SUMMER 2025 DETAILS NEWSLETTER - DELTA DENTAL OF RHODE ISLAND

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Introducing the Delta Dental of Rhode Island Dentist Loan Repayment Program

Delta Dental of Rhode Island is proud to announce the launch of the Delta Dental of Rhode Island Dentist Loan Repayment Program, a new initiative supporting recent dental school graduates. The program will provide loan repayment assistance of up to $20,000 per year for up to three years. Up to 10 awardees will be selected annually, after review of their qualifications by a local advisory committee.

Program overview

Administered by the Rhode Island Foundation and funded through a $5 million investment from Delta Dental of Rhode Island’s reserves, the program aims to ease the student loan burden for early-career dentists while expanding access to care in underserved communities. As the only loan repayment initiative in Rhode Island exclusively for dentists and dental specialists, the program is open to those practicing in a variety of settings, including private practices, dental service organizations (DSOs), and community health centers.

Eligibility criteria

• Applicants must be within the first two years of practice since graduating from a U.S.-based or foreign dental school

• Work a minimum of 32 hours per week in Rhode Island

• Participate in the Delta Dental of Rhode Island network

• Commit to helping address the oral health needs of under-served Rhode Islanders

Application information

Interested candidates are encouraged to visit rifoundation.org/deltadental to review full eligibility requirements and application details.

Supporting your practice: 2025 Hygiene Workforce Program disbursements

Delta Dental of Rhode Island is pleased to continue our Hygiene Workforce Program, which was launched in 2024 to help network dentists in the recruitment and retention of hygienists amid a nationwide workforce shortage.

Disbursement schedule for 2025

The first 2025 disbursement will be issued in July for qualifying hygiene services (D1110, D1120, D4910) rendered between January 1 and June 30, 2025. A second disbursement will follow in January 2026 for services rendered between July 1 and December 31, 2025.

Since its launch, the Hygiene Workforce Program has been well received, with dentists reporting they are using the funds to hire new hygienists and offer pay increases to existing staff.

Questions?

For questions about eligibility or program details, please contact Nancy Thibodeau at 401-752-6227 or nthibodeau@deltadentalri.com

Bringing smiles on the move: The Molar Express

rolls

into Blackstone Valley

The Molar Express, a vital pediatric mobile dental program in Rhode Island, is expanding its reach—thanks to a new partnership with Blackstone Valley Community Health Care (BVCHC) and financial support from Delta Dental of Rhode Island.

Since 2007, The Molar Express has delivered essential dental services to children and young adults at schools, Head Start programs and other community programs through a custom-built, 40-foot mobile clinic. The Molar Express is a nonprofit collaboration between Ronald McDonald House Charities of New England, East Bay Community Action Program (EBCAP), Comprehensive Community Action Program (CCAP), and BVCHC.

The expansion into the Blackstone Valley expands access to critical oral health care for children in underserved neighborhoods in Central Falls and Pawtucket. In 2024 alone, the program served nearly 1,500 patients, with the vast majority insured through Medicaid.

This collaboration strengthens our shared commitment to ensuring every child, regardless of circumstance, has access to the dental care they need and deserve.

Welcome to the Delta Dental of Rhode Island network

Delta Dental of Rhode Island is pleased to welcome the following recently credentialed dentists to our network:

Rawan Abu-Gazzeh, DMD

Harrisville Dental Associates

Vrunda Adeshara, DMD

Comprehensive Community Action Program

Juyong An, DMD

Pediatric Dentistry Limited

Oluwabukola Awoleye, DDS

Providence Community Health Centers

Lujane Barakat, DMD

Providence Community Health Centers

Alexandra Brennan, DMD

Children’s Dentistry of RI II

Laura Carrasco, DDS

Comfort Dental

Ashley Cuevas, DMD

Thundermist Health Center

Laila Dantas, DMD

Cumberland Dental Specialists

Hannah Demers, DMD

Atwill Conroy Dental Smithfield

Kevin Eagan, DDS

Jefferson Dental Associates

Robert Gargano, DDS

Cranston Dental Associates

Zahra Hanif, DMD

Tourister Dental

Stephanie Harding, DDS

Jet Dental of Rhode Island, LLC

Kelsey Herbert, DMD

Paolucci Dental Associates

Christian Johnson, DDS

Happy Smile Rhode Island

Soung Kim, DMD

Premier Care Family Dental

East Greenwich

Kelly Kirtland, DDS

Tri-County Community Action Agency

Zachary Kofos, DMD

Pawtucket Orthodontics Health Centers

Yujin Lee, DMD

Warren Dental Associates

Yu Liu, DDS

Riverside Family Dental

Warwick Family Dental Group

Daniel Nho, DMD

Johnston Dental Group

Nindu Saini, DMD

Ocean State Endodontics

Dr. Matrullo & Associates

Aaron Shin, DDS

Happy Smile Rhode Island

Courtney Silva, DMD

Diamond Hill Dental and Associates

Janik Shingala, DMD

Paolucci Family Dentists

Manuela Teixeira, DMD

Pedro Teixeira, DDS

Weihao Wang, DMD

Paolucci Family Dentists

Michelle Yau, DMD

Dental Associates of Rhode Island

Complete claim standard

For your claims to be processed quickly and accurately, it’s important to include all the necessary information. We can only start processing once your claim meets our Complete Claim Standard.

Please ensure that your claim meets the following criteria:

• Paper claims must be submitted using a current ADA form. All information must be legible.

• Electronic claims must be in a HIPAA-compliant format.

• Submitted subscriber/patient information (name, date of birth, and Delta Dental ID number) must be accurate and must match Delta Dental’s records for that subscriber/patient.

• Treatment must be billed using the appropriate CDT codes.

• Date of service must be noted for each procedure.

• The providers’ charge for each procedure must be noted.

• The treating dentist and complete address of the treatment location must be indicated and must match the information that Delta Dental has in its records.

• The provider’s TIN and individual NPI must match the information that Delta Dental has in its records.

• Appropriate documentation from the other carrier must be included for claims that require Coordination of Benefits.

• Appropriate documentation must accompany claims for any procedures that are eligible for clinical review, in accordance with our Utilization Review Guidelines listed in the Dentist Section of the Delta Dental of Rhode Island website.

• Submitted X-rays must be less than two years old and of diagnostic quality showing the entire treatment site. X-rays must be mounted, labeled with the patient’s name, the date they were taken and if applicable, right or left must be indicated.

• Treatment notes, narratives or charting submitted with claims must be legible and may not contain abbreviations.

• Payer must have no reason to believe that the claim was submitted fraudulently and that there is no material misrepresentation.

If the above conditions are not met, the claim is not considered to be a complete claim and is therefore not subject to applicable statutory/regulatory prompt pay provisions.

To learn more about the requirements and timelines for claims documentation, visit www.deltadentalri.com, click on the Dentists tab, and then select the link for Utilization Review Guidelines.

2025 credentialing meeting schedule

Please ensure that your completed application is submitted at least 7 days before the scheduled meeting date. Only fully completed applications will be reviewed at the meeting. If your application is incomplete, it will be reviewed at the next available meeting date once all required documents have been received. Below, please find the remaining meeting and application due dates for 2025.

13

17

15

12

10

6

10

8

5

3 January 14, 2026 January 7, 2026

Remaining 2025 holiday schedule

Please make note of the following Delta Dental of Rhode Island corporate office closures.

August 11 (Monday) Victory Day*

September 1 (Monday) Labor Day

October 13 (Monday) Columbus Day/ Indigenous Peoples’ Day*

November 11 (Tuesday) Veterans Day*

November 27 (Thursday) Thanksgiving Day

November 28 (Friday) Day after Thanksgiving

December 25 (Thursday) Christmas Day

*Delta Dental of RI Customer Service office is open

National dental holidays

Every year, it’s important to take time to celebrate the hard work of your practice. These occasions also offer great opportunities to educate your patients about oral health issues. Be sure to add the dates below to your calendar.

Reminders

Help keep our records accurate Accurate information helps us process your claims quickly and efficiently. When changes happen in your office, contact Debra Fernandes in our Professional Relations Department at 401-752-6206, or email dfernandes@deltadentalri.com

Electronic attachments

Delta Dental accepts electronic attachments like X-rays, periodontal charting, narratives, and COB information using National Electronic Attachment, Inc. (NEA) services, Dental Xchange and Change Healthcare.

ADA dental claim form

To ensure your claim is processed without delay, please use the current ADA dental claim form.

Honoring achievements in 2025

Leadership

update

Congratulations to Dr. Fotini Dionisopolous on being named President of the Rhode Island Dental Association.

2025 RIDA awards

Congratulations to the following award recipients:

• Dr. Elizabeth Benz, Humanitarian Award

• Dr. Robert Conte, Dr. A. James Kershaw Award

• Dr. Michael Reilly, Good Citizen Award

• Dr. Fred Hartman, Dr. Joseph Box Everyday Leadership Award

Re-credentialing policy

When re-credentialing, please return the following documents:

• Your completed re-credentialing profile.

• A copy of the first page of your current professional liability insurance.

• An updated W-9 form if changes have been made.

Appeals and complaints

To learn more about our appeals and complaints processes, please visit the FAQs page at https:// deltadentalri.com/Provider/PublicFAQ

Value-Based Care program

Mid-year Practice Profile Scorecards used for our Value-Based Care program will be mailed to eligible offices in August. For questions about the program or your practice scorecard, please contact our Professional Relations Department. Contact Professional

10 Charles Street, Providence, RI 02904-2208

Telephone: 401-752-6206

Fax: 401-752-6060

Website: www.deltadentalri.com

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