Delta Dental of Washington (DDWA) – Provider Reopening Support Program (PSRP)
As dental offices reopened, dentists shared with us the new protocols they are implementing to further protect the health and safety of their patients and employees. We are supporting our network dentists as they make the necessary enhancements to their practices. The DDWA PSRP will pay participating DDWA dentists a per patient visit fee of $10. The fee will be paid by DDWA. The payment will not be included in the claims experience, so the WCIF will not be charged, and further, neither should the member/patient be charged.
If members have already paid, they should contact their provider to seek a refund.
Posted May 11, 2020: From Willamette Dental Group
In response to minimized restrictions, Willamette Dental Group started to expand our scope of care beyond dental emergencies at all of our offices in Oregon, Washington and Idaho.
The timeline below outlines our phased plan for the continued expansion of care over the next few weeks with most offices open 6 days a week, 10 hours a day by May 18, including select offices open for care on Sundays. Timing varies slightly by state due to current reopening guidelines as published by each state’s government.
All patients whose appointments were affected by COVID-19 are currently being contacted and rescheduled based on the timeline below.
The health and safety of our patients and staff remains our highest priority. Enhanced in-office safety protocols have been implemented based on recommendations from the ADA, CDC and OSHA.
Care Expansion Timeline
- Select elective & non-urgent general dentistry appointments available in OR and ID
- Urgent (non-ER) general dentistry appointments available in WA
- Select elective & non-urgent endodontic and oral surgery specialty appointments available in OR and ID
- Urgent (non-ER) endodontic and oral surgery specialty appointments available in WA
- Select elective & non-urgent general dentistry appointments added in WA*
- Limited Orthodontic care available in select locations in OR and ID
- Most offices open 6 days a week, 10 hours a day and select Sundays
- Teledentistry program offered in OR
- Limited Orthodontic care available in select locations in WA*
- Additional provider and appointment availability at select locations in OR, ID and WA
- New patient exams available in OR, WA, ID (without dental cleanings**)
*based on current projection for lifted restrictions in WA
**dental cleaning procedures are very high risk for contracting Coronavirus so these appointments will be postponed until safe to resume
Posted April 22, 2020 – From Premera Blue Cross:
YOU NOW HAVE GREATER ACCESS DURING THE COVID-19 OUTBREAK
Starting April 21, 2020, Premera Blue Cross is expanding telehealth access options for mental health and substance use disorder. Three in-network provider options have been added to help support you during the COVID-19 pandemic.
- Doctor On Demand – Video-based mental health therapy
- Boulder Care – Video-based treatment for opioid use disorder
- Workit Health – Video-based treatment for alcohol use disorder
In addition to new providers, Premera added new covered services for care delivered virtually. Telehealth is now covered for:
- Applied behavioral analysis (ABA)
- Partial hospitalization programs (PHPs) for mental health and substance use disorders
- Intensive outpatient programs (IOPs) for mental health and substance use disorders
For additional information, please review the Telehealth information found on the Premera website.
Customers may begin treatment with existing in-network providers or Premera’s new telehealth providers without a referral. Member cost shares are waived for all telehealth services. Access to these new providers and the waiving of member cost shares are available through June 30, 2020 with the potential to extend duration based on business and epidemiological considerations.
Other resources clients can use:
- Many in-network providers, including local counselors, therapists, psychologists, psychiatrists, and facilities are offering care virtually during this time.
- Customers can also receive care from Premera’s national telehealth provider for talk therapy, Talkspace and Teladoc.
- If customers have already established care with an in-network provider or provider group, they may reach out to them to learn more about telehealth options for medical care and behavioral health care. To find an in-network provider, use the Find a Doctor tool on premera.com.
- Some customers may also have access to behavioral health care through an employee assistance program (EAP).
Important information to note:
- If a telehealth provider charges you a copay, deductible or coinsurance for telehealth services through June 30, 2020, Premera or the telehealth provider will reimburse you when the claim is processed.
- Telehealth providers can’t diagnose COVID-19 or order any COVID-19 testing. They may be able to assist with a review of symptoms and recommendations on next steps.
- Only providers seen in-person can diagnose the COVID-19 virus. Testing can also be performed at drive-through locations.
For questions relating to this in-network provider expansion and how Premera is responding to COVID-19, please visit www.premera.com or contact your WCIF Account Executive.
For more information and to stay up to date on the latest coronavirus information please visit: www.coronavirus.wa.gov.
Posted April 17, 2020 – From Willamette Dental Group:
Willamette Dental Group is committed to supporting our members during this pandemic while we continue to focus on emergent appointments and 24/7 on-call services, following guidance from the CDC, ADA, and local, state and federal governments (Washington, Oregon, Idaho).
In an effort to provide assistance to all members during this difficult time, we are waiving all general office visit copays* for emergency appointments starting April 13. It is our hope that this waiver will help to relieve stress that our patients may be experiencing in their emergency oral health situations amid this global crisis.
Update from Premera on COVID-19 outbreak
Important Information For Your Employees As of April 2, 2020:
- Premera is waiving cost shares and deductibles for all COVID-19 related testing and treatment (both inpatient and outpatient) effective April 2, 2020.
- This cost share waiver will continue through October 1, 2020.
- This includes hospitalizations and medical transport when needed, and FDA-approved medications delivered as in-patient for in or out of network providers.
- Premera Blue Cross will review claims received since January 1, 2020 and reprocess any with COVID-19 related diagnoses. If an employee believes they have a claim where cost share waivers weren’t applied for treatment related to a COVID-19 diagnosis prior to March 9, have them contact Premera’s customer service team with the following information: Date of claim, provider, name of patient.
For more information, please visit the member website: https://www.premera.com/wa/visitor/outbreaks/
COVID-19 Treatment Update from Kaiser Permanente
Kaiser Permanente is announcing the adoption of $0 member out of pocket costs for the treatment of COVID-19, including related inpatient and outpatient services.
This $0 member cost share would apply for all dates of service from April 1 through May 31, 2020, unless superseded by government action or extended by Kaiser Permanente.
For more information about benefits and coverage, Kaiser Permanente members should call Member Services at 1-888-901-4636.
CARES Act Expands Health Coverage Rules
On March 27, 2020, the U.S. Congress passed the Coronavirus Aid, Relief and Economic Security Act (CARES Act) to provide $2.2 trillion in federal funding to address the COVID-19 crisis. The President signed the CARES Act into law the same day. Following and building upon two other federal laws that were recently enacted to address the pandemic—the Families First Coronavirus Response Act (FFCRA) and an emergency funding bill—the CARES Act makes a variety of changes affecting health plans.
Health Plan Coverage Provisions
The CARES Act includes provisions to:
- Expand the types of coronavirus testing that all comprehensive private health insurance plans must cover without cost-sharing or barriers under the FFCRA;
- Accelerate the process that would make permanent the requirement for health plans to cover preventive services and vaccines related to COVID-19;
- Allow telehealth and other remote care services to be covered under a high deductible health plan (HDHP) before the deductible is met, without affecting the HDHP’s compatibility with Health Savings Accounts (HSAs) (applicable for HDHP plan years beginning on or before Dec. 31, 2021); and
- Treat additional over-the-counter medications, along with menstrual care products, as qualified medical expenses that may be paid for using HSAs or other tax-advantaged arrangements.
(Provided by Zywave, Inc.)
EAP COVID-19 resources
First Choice Health EAP has a wealth of resources for employees and employers on their website.
Log onto: https://www.fchn.com/Members/EmployeeAssistance, Username: wcif
Then click on the bar at the top of the homepage: Coronavirus COVID-19 Pandemic Resources
On the COVID-19 Coronavirus Pandemic page you can view articles, webinars, and more:
New Coronavirus Relief Law Requires Paid Employee Leave
As part of the Families First Coronavirus Response Act signed into law by President Trump on March 18, 2020, two laws were enacted that provide workers with paid leave for reasons related to the coronavirus (COVID-19) pandemic. One of the new leave provisions, the Emergency Family and Medical Leave Expansion Act,” allows 12 weeks of partially compensated FMLA leave to care for a child whose school or child care facility has been closed due to COVID-19. The leave applies only to workers who have been employed by their current employer for 30 days.
The other new law providing employee leave, the “Emergency Paid Sick Leave Act,” requires employers to provide 80 hours of paid sick time to employees in specified circumstances, including:
- A quarantine or isolation order for the employee or someone the employee is caring for, or medical advice to self-quarantine;
- When the employee has symptoms of COVID-19; or
- When the employee’s child’s school or child care facility is closed.
Employers with 500 employees or more are exempt from the laws, and employers may exclude employees who are health care providers and emergency responders.
The legislation also allows for future regulations exempting businesses with fewer than 50 employees from providing leave for child care reasons if the leave would jeopardize the viability of the business. The leave benefits take effect on April 1, 2020, and expire on Dec. 31, 2020.
Employers should familiarize themselves with the new leave requirements to ensure compliance.
- Coronavirus relief legislation requires employers with fewer than 500 employees to provide 12 weeks of FMLA leave for child care reasons related to COVID-19.
- The new FMLA leave must be compensated after the first 10 days, at two-thirds of an employee’s wage, up to $200 per day.
- Employers must also provide 80 hours of paid sick time for specified reasons related to COVID-19.
March 18, 2020
President Trump signed coronavirus relief legislation into law.
April 1, 2020
Employee leave provisions take effect.
Dec. 31, 2020
New leave laws sunset.
(Courtesy of DiMartino Associates)