self-Care from Tulane University. This user-friendly site has information on meditation, at-home exercise, and connecting with friends and loved ones during social distancing. 
  •  Psyberguide from the National Institute of Mental Health. Among its resources, this website has 3-minute reading articles on using technology to mind your mental health and 40 things to do at home while you’re self-isolating. Read more here.
  •  Decision Fatigue. This brief article discusses the challenges of managing crisis situations, when ordinary actions have become high-stake decisions.

New Testing Codes. On April 14, 2020, the ADA Code Maintenance Committee, including AAPD representative Dr. James Nickman, unanimously voted to approve the following new CDT 2021 codes for COVID-19 testing by a dental provider.

  • D0XXX antigen testing for a public health related pathogen including coronavirus
  • D0XXX antibody testing for a public health related pathogen including coronavirus 

The current code until CDT 2021 is implemented is:

  • D0999   unspecified diagnostic procedure, by report
    Use of a procedure that is not adequately described by a code. Describe the procedure.

The new codes will not be official until January 1, 2021. However, when COVID-19 testing becomes available, providers are encouraged to use these codes in their practice management systems for record-keeping and document these codes in patient records so that data collection can begin.  Whether the codes can be transmitted on a claim form, and whether they will be accepted for coverage in 2020, is under review by the payers.

9 tips to protect your reputation during COVID-19. This April 15 article from Ragan’s PR Daily outlines what businesses can do to safeguard carefully developed reputations and digital presences. View the article here.

AAPD Podcasts. Join your host, Dr. Joel Berg, as he interviews experts in the field and discusses crisis management, tele-dentistry, infection control/PPE, the CARES Act and small business loans, dealing with your practice’s finances during a crisis, and more. Tune in for episodes to get your COVID-19 questions answered. (They are also available on Spotify, iTunes, Google Podcasts, Android and Stitcher.) Click here to listen.

This free e-webinar from the American Association of Dental Consultants (AADC) will help prepare providers for the "re-entry" to dental practice by addressing OSHA and infection control concerns for the dental office staff and patients in the COVID era. To register for the meeting, click here.

SoFi Update. SoFi offers a free webinar on understanding the Paycheck Protection Program, aired on April 22 and now available online. View now.

SoFi has built an online marketplace called Lantern for small businesses to shop across multiple lenders and compare financial solutions, including those that are part of the  SBA Paycheck Protection Loan Program (PPP).

The CARES Act suspends federal student loan payments without the accrual of interest through 9/30/2020.  Additionally, these suspended payments are to count as qualified payments for the purpose of loan forgiveness programs. The bill does not affect private loans. When a borrower refinances a federal loan with SoFi, they obtain a private loan, and are no longer a federal loan borrower. Regarding employer contributions to student loans, contributions from an employer to an employee’s student loan have been taxed as ordinary income to the employee. Under the CARES Act, employers may contribute up to $5,250 to employees’ student loans, tax free to the employee. To learn more about your SoFi loans, click here for  details and customer service contact information. View the SoFi page here.

Dental Benefits.The ADA has sent a letter to third-party payers urging administrators of dental benefit plans to adapt reimbursement procedures important to dentists and patients, including coverage for temporary procedures, teledentistry, out-of-network benefits, and fee schedule adjustment to account for cost of increasing infection control procedures. Click here to view the letter.

To find out more about how specific payers are managing the current pandemic, review pages 10 – 17 of the ADA’s COVID-19 Coding & Billing Interim Guidance. 

Delta Dental Plans of America recently issued a press release on its main website that provides links to summarize what the various states are doing to help providers.

Benefits provider Delta Dental of Arkansas has pledged $6.5 million in emergency financial assistance to dental practices in Arkansas. The Delta Dental of Arkansas Advance Receipts Program will provide financial support to dental practices that are limited to providing only emergency services during the COVID-19 outbreak.

Unemployment Assistance. The National Law Review published information on a new Pandemic Unemployment Assistance that is of practical interest to independent contractors of pediatric dental offices. Click here for the article.

You would apply through your state unemployment office. See this website for more details.

Teledentistry and Coding. As a result of the COVID-19 pandemic and extenuating circumstances, the ADA surveyed 21 Dental Insurance Carriers on benefits for limited problem-focused evaluations using teledentistry codes, consultations with physicians, and impact of frequency limitations for evaluations per year.  Of the 21 responses, 19 are benefitting limited problem-focused evaluations (D0140) when using telecommunication technology. Two of the carriers are still reviewing its policies. Each carrier appears to have different protocols on combining the traditional D0140 code along with attaching D9995/D9996 to indicate it is teledentistry. As teledentistry is a relatively new treatment option, the AAPD encourages a discussion with the parent or caregiver regarding possible patient financial responsibility/obligations related to the virtual visit. The safety of the patient, family and caregivers is of utmost importance, and teledentistry allows most emergencies to be addressed in a caring, safe, patient-centered manner. Click here to see the latest ADA guidance.

United Concordia addresses COVID-19 concerns and current policy on teledentistry.  Health issues with a video or photograph assessment with their dentists are covered for United Concordia’s members. The recommendation is to use CDT D0140. For more information, click here.

This fact sheet from DentaQuest provides COVID-19 crisis support to dental providers, particularly on access to care and covered benefits for DentaQuest members via teledentistry.  You can keep up to date with DentaQuest’s latest responses to the COVID-19 outbreak at dentaquest.com. 

This fact sheet from Cigna Dental offers temporary guidelines for teledentistry consultations, including standard policies and use of procedure codes. 

Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency. To promote increased access to services during this time of otherwise restricted access to clinical practices, the HHS Office for Civil Rights will be extending leniency toward HIPAA noncompliance of telehealth regulatory requirements. Details on HIPPA compliant technology venders can be found here.

General Staff Management. The AAPD is working closely with the ADA and the Organized Dentistry Coalition to minimize the impact of new federal leave requirements on small dental practices. Learn more here.

You will find guidance from the Society for Human Resources Management on such topics as compensation, attendance policies, and staff communication here

From the CDC, Interim Guidance for Businesses and Employers is a great starting point for practice managers and providers during the COVID-19 outbreak. This website includes a host of other links that providers will find useful. 

The Occupational Safety and Health Administration (OSHA) COVID-19 website offers information on COVID-19 history and developments, as well as hazard recognition, medical information, standards, control and prevention, and workers’ rights. Learn more here