November 1999 Newsletter

Attendance: Bloom, Chustckie, Engel, Fertig, Glickman, Huberman, Kahn, Kline, Krantz, Livanos, McLaughlin, Perlmutter, Prabhu, Rosen, Schambra, Silverstein, Weiner

Acceptance of Minutes-9/14/99-Vote unanimous.

President’s Report-M. Schambra
The ADA Emergency Fund will make grants available of up to $1000 to dental professionals for immediate assistance for damage suffered from Hurricane Floyd if they are in one of the declared disaster areas (Bergen, Essex, Mercer, Middlesex, Morris, Passaic, Somerset, and Union Counties). Applications for Emergency Fund grants are available from the ADA and must be filed within two months of the disaster. The ADA Endowment and Assistance Fund also has loans available to assist dentists in restoring, repairing, and reconstructing a practice facility. Eligibility will be determined on a case-by-case basis of need, but shall not exceed $15,000. Anyone wishing to file a personal or business claim with FEMA can begin the application process by calling FEMA at 1-800-426-9029.
The President-President Elect Conference was held in September. Tim Clark, new Director of Governmental Affairs (succeeding Bill Prentice) urged all Board members to contact Rep. Frank LoBiondo, NJ, and ask him to support the Norwood-Dingell Bill HR2723 “Patient Bill of Rights” legislation.
Year 2000 dues for Associate Members and Active Life Members were discussed and accepted.
Essex County Dental Society sent a letter to all component presidents to read at their board meeting and discuss prior to the House of Delegates meeting regarding component societies right to collect their own dues.
All Board members giving reports need to have a written summary of their report to submit to the recording secretary to facilitate minutes reporting and to finish the meeting at a reasonable hour.

Editor Reports
R. Kline, Business Editor-Ads that were placed for one year are now ready to renew and will be contacted. Unsolicited calls are now coming in for advertisements in the MCDS newsletter.

NJDA Council Reports:

NJDA Board of Trustees Report-D. Krantz
See full report below.

Dental Benefits-D. Krantz
See full report below.

Communications-R. Silverstein
The American Academy of Oral and Maxillofacial Radiology requested that we provide a link from NJDA’s web site to their home page. A motion to allow this was defeated. The Council voted to allow direct links from NJDA’s web site to members’ home pages, however, this will not be implemented for 3 months to allow members who don’t have practice web sites to have a site made.
There is no stated NJDA policy regarding patient referral to member dentists when someone calls NJDA and requests a referral. NJDA wanted to know if the individual components would object to NJDA coming up with a stated policy (rather than having NJDA refer such calls to the components as it does now).
The Capsule will be published 10 times in the coming year.

Dental Health-B. Huberman
The Sixth annual “Smile line” will most likely be held at this year’s annual session. Volunteers will be needed once again to man the phones.
OSHA- a reminder that sample manuals are on the website (i.e., exposure control). The council has started to look at the proposed regulations that may be imposed down the line regarding ergonomics. They are looking at injuries that are sustained by an employee due to repeated physical motion in the workplace.
New articles are being formulated for the NJDA website patient information section. It was also suggested that a question and answer section be added to the website. That discussion will be further pursued with Art Meisel regarding the legalities of the concept.
A new fluoridation campaign was recommended to include legislation, promotion, and training of spokesperson dentists. Cooperation with NJDA Council on Communications and Council of Governmental Affairs will be sought.

New Dentists-M. Weiner
The Tri-County representative to the New Dentist Council contacted Dr. Weiner to inquire about the new member induction certificates and frames that are presented to MCDS new members, as they are seeking to present a similar certificate.

Peer Review-J. Fahsbender
Three cases have been reviewed and settled.

MCDS Committee Reports:

Budget Committee-I. Rosen
The proposed budget was discussed and modified. The revised budget was unanimously approved and will be presented to the membership at the next monthly meeting and voted upon.

Mentor-E. Glickman
The Perio Stat/Perio Chip/Atridox course presented June 22, 1999 at St. Peter’s Hospital had 120 people in attendance, 13 of which were nonmembers and will be contacted to invite them to join MCDS. More Mentor courses are in the planning stages. Dr. Greg Livanos will now be co-chairing the Mentor Committee, and anyone interested in joining the committee should contact him or Dr. Ethan Glickman.

Old Business
The By-laws need to be amended regarding Associate Editors. The By-laws need to pluralize to Associate Editors and include corporate sponsorship and advertising to duties and delineate separate editors and duties.
The treasury surplus was re-addressed, and discussion ensued regarding a dues reduction, a full-day CE course at no cost to the membership, and the possible hiring of a part-time executive secretary to answer phones, record the minutes, assist in mailings, and any other activities needed. These discussions were tabled until the November meeting until more information can be gathered.

New Business
The next Board meeting will be November 2nd rather than November 9th. Art Meisel will speak to the Board and will solicit advice form members regarding what is effective at NJDA and what needs improvement, addition, or deletion. The Board will be asked for suggestions, so confer with other members and be prepared to discuss on November 2nd.
Respectfully submitted, Bruce Huberman, DMD, Secretary

1. It was brought to our attention that Massachusetts Delta has opened a clinic with Harvard University for “research”. We will keep track of the implications of this.
2. A presentation was made for a new public awareness campaign. This campaign will consist of billboards, in-office promotional materials and radio spots on NJ 101.5 FM. The theme will be Good Health, Good Looks, Good Nutrition.
3. A resolution to fund the National Museum of Dentistry in Baltimore. They are instituting a “Wall of States” and we decided to participate to the tune of $6000 ($1.50 per member).
4. A resolution was passed to delay SNODENT, until further study of the costs (ie: upgrading software) have been done.
Council on Dental Benefits
1. The council reviewed NJDA’s letter to Dept on Banking and Ins. requesting a ruling regarding application of the PIP multiple procedure reduction formula to TMJ surgery performed on both joints.
2. The council met with Delta of NJ regarding their policy of “disallowing” procedures. Delta agreed to take the matter “under advisement”.
3. It is recommended that all members purchase the CDT-3 Since there are new codes and some deletions.
4. The ADA conducted a survey of dentists’ experiences with capitation and PPO’s. Some findings were: 60% of dentists said their patient base had increased, only 49% said that their practices’s gross income had increased, less than 40% said their net income had increased, while 24.7% said their net income had actually decreased.
5. The ADA is supporting a bill, H.R. 1304, which would allow physicians, dentists and other health care professionals to collectively negotiate contracts with health plans. This ability is currently prohibited under anti-trust legislation.
6. We reviewed a NY Times article about the lack of access to health care nationally for Medicaid beneficiaries, and the effect this is having on the oral health of low-income children (NJ has the lowest fee nationally, and probably the worst access to care and was not mentioned in the article).
7. The Kansas Dental Board promulgated a policy statement affirming that dental consultant review is to be considered the practice of dentistry.
8. The Prompt Payment Legislation, already signed by the Governor, will go into effect on Jan.1, 2000. It will require payment of paper claims within 40 days and 30 days if filed electronically. There are other provisions which will be changed into rules by the Dept. of Banking and Ins. and will be analyzed by us as soon as it is done.
Daniel B. Krantz, DDS

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In last month’s Tidbit, I talked about UCR. I mentioned the term “percentile”. Someone called me and didn’t understand the term. Webster’s Collegiate Dictionary, 10th ed, defines it as: “a value on a scale of one hundred that indicates the percent of distribution that is equal to or below it.” You might remember “percentile” from the standardized tests you or your children took. The raw score, or number of questions answered right, was meaningless unless it was compared to the scores of everyone taking the exam. If you answered 60 out of 100 questions correctly, but almost everyone else who took the examination answered 50 correctly, your score would be at about the 99th percentile and not 60%.
This works similarly with dental fees. If a doctor’s fees are at the “80th percentile”, what this means is that 80% of doctors in the same area charge less and about 20% charge more. Insurance companies have a way of accumulating fees submitted for all procedures done by doctors where an insurance claim has been submitted. This raw data is separated by doctor’s zip code, by procedure, and finally by amount charged. This data is then subjected to a statistical analysis, the end result being a chart listing which fees are at which percentile level, separated by procedure and zip code. If doctors in a particular geographical region have to charge higher for a procedure because of higher overhead costs, higher costs of living, etc., the fee at a particular percentile level would be higher than doctors from an area where costs were lower. Thus the same procedure, from the same insurance plan, at the same percentile level would be paid at different amounts depending on zip code. Similarly, as I mentioned last month, the same procedure, by the same doctor, on patients from different plans would be paid differently depending on which percentile level coverage plan the employer purchased. Let me invent one final scenario: Two doctors in the same neighborhood, perform the same procedure on two patients who work for the same company, but charge different fees for these procedures. Assume also that the employer purchased a plan at the 70th percentile level and one doctor’s fee is higher than the 70th, the other doctor’s is lower than the 70th. The plan would probably pay Dr. Higher the maximum amount the plan at that percentile level would allow and would pay Dr. Lower his submitted fee. Dr. Higher’s patient would have a co-charge (patient’s portion) while Dr. Lower’s patient would not, since his lower fee was satisfied by the plan. This example is, of course, grossly oversimplified; it doesn’t take into consideration such factors as deductibles, subscriber contract limitations, maximum yearly amounts, coverage levels for preventive, basic and prosthetic services, but the concept is valid.
Insurance companies don’t pick their reimbursement and percentile levels out of thin air, they use the fees we submit to them to determine these levels. Percentile levels are merely one method used by insurance companies to codify and organize our submitted fees, to make themselves more competitive in the dental benefit market.

Daniel B. Krantz, DDS
Middlesex Representative to Council on
Dental Benefits