November 2009 TDA TODAY

NOVEMBER JUNE, 2008 2009

VOLUME ISSUE VOLUME 9, 10, ISSUE 6 11

AVAILABLE ONLINE AT TDA.ORG

Hispanic Dental Association’s Every Member Matters

Council on Dental Economics 17th Annual Meeting in Receives Fluoride and Media Rise’ Lyman, DDS, TDA Future Focus Committee Spokesperson Training Membership growth is vital to any thriving organization.

The Texas Dental Association (TDA) Board is strongly Houston

committed to the Membership goal within the “TDA 2009” strategic plan, which addresses continued growth. and for the second yeartheinTDA a row, the TDA received TDA president Dr. I am proud to report that, as evidence of that commitment

On Friday, November 20, 2009, Council on Dental Matthew B. Roberts the following ADA awards in 2008: Economics (CODE) participated in the American Dental Association’s Texas“Fluoride had a net gain of 198 members in the year ADA 2007.staff traveled addressed attendees at• Greatest Percentage Membership Net Gain: (ADA) and Media Spokesperson Training.”

• Top Constituent Dental Society with Greatest Percentage of Non-Members to Membership: the opening ceremony to Austin to conduct the training. The morning segment provided Represents a conversion of 4.7 percent of fluoridation non-members of the 17th annual meeting of factsinto andmembership at end of year 2007.

• Top Constituent Dental Society to Improve Retention Rate Percentage in 2007: Represents a 97 the Hispanic Dental Association information regarding current an increase of movements; 7 percent from the previous year.

(HDA) last month in Houston. percent Association retention rate, which is anti-fluoridation • Greatest Percentage of New Dentist Members: Represents a gain of 111 new dentist members (those TDA member Dr. Victor the afternoon segment consisted dentists who are 1-9 years out of school). of basic presentation and media Rodriguez of Houston is the HDA’s 2009-10 president elect. by a mockProgram, media which builds student awareness Another example of the commitment to the growth of our Association skills is thefollowed TDA Externship interview session. of organized dentistry.

This innovative program, created in 2007, offers students the opportunity to gain insight into the different components Attendees and students took part of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and in educational sessions, networking The council is available to assist to gain a betterpanel understanding The program is open to dental students from each of the three opportunities, discussions,of their role as future leaders of the dental team. component societies when dental schoolsAttendees in Texas.were This year the externship program will take place June 20 – June 27 in Austin at the TDA central office. and exhibits. fluoride issues arise. If you As aanpreview ongoing to enhance the value and benefits of the Association, the TDA Council on Membership developed a survey that was sent offered of effort the upcoming have comments or questions to all members in 2006.

Thethat results clearly showed that members have a high satisfaction rating with benefits such as the TEXAS Meeting, TDA cultural awareness program about fluoride issues in your TDA president Dr. Matthew B. Smiles Foundation. publications, and theand ability to participate philanthropically in the TDA A great number of the discounted programs offered to HDA has designed is currently area, please contact CODE via The ADA’s Mr. Richard Green Roberts participates in the opening members through the TDA Perks Program also received a high satisfaction rating.

In accordance with the strategic plan, the Council on Membership, promoting.

Cassidy Neal at (512) conducts mock interviews with CODE ceremony at the Hispanic Dental will survey members again in 2009.

443-3675. chair Dr. Delton Yarbrough of Fort For more information on the HDA, Association’s 17th annual in the ADA, Participation from all members and a collaborative effortmeeting between TDA, and local component societies are the keys to Stockton. please visit hdassoc.org.

Houston last month. successful membership recruitment and retention. We encourage every member to get involved whether it is by attending local meetings, taking part in Give Kids a Smile! Day activities, volunteering at a Texas Mission of Mercy, or participating in TDA Legislative Day activities in Austin. Each member matters and is essential to the continued growth of our Association and of organized dentistry.

This is the seventh and final in a series of articles focused on the TDA’s accomplishments guided by the strategic plan. To view the entire plan, log in at www.tda.org and click on “TDA 2009” under “Current Issues” on the member homepage. For more information, please contact Lyda Creus Molanphy, staff liaison to the Future Focus Committee, at the TDA central office, (512) 443-3675.

Texas Dental Association Notice TDA Committee on the New of Grant Availability 501(c)(3) Dentist

The TDA Committee on the New Dentist met with the 2009 Non-Profit Dental Organizations Summer Mission: To be The Voice of DenTisTry in Texas Externship participants on November 20 at TDA Headquarters.

The TDA announces availability of financial assistance for qualifying 501(c)(3) non-profit organizations affiliated with dentistry. The monies are derived from TDA Relief Fund interest income earned Organizational over the previous Advocacy fiscal Manpower year. Grantees will be determined by the TDA Board of Directors.

Excellence

The purpose of the meeting was to develop new leadership opportunities at the dental schools and within organized dentistry while enhancing the tripartite’s Public strength at the dental school level.

Development

Membership

Image Dr. Courtney Alexander chaired the meeting with Drs. Josh Austin and Paul Kennedy III attending. Dr. Lisa Masters also attended as committee board liaison. Externs Megan Holme and Blake Johnston attended from UT Health Science Center in San Antonio and Summer Ketron-Adkins attended from the UT Dental Branch at Houston.

Eligibility: Grantees must be 501(c)(3) non-profit organizations affiliated Membership with dentistry.

Dentists will value membership and participation in the TDA. Application: Letters of Interest — detailing the proposed projects(s) and Objectives including a budget(s) — should be mailed to: 1. Improve perceived value and benefits of membership in TDA. TDA Board of Directors, 1946 IH-35, Suite 400, Austin, TX 78704 a. Increase members’ knowledge about the impact and benefits of TDA membership.

Attn: Terry Cornwell b. Ensure that components are an integral aspect of the membership process.

Deadline:c.Letters of Interest be received no availability later than January 2010.

Create greatermust awareness of the of the31, Peer Review, Ethics & Judicial, and Risk Management benefits. d.

Actively promote adherence to the Code of Ethics.

Approval: Letters of Interest will be reviewed and considered by the Texas e. Enhance communication members non-members.

Dental Association’s Board of Directors atwith its March 2010and meeting. f. Build student awareness of and interest in organized dentistry and membership in TDA. Notification: All applicants willcontact be notified writing throughout

by May 15, 2010. g. Ensure ongoing withinstudents dental school. h.

Work closely with dental school faculty.

Previous Recipients: In 2009, grants were awarded to Christian Comi. Evaluate number of nonmember dentistsofwho attend(Luband participate in TDA activities (TEXAS Meeting, TDA Smiles munity Action (Lewisville), Community Health Center Lubbock Foundation programs, etc.). bock), Dental Health for Parker County (Weatherford), Dental HELP Metrics Project (Houston); HOPE Clinic (Alvin), and HOPE Project, (Tenaha, 1. County).

Seventy percent of active licensed dentists in TX will be members of TDA by 2009 (baseline of 68.5% in January 2007); increase Shelby membership retention rate to 97 percent by April 2007 (baseline 96% in 2006).

For morea-d. information, contactofTerry Cornwell, TDA central office,peer review Increase please the number dentists serving on component andKennedy ethics and affairs committees to attain aon the New Dr. Paul III judicial leads discussion at the TDA Committee (512) 443-3675 or terry@tda.org. participation rate of 2-5 percent relative to the total number of component society this members Dentist meeting month.by August 2009.

2. Ninety percent of TX dental school graduates actively licensed in TX will be members of TDA five years after graduation (89% dental student conversion from the graduating class of 2005 in Texas).

3. Increase the number of member dentists actively participating in TDA by 1 percent a year (as measured by a variety of means – participation at TX Meeting, TMOM, TXDDS, FSI programs, DENPAC participations, TDA legislative day) with annual report to TDA Board by on Membership.

TDA secretary-treasurer Dr.the J. Council Preston Coleman will not seek re-election at the May 2010 TDA House of Delegates. Therefore, the 4. Establish of nonmember participation at TDA activities (CAS, TDA Smiles Foundation, Membership) position is open baseline for nominations.

5. Established baseline of members’ understanding of and satisfaction with the benefits of their TDA membership through Member Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must accompany a letter Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009. of intent and the nominee will also have to sign a conflict of interest statement. We request that nominations are made as early as possible so 6. Sixty-five percent of all full-time faculty will be TDA members by 2009 (2006 baseline = 63%). that membership eligibility can be verified and the House of Delegates can be prepared for an informal vote.

Official Call for Secretary/Treasurer Nominations

Duties of the Secretary-Treasurer are enumerated in the Bylaws and include the following:

The TDA will update it’s strategic plan with another statewide retreat in August of 2008.

• • • • • •

Serve as chair of the Budget Committee; Serve as chair of Assets Management Committee; Examine income and expenses of TDA and report at each Board meeting; Ensure that House of Delegates and TDA Board minutes are maintained; Serve as a non-voting member of TDA Executive Committee; and Perform other duties as specified by the Board of Directors.

Nominations are to be mailed to Dr. J. Preston Coleman, TDA Secretary-Treasurer, Texas Dental Association, 1946 South IH-35, Suite 400, Austin, Texas 78704; or e-mailed to TDA Executive Director Ms. Mary Kay Linn, marykay@tda.org.

(According to Article V, Section 10 of the Constitution of the Texas Dental Association and the TDA Bylaws, Chapter IV — Section 30, Chapter V — Section 40, Chapter VI — Sections 10, 20, 30 70 and 90).

In 2003, Texas Dental Association members from across the state develop TDA’s first strategic plan, TDA 2009.

Inside Inside Medicaid in My Office?

TDA Smiles Foundation Yes, I Think So! Atlanta M. Smiles on DDS Wheels — Take Two Richard Smith, TDASF Supports Dental Education TDA Smiles Foundation TMOM gains ardent advocate Evidence-based Tip of the Month Ask the President Incoming President’s message DentalIsraelson, Quick, Part Hilton DDS2 of 2 Endorsed by TDA Perks Program Let’s Talk Outgoing President’s message on Dental Economics A.Council David May, Jr., DDS Integration v. Coordination of 2008-2009 Benefits TDA Board of Directors Meet Your TDA Staff TDA’s new Finance Director TSBDE Rule Update Dee Dee Delagarza Federal Trade Commission “Red Congratulations to TDA Component Flags” Rule Societies Streamline Your Insurance Claims Speeding up confirmation of benefits and eligibility December

Journal News TSBDE Rule Update Requirements for dental office radiograph Star of the machines South Dental Meeting

In the News TDA members inEfficacy the news Antimicrobial of Soap and Water Hand Washing Versus an

July Journal News Alcohol-based Hand Cleanser

Tooth Whitening: A Clinical Review Dental Surgery for Patients on TDA Historical Perspectives Anticoagulant Therapy with Dentists, dental hygienists, and the dental team Warfarin: A Systemic Review and Meta-analysis The 2007 C.T. Rowland Award Orthodontic case report The El Paso Dental Conference

Around the State Around the State

December 4 August 14: Foundation Board TDA Smiles TDA Board Meeting Meeting, Austin Austin, Texas October 15-19: January 21 – 23 ADA Annual Session Southwest Regional Dental San Antonio, Texas Conference, Dallas

Click & Connect Update Profile Click & Connect tda.org – Membership Info Ask Colleague Paya2010 Dues Online tda.org – Features tda.org/paydues TEXAS Meeting Photos texasmeeting.com/estore Ask a Colleague Volunteer for ‘08 ADA tda.org – Features tda.org/volunteerada08

Evidence-Based Practice Tip of the Month Stephen R. Matteson, DDS, Editor

Third Molar Dry Socket

An extensive list of articles is revealed by searching pubmed.gov on alveolar osteitis (AO) following extraction of mandibular third molars. An incidence of up to 14 percent of AO is reported. I recall many patients telling me that the pain associated with dry socket after mandibular third molar removal was extremely excruciating, and I will bet that most practicing dentists have heard the same story.

There is a difference of opinion about the use of pre- and post-operative use of oral antibiotics, but most articles seem to suggest that pre operative medication reduces the incidence of AO. Smokers, female patients, pericoronitis, and perhaps oral contraceptives appear to increase the risk of developing AO and removal of third molars prior to age 24 is reported to reduce the development of AO. Several authors recommend the application of bioadhesive 0.2 percent chlorhexidine to the extraction site for 1 week postoperatively, and simply rinsing with chlorhexidine the day of surgery and for 7 days postoperatively is reported to reduce AO incidence.

References 1.

2.

3.

4.

5.

Chlorhexidine gel reduces incidence of alveolar osteitis after extraction of the mandibular third molars. Smith KG. Evid Based Dent. 2009;10(2):54-5.

Modern concepts in understanding and management of the “dry socket” syndrome: comprehensive review of the literature. Noroozi AR, Philbert RF. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jan;107(1):30-5.

Effectiveness of chlorhexidine gel versus chlorhexidine rinse in reducing alveolar osteitis in mandibular third molar surgery. Hita-Iglesias P, Torres-Lagares D, Flores-Ruiz R, Magallanes-Abad N, Basallote-Gonzalez M, Gutierrez-Perez JL. J Oral Maxillofac Surg.

2008 Mar;66(3):441-5.

Effectiveness of antibiotic prophylaxis in third molar surgery: a meta-analysis of randomized controlled clinical trials. Ren YF, Malmstrom HS. J Oral Maxillofac Surg. 2007 Oct;65(10):1909-21.

Prevention of alveolar osteitis with chlorhexidine: a meta-analytic review. Caso A, Hung LK, Beirne OR. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Feb;99(2):155-9.

The editor would be interested to learn the experiences of Texas dentists regarding the prevention and treatment of alveolar osteitis following mandibular third molar extraction. Please send comments to smatteson@ satx.rr.com and let me know if you are willing to allow me to post them in a future TDA Today.

Tenant Luncheon

The Freedom-of-Choice Dental Insurance Plan Endorsed by the TDA Perks Program Questions and Answers about DentalQuick — Part 2 of 2

Excitement has been generated by DentalQuick, the new freedom-of-choice individual/family dental insurance plan recently endorsed by the TDA Perks Program. Here are answers to questions about this newly endorsed TDA Perks Program.

Q. Does DentalQuick have a strict 6-month cleaning limitation?

A. DentalQuick, like most dental plans, limits cleanings to twice per year, but does not hold a patient to an exact six months schedule as many plans do.

Q. Does DentalQuick require a covered person to pay a deductible before receiving any portion of the benefits listed in the procedure reimbursement schedule?

A. No, there is no deductible to pay in any DentalQuick policy.

Q. Many individual dental plans delay filing a claim for basic and major procedures for a year or more. Does DentalQuick have a similar waiting period included in their policies?

A. DentalQuick has a graduated schedule of benefits that increases with each year the patient is covered, eliminating the long waiting period without any significant patient benefits typical with many other individual dental plans.

Q. Will the patient consider first year reduced benefits, which graduate to full scheduled benefits at the end of 2 years, as unsatisfactory?

A. Most patients are pleased that there is a smaller, but available first year schedule of benefits, which increases the second year of their policy, rather than receiving no benefits during an enforced, elongated waiting period which is common to many other individual dental policies. The full $1,650 maximum benefit is available each year of the policy.

Each year the TDA hosts a luncheon for its tenants to show appreciation for their continued abidance and to kick-off the holiday season. Several of TDA’s tenants have leased spaced in the main building since it opened the doors in 1986 while other tenants range from five to 15 years with TDA.

Q. Does DentalQuick, which is endorsed by the TDA Perks Program, require a dental office to sell DentalQuick policies?

A. Definitely not. A TDA member’s dental office may choose to refer patients to a DentalQuick phone number or to the DentalQuick web site to calculate premiums for the patient’s age group and geographical area, choose individual or family coverage, calculate the applicable premium, and review the list of reimbursements for dental procedures. While online a patient may also apply for coverage. Of course, TDA members can choose not to participate in the DentalQuick program at all.

Tenants Fred Perez of Mex-Latin Imports and Richard Galbraith of Galbraith Construction Inc. have Grady Basler and Melissa Mims of Dental both leased space in the TDA Oncology Education Program (DOEP). building since 1986.

Q. Could our office earn income from DentalQuick referrals if we choose to?

A. Yes, there is a provision in the TDA Perks Program endorsement contract that can create income for a

Happy, Healthy Smiles …

That’s Our Mission!

Atlanta Smiles on Wheels — Take Two

Since the inception of Smiles on Wheels, TDA Smiles Foundation’s (TDASF) newest mission program, volunteers have had to away turn patients at only one event. On April 4, 2009, volunteers at the single-day Cass County (Atlanta, TX) Smiles on Wheels were faced with more patients than they were able to serve.

As a result, TDASF held the Atlanta Smiles on Wheels II on October 24, 2009, to alleviate pain, improve health, and repair smiles in that area. Volunteers at the Atlanta Smiles on Wheels II provided more than $100,000 in charitable care and Dr. Richard Gibson of Texarkana served 150 patients, establishing two Smiles on Wheels records for charitable dental hugs one of his pediatric patients after care value provided and serving the largest percentage of pediatric cases. completing his treatment.

Dr. David Nichols of Tyler is assisted

by Northeast Texas Community College dental hygiene student Jade Ehrhardt and Baylor Dental School student Corbin Gatlin to restore a happy, healthy smile Dr. Jon Williamson from Cedar Hill and dental assistant to a Cass County Jessi Leuba work side by side in the Dallas County resident.

Dental Foundation’s van to serve pediatric patients.

TDASF Supports Dental Education

Each year, the TDASF rewards $1,000 scholarships from the Felix Crawford Endowment Fund to two students at each dental school across the state. Texas A&M Health Science Center Baylor College of Dentistry’s scholarship recipients are first-year dental students Alissa Nguyen and Kimberly Lauren Rogers, pictured with Associate Dean for Student Affairs Dr. Jack Long and Dean Dr. James S. Cole.

November 2009 / TDA Today / 2

dental office if a TDA member chooses to do so. The DentalQuick staff will be pleased to provide the information you need to make an informed decision.

Q. What if our standard fee for a procedure is much more than the benefit paid by a DentalQuick policy?

A. The value of a policy to a patient is derived by comparing the claims paid by the insurance company relative to the premiums paid by the purchaser of the policy, not by comparing the claims paid relative to your fee.

Q. What is a common premium for a DentalQuick policy?

A. Individual rates are as low as $37 per month.

Premiums depend on the age of the purchaser (higher for older patients) and the area in which they live (higher for metropolitan areas). The monthly premium for a 37year-old individual in Houston is $44 or $528 per year.

Available annual dollar benefit for a person paying a $528 premium is $1,650. A 55-year-old in Austin will pay $50 per month for the same $1,650 in annual benefits. Each can add a spouse to the policy for 10 percent less than the applicable individual rate. Children can be added for $23/month each up to 22 years if living at home.

Q. But, don’t group policies reimburse at a higher level than individual policies?

A. Yes, that is because actuaries can determine much more closely the dollar amount of claims an average group will file. When comparing the value of a group dental insurance plan to an individual policy, it is always better if the patient has access to a group plan, especially if their employer pays for all or even a part of the premium. For those who have no available group plan, their option is to purchase an individual plan. The relative value of an individual or family dental insurance plan should be compared to other available individual dental insurance plans…and an individual patient should compare premium price to reimbursement benefits to determine if an individual policy purchase is advantageous to them.

Q. What about discount dental plans?

A. Discount dental plans do not have a reimbursement feature at all. A discount dental plan company negotiates with dental offices to discount normal service fees and then the company sells access to the list for a monthly fee. Many of these plans add vision, pharmaceutical, and chiropractic discounts to their plan.

There are no claims filed and no reimbursements paid by a discount dental plan.

Contact TDA Perks Program general manager David Baker, david@tda.org; multi-media specialist Teresa Kim, tkim@tda.org; or marketing specialist Josh Epstein, josh@ tda.org, for information about products or services. Log on to tdaperks.com or call TDA at (800) 832-1145.

Thank You! This holiday season, the TDASF Board of Trustees and staff give thanks to all of those who have supported us in unique and creative ways.

Special recognition to Dr. John Wise of McKinney and the staff of Wise Orthodontics for their “Community Rewards” program that allows new patients to donate a portion (up to 5 percent) of their orthodontic fee to the charity of their choosing, benefitting the patient with the tax deduction and TDASF with a wonderful, unique income stream.

Thank you, Dr. Wise, for the donations over the course of the year and for helping instill in others that it is better to give than to receive.

LAST CHANCE! TDASF Holiday Cards Consider honoring those who support you with the gift that keeps on giving!

TDASF holiday cards can be purchased for $25 each, and 100 percent of the purchase price goes directly to TDASF missions to provide improved access to care and education for the public and profession.

TDASF holiday cards are easy to send!

Option One Log onto tdasf.org, let us know your gift recipients, and leave the rest to us.

We’ll process, stamp, hand address and mail your gifts out on your behalf!

You can pay with a credit card online or via mail with a check (1946 S IH 35 #300; Austin, TX 78704).

Option Two Mail us payment and an order form printed from tdasf.org, and we will send your cards in a package to your office for personal handling.

On behalf of the thousands of Texans we help each year, thank you for your generous gift giving!

In The Loop

MK’s Board Notes

Matthew B. Roberts, DDS, TDA President 2009-2010

Mary Kay Linn, TDA Executive Director

August 21, 2009: Summary of TDA Board of Directors’ actions, with TDA president Dr. Matthew B. Roberts presiding.

Thanksgiving is over and the holiday season has officially begun. We will be bombarded with advertising telling us the latest and greatest gifts to satisfy the deep desires of our heart. In this difficult economy, I often wonder exactly what motivates the spending habits of the public at large. This year may well bring a lasting change to the way we spend our money, but if history is any indication, once this crisis is over, consumers will return to their old habits.

Board Policy Resolutions (10)

As I travel around Texas, the message I hear varies in regards to the membership’s economic status. As you would expect, some are having banner years and the turmoil affecting the consumer is a distant drumbeat. Others have been hit hard due to layoffs and work closures in the communities in which they practice. Still others are feeling the effects with no growth for the first time in years. What is one to make of this? It has been my observation that, for the most part, dentistry often competes for the discretionary dollars that are spent in this economy. Value still means something and we as ethical health care professionals must always place the needs of the patient above our own.

22-2010-B (P): Authorized TDA to advocate for simplified dental benefits within the Children’s Health Insurance Program (CHIP), including removal of the three-tier system for therapeutic dental services, and an increase in maximum dental benefits to $1,000 per CHIP enrollee — with a report at the November 2010 TDA Board meeting.

23-2010-B (P): Authorized TDA to pursue legislative action amending the Texas Oral Health Improvement Act to require that the program be led by a Texas licensed dentist.

30-2010-B (P): Approved a one-time $75 registration fee for non-members of the TDA for attendance at the 2010 TEXAS Meeting to encourage TDA membership. Course fees will be required for participation in CE sessions.

31-2010-B (P): Resolution regarding policy strategies to assess oral health care problems, bolster staff training, and increase access to dental care in Texas nursing homes referred back to the Council on Dental Education, Trade and Ancillaries.

32-2010-B (P): Approved “Excellence in Patient Advocacy” awards to Sen. Florence Shapiro (R-Plano), Sen. Carlos L. Uresti (D-San Antonio), Rep. Charles L. “Chuck” Hopson (D-Jacksonville), and Rep. Lois W. Kolkhorst (R-Brenham) to acknowledge outstanding commitment to insuring access to quality dental care in Texas; and legislative staff awards to Ms. Lindsay Mullins, Ms. Cheryl Lively, Ms. Rachel Johnston, and Ms. Jennifer Deegan.

33-2010-B (P): Approved funding to sponsor the annual Caring for Children Foundation’s Golf Tournament in Austin, Texas on September 21, 2009.

35-2010-B (P): Approved simplification of the function of the Future Focus Committee, as follows: “to monitor and adjust all aspects of the Association’s current strategic plan.”

37-2010-B (P): Defeated a resolution to rescind Resolution 67-1999-H, which states that any member or staff representing TDA in an official capacity shall make no statement contrary to the policy of the Association.

39-2010-B (P): Referred a resolution acknowledging that the Building Better Oral Health: A Dental Home for All Texans report contains recommendations to the State of Texas that were not policy, but were published, distributed, and promoted by the TDA. 40-2010-B (P): Defeated a resolution requiring that petitions of TDA be delivered in writing along with a request for a timely written response by those being petitioned. And further, that these documents become a part of the permanent record of the Association.

Membership in the Texas Dental Association has never been more important. The TDA is still relevant and working on your behalf. As dues statements go out, I would ask you to look at the value added to our profession and remain a member in this Association. Your TDA Board of Directors works extremely hard to not only maintain but increase the return on your dues investment. We, as consumers, also spend our discretionary dollars. Don’t look at your dues as discretionary, but rather a must for our professional good.

As I close this message, let me again say thanks for these past 6 months of my presidency, and stay involved as a dues paying member of the best professional association in the state of Texas.

Integration v. Coordination of Benefits Council on Dental Economics

In our fast paced, high-cost society, many married couples have jobs outside of the home. Because of this, both spouses often have his/ her own employer-provided group health coverage, and each is covered as a dependent by the other’s plan. This double coverage can result in individuals being overinsured, which could actually result in a profit from illness if both insurance policies paid each claim individually at their maximum allowable benefits. This would equate to a total reimbursement in excess of 100 percent of the fee charged.

To avoid this, a provision, the Coordination of Benefits (COB), is required by law in most states. The provision sets forth the guidelines to determine which company will pay as the primary and which will pay as the secondary, with the total reimbursement not to exceed 100 percent of the total fee. The insurer covering the employee who has the claim is the designated primary insurance carrier. The primary must pay the claim within the limits of its benefits regardless of secondary coverage. The spouse’s insurance company is the designated secondary insurance company and is responsible for the amount that the primary did not cover, within the policy terms of this particular policy.

An example of how this would work in a traditional COB setting would be: The husband had a PFM crown done at a fee of $1000. He has already met his policy deductible, and the fee is within his insurance company’s maximum allowable charge for this procedure payable at 50 percent. The payment for this service from his insurance company would be $500. The claim would then be sent to the wife’s insurance company upon receipt of payment from the primary carrier. The fee also falls within the maximum allowable fee from her company payable at 50 percent which results in a $500 payment from the secondary. This would leave a $0 balance so there would be no out-of-pocket expense from the patient. It is also important to note that each insurance carrier would deduct $500 from the yearly maximum since each one paid out that much.

There are some companies that no longer coordinate benefits when they are the secondary carrier. The COB clauses in the patient’s dental insurance contract will use the term non-duplication of benefits. These companies are integrating their secondary benefit payments with the primary carrier’s benefits. The secondary insurance will subtract whatever it would have paid from what the primary paid. In the example cited above, the wife’s secondary insurance company allows a payment of $500, which was also the amount paid by the primary carrier. If the wife’s insurance company is integrating, it will subtract the $500 payment it would have made from the $500 payment made by the primary carrier resulting in a payment of $0. This means the patient has to make up the $500 difference out of pocket. This is significant — $0 out of pocket when the secondary company coordinates, or $500 out of pocket when the secondary integrates. Then, on top of this, the secondary company may subtract the $500 from the yearly policy max even though it paid nothing.

When verifying benefits, the insurance rep should be asked if the patient has a non-duplication clause. Then ask if the primary payment will be subtracted from the secondary’s maximum allowable charge for that particular procedure when computing the benefit the secondary is liable for. If the answer to this question is yes, then it is integration rather than coordination. Then ask whether this amount will be deducted from the yearly policy max even though it is not paid by the secondary. In today’s environment, double coverage no longer means little or no out of pocket expense for some patients. When patients are double covered, our front office staffs need to pay close attention to this to avoid misunderstandings and patients not being able to pay what they owe.

If you have issues or questions you would like the council to address, please contact Cassidy Neal at cassidy@tda.org or call at (800) 8321145 ext. 152.

Non-Policy Resolutions (8) Appointments (1) 36-2010-B (NP): Approved Dr. Burton J. Kunik, Ms. Paula Owens, Dr. Don A. Lutes, Dr. Richard M. Smith, and Dr. W. Kurt Loveless as trustees of the TDA Smiles Foundation, June 1, 2009 through May 31, 2010.

MISCELLANEOUS (10) 26-2010-B (NP): Directed that TDA join the Texas Medical Association in filing an amicus brief in the case styled TMA versus Texas Board of Podiatric Medical Examiners now in the Texas Supreme Court.

28-2010-B (NP): Directed the Building Committee to complete construction drawings for release to a minimum of three general contractors for bidding.

29-2010-B (NP): Approved engagement of Richard P. Slaughter Associates, Inc. as investment management consultant and professional investment counsel for the TDA Reserve Fund upon recommendation of the Assets Management Committee; and authorized the treasurer and executive director to open a discount brokerage account with Charles Schwab & Company, Inc. and to act as Custodian of securities owned by the fund and to perform custodian duties as defined in the Investment Policy Statement of the TDA. 34-2010-B (NP): Approved purchase of the EZ-Flip online application program, allowing readers to read the Texas Dental Journal online and flip the pages on their computer screens.

The TEXAS Meeting — May 6–9, 2010

Frank L. Higginbottom, DDS, Council on Annual Session

There are many important dates in our lives. By the time you receive this issue of TDA Today, you will have survived Thanksgiving, the easy holiday. You don’t have to buy gifts and you have a lot of time off with family and friends. How great it is to focus on all things we are thankful for!

Things get a little more complicated now. After Thanksgiving, there are only 28 shopping days left until Christmas, and you have 32 days to decide what you will do for New Years Eve. Next, you will need to have a good plan for Valentines’ Day or you are toast — only 74 days!

The most important date in your future, however, is the TEXAS Meeting, May 6-9, 2010. It seems so far in the future, but it is only 160 days away. When you think about it, what things do you do at the last minute? Like many people, I am a great procrastinator. This can bring lots of stress and anxiety to one’s life. We tend to judge how well our attendance will be at the annual meeting by our preconference registration numbers.

A trip to the TEXAS Meeting in beautiful San Antonio this May would be a great reward for you and your staff for a job well done.

Consider how great you would feel by completing the TEXAS Meeting registration for you and your staff early. Great continuing education opportunities abound for all dental professionals. The Texas State Board of Dental Examiners educational requirements can be completed at this one event. Preconference registration numbers help your TDA Council on Annual Session project TEXAS Meeting attendance numbers, session room assignments, and social event participation to make your TEXAS Meeting experience productive and memorable.

The registration brochure will be mailed the last week in November, so be sure to check your mail.

Hotel reservations will be available online at www.texasmeeting.com on December 1, 2009. So, step up and book your favorite hotel.

Meeting registration will open on January 1, 2010 for the early birds — which should include you! Register everyone and register early! We look forward to seeing you in San Antonio.

November 2009 / TDA Today / 3

TSBDE Rule Update This recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices.

Question: Question: Is there a requirement that removable prosthetic devices bear the name of the patient to whom the device belongs?

Answer: This issue is addressed in Texas State Board of Dental Examiners’ (TSBDE) Rule 116.10 — Prosthetic Identification.

The rule requires Texas dentists to ensure that “all removable prosthetic devices or removable orthodontic appliances delivered to a patient under his or her care bear a permanent identification marking suitable to determine that the … device or … appliance belongs to that patient.”

Rule 116.10, which applies to removable devices or appliances delivered to any patients under the dentist’s care — not just those in nursing homes — requires such devices or appliances to include the patient’s last name and first initial and/or social security number. The requirement does NOT apply to removable devices or appliances that “contain no acrylic, vinyl, or plastic base denture base” or to appliances that are “too small to reasonably accomplish [the marking] procedure.”

Note that Rule 116.10 also includes subsection (f ) that requires registered dental laboratories to label or certify in writing to the prescribing dentist that the prosthesis or appliance was either: manufactured entirely by the registered laboratory; manufactured in part or whole by a domestic laboratory inside the U.S.; or manufactured in part or whole by a foreign laboratory outside the U.S. For more information contact Diane Rhodes at diane@tda.org or (512) 443-3675.

FTC Postpones “Red Flags” Rule Implementation until June 1, 2010 Due to the hard work of grassroots dentists, the Federal Trade Commission (FTC) is delaying enforcement of the “Red Flags” Rule until June 1, 2010. The American Dental Association (ADA) succeeded in getting Rep. Barney Frank (D-Mass.), chairman of the House Financial Services Committee, to sign on to a letter to FTC Chairman Jon Leibowitz, urging him to issue another enforcement delay.

The ADA continues to advocate on behalf of its members and is working in the Senate to pass legislation that will exempt health care practices with 20 or fewer employees, which means most private practice dental offices, from the regulations. Please look for more information in the TDA Today as this issue moves forward. In the meantime, contact Diane Rhodes at (512) 443-3675 or diane@tda.org.

In the News Dr. William Berlocher, pediatric dentist, was elected president of the American Academy of Pediatric Dentists (AAPD) for a 1-year term. Dr. Berlocher has been a member of TDA since 1988 and has been active in AAPD for more than 30 years.

EDITORIAL STAFF Dr. Stephen R. Matteson, D.D.S., Editor Edwina J. Shires, Director of Publications Nicole Scott, Publications Coordinator Barbara S. Donovan, Art Director BOARD OF DIRECTORS Matthew B. Roberts, D.D.S., President Ronald L. Rhea, D.D.S., President-Elect Hilton Israelson, D.D.S., Immediate Past President Vice Presidents Craig S. Armstrong, D.D.S., Southeast Johnny G. Cailleteau, D.D.S., Southwest J. Brad Loeffelholz, D.D.S., Northwest Arlet R. Dunsworth, D.D.S., Northeast Senior Directors R. Lee Clitheroe, D.D.S., Southeast John W. Baucum III, D.D.S., Southwest Kathleen Nichols, D.D.S., Northwest Donna G. Miller, D.D.S., Northeast Directors Karen E. Frazer, D.D.S., Southeast Lisa B. Masters, D.D.S., Southwest Robert E. Wiggins, D.D.S., Northwest Larry D. Herwig, D.D.S., Northeast J. Preston Coleman, D.D.S., Secretary-Treasurer Glen D. Hall, D.D.S., Speaker of the House Michael L. Stuart, D.D.S., Parliamentarian Stephen R. Matteson, D.D.S., Editor Mary Kay Linn, Executive Director William H. Bingham, Legal Counsel TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices.

POSTMASTER: Send address changes to TDA TODAY, 1946 S. IH-35, Ste 400, Austin, TX 78704-3698.

Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental Association (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30.

Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6.

Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. Every effort will be made to return unused manuscripts if a request is made but no responsibility can be accepted for failure to do so. Anonymous communications will receive no consideration whatsoever. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. The Information for Contributors is available at tda.org.

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PCI Standards Compliance November 2009

VOLUME 10, ISSUE 11 AVAILABLE ONLINE AT TDA.ORG

First you had OSHA, then HIPAA; more recently, Red-Flag laws, and now PCI? What is it? PCI DSS (or simply PCI) stands for Payment Card Industry Data Security Standards. PCI chiefly focuses on protecting credit card numbers, and compliance with the standards is, in practice, required of every merchant that accepts credit cards as a form of payment. (You can learn more at pcisecuritystandards.org.) The main impetus of the new regulations is to establish industry-wide standards for protecting card account data.

Several credit card processing companies are faxing and/or calling dental practices and telling them that their equipment is not PCI-compliant, and that they need to call them. These companies probably don’t know what kind of equipment the offices have, and are simply using a ploy to try to become their merchant processors. Nearly all credit card terminals are PCI-compliant, or with a software download, become so. Some PIN pads, however, will not be, because of their ability to store PIN numbers (four-digit codes for debit cards). Most dental practices don’t have a PIN pad. If yours does, please call your processor to find out if it’s compliant.

Download a complete version of this article at: tdaperks.com.

If you have additional questions regarding PCI, call your processor, or TDA Perks Program-endorsed credit card processing company, Best Card, at (877) 739-3952.