NOVEMBER 2009 VOLUME 10, ISSUE 11 AVAILABLE ONLINE AT TDA.ORG

Inside

TDA Smiles Foundation

Atlanta Smiles on Wheels — Take Two

TDASF Supports Dental Education

Evidence-based Tip of the Month

Dental Quick, Part 2 of 2

Endorsed by TDA Perks Program

Council on Dental Economics

Integration v. Coordination of

Benefits

TSBDE Rule Update

Federal Trade Commission “Red

Flags” Rule

December Journal News

Star of the South Dental Meeting

Antimicrobial Efficacy of Soap and

Water Hand Washing Versus an

Alcohol-based Hand Cleanser

Dental Surgery for Patients on

Anticoagulant Therapy with

Warfarin: A Systemic Review and

Meta-analysis

Around the State

December 4

TDA Smiles Foundation Board

Meeting, Austin

January 21 – 23

Southwest Regional Dental

Conference, Dallas

Click & Connect

Pay 2010 Dues Online

tda.org/paydues

Ask a Colleague

tda.org – Features

JUNE, 2008 VOLUME 9, ISSUE 6 AVAILABLE ONLINE AT TDA.ORG

InsideMedicaid in My Office?Yes, I Think So!Richard M. Smith, DDS

TDA Smiles FoundationTMOM gains ardent advocate

Ask the PresidentIncoming President’s messageHilton Israelson, DDS

Let’s TalkOutgoing President’s messageA. David May, Jr., DDS

2008-2009 TDA Board of Directors

Meet Your TDA StaffTDA’s new Finance Director Dee Dee Delagarza

Congratulations to TDA Component Societies

Streamline Your Insurance ClaimsSpeeding up confirmation of benefits and eligibility

TSBDE Rule UpdateRequirements for dental office radiograph machines

In the NewsTDA members in the news

July Journal NewsTooth Whitening: A Clinical Review

TDA Historical PerspectivesDentists, dental hygienists, and the dental team

The 2007 C.T. Rowland AwardOrthodontic case report

The El Paso Dental Conference

Around the StateAugust 14:TDA Board MeetingAustin, Texas

October 15-19:ADA Annual SessionSan Antonio, Texas

Click & ConnectUpdate Profile tda.org – Membership Info Ask a Colleague tda.org – Features TEXAS Meeting Photostexasmeeting.com/estore

Volunteer for ‘08 ADAtda.org/volunteerada08

Every Member MattersRise’ Lyman, DDS, TDA Future Focus Committee

Membership growth is vital to any thriving organization. The Texas Dental Association (TDA) Board is strongly committed to the Membership goal within the “TDA 2009” strategic plan, which addresses continued growth. I am proud to report that, as evidence of that commitment and for the second year in a row, the TDA received the following ADA awards in 2008:• Greatest Percentage Membership Net Gain: Texas had a net gain of 198 members in the year 2007.• Top Constituent Dental Society with Greatest Percentage of Non-Members to Membership: Represents a conversion of 4.7 percent of non-members into membership at end of year 2007.• Top Constituent Dental Society to Improve Retention Rate Percentage in 2007: Represents a 97 percent Association retention rate, which is an increase of 7 percent from the previous year.• Greatest Percentage of New Dentist Members: Represents a gain of 111 new dentist members (those dentists who are 1-9 years out of school).

Another example of the commitment to the growth of our Association is the TDA Externship Program, which builds student awareness of organized dentistry. This innovative program, created in 2007, offers students the opportunity to gain insight into the different components of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and to gain a better understanding of their role as future leaders of the dental team. The program is open to dental students from each of the three dental schools in Texas. This year the externship program will take place June 20 – June 27 in Austin at the TDA central office. As an ongoing effort to enhance the value and benefits of the Association, the TDA Council on Membership developed a survey that was sent to all members in 2006. The results clearly showed that members have a high satisfaction rating with benefits such as the TEXAS Meeting, TDA publications, and the ability to participate philanthropically in the TDA Smiles Foundation. A great number of the discounted programs offered to members through the TDA Perks Program also received a high satisfaction rating. In accordance with the strategic plan, the Council on Membership, will survey members again in 2009. Participation from all members and a collaborative effort between the ADA, TDA, and local component societies are the keys to 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.

MembershipDentists will value membership and participation in the TDA.

Objectives1. Improve perceived value and benefits of membership in TDA. a. Increase members’ knowledge about the impact and benefits of TDA membership. b. Ensure that components are an integral aspect of the membership process. c. Create greater awareness of the availability of the Peer Review, Ethics & Judicial, and Risk Management benefits. d. Actively promote adherence to the Code of Ethics. e. Enhance communication with members and non-members. f. Build student awareness of and interest in organized dentistry and membership in TDA. g. Ensure ongoing contact with students throughout dental school. h. Work closely with dental school faculty. i. Evaluate number of nonmember dentists who attend and participate in TDA activities (TEXAS Meeting, TDA Smiles Foundation programs, etc.).Metrics1. Seventy percent of active licensed dentists in TX will be members of TDA by 2009 (baseline of 68.5% in January 2007); increase

membership retention rate to 97 percent by April 2007 (baseline 96% in 2006). a-d. Increase the number of dentists serving on component peer review and ethics and judicial affairs committees to attain a

participation rate of 2-5 percent relative to the total number of component society members 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 the Council on Membership.

4. Establish baseline of nonmember participation at TDA activities (CAS, TDA Smiles Foundation, Membership) 5. Established baseline of members’ understanding of and satisfaction with the benefits of their TDA membership through Member

Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009.6. Sixty-five percent of all full-time faculty will be TDA members by 2009 (2006 baseline = 63%).

Mission: To be The Voice of DenTisTry in Texas

Manpower Advocacy OrganizationalExcellence

Public Image

Development Membership

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

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

Hispanic Dental Association’s 17th Annual Meeting in Houston

TDA president Dr. Matthew B. Roberts addressed attendees at the opening ceremony

of the 17th annual meeting of the Hispanic Dental Association (HDA) last month in Houston. TDA member Dr. Victor Rodriguez of Houston is the HDA’s 2009-10 president elect.

Attendees and students took part in educational sessions, networking opportunities, panel discussions, and exhibits. Attendees were offered a preview of the upcoming cultural awareness program that HDA has designed and is currently promoting. For more information on the HDA, please visit hdassoc.org.

Official Call for Secretary/Treasurer Nominations TDA secretary-treasurer Dr. J. Preston Coleman will not seek re-election at the May 2010 TDA House of Delegates. Therefore, the position is open for nominations.

Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must accompany a letter 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 that membership eligibility can be verified and the House of Delegates can be prepared for an informal vote. Duties of the Secretary-Treasurer are enumerated in the Bylaws and include the following:• ServeaschairoftheBudgetCommittee;• ServeaschairofAssetsManagementCommittee;• ExamineincomeandexpensesofTDAandreportateachBoardmeeting;• EnsurethatHouseofDelegatesandTDABoardminutesaremaintained;• Serveasanon-votingmemberofTDAExecutiveCommittee;and• PerformotherdutiesasspecifiedbytheBoardofDirectors. Nominations are to be mailed to Dr. J. Preston Coleman, TDA Secretary-Treasurer, Texas Dental Association, 1946 South IH-35, Suite 400, Austin,Texas78704;ore-mailedtoTDAExecutiveDirectorMs.MaryKayLinn,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).

Texas Dental Association Notice of Grant Availability 501(c)(3) Non-Profit Dental Organizations 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 over the previous fiscal year. Grantees will be determined by the TDA Board of Directors.

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

Application:LettersofInterest—detailingtheproposedprojects(s)andincludingabudget(s)—shouldbemailedto:TDA Board of Directors, 1946 IH-35, Suite 400, Austin, TX 78704 Attn: Terry Cornwell

Deadline: LettersofInterestmustbereceivednolaterthanJanuary31,2010.

Approval: LettersofInterestwillbereviewedandconsideredbytheTexasDental Association’s Board of Directors at its March 2010 meeting.

Notification: All applicants will be notified in writing by May 15, 2010.

Previous Recipients: In 2009, grants were awarded to Christian Com-munityAction(Lewisville),CommunityHealthCenterofLubbock(Lub-bock),DentalHealthforParkerCounty(Weatherford),DentalHELPProject(Houston);HOPEClinic(Alvin),andHOPEProject,(Tenaha,Shelby County).

For more information, please contact Terry Cornwell, TDA central office, (512)443-3675orterry@tda.org.

Council on Dental Economics Receives Fluoride and Media Spokesperson Training On Friday, November 20, 2009, the TDA Council on Dental Economics(CODE)participatedintheAmericanDentalAssociation’s(ADA) “Fluoride and Media Spokesperson Training.” ADA staff traveled to Austin to conduct the training. The morning segment provided fluoridation facts and information regarding current anti-fluoridationmovements;the afternoon segment consisted of basic presentation and media skills followed by a mock media interview session.

The council is available to assist component societies when fluoride issues arise. If you have comments or questions about fluoride issues in your area,pleasecontactCODEviaCassidy Neal at (512) 443-3675.

Dr. Paul Kennedy III leads discussion at the TDA Committee on the New Dentist meeting this month.

TDA president Dr. Matthew B. Roberts participates in the opening ceremony at the Hispanic Dental Association’s 17th annual meeting in Houston last month.

TDA Committee on the New Dentist The TDA Committee on the New Dentist met with the 2009 SummerExternshipparticipantsonNovember20atTDAHeadquarters.The purpose of the meeting was to develop new leadership opportunities at the dental schools and within organized dentistry while enhancing the tripartite’s strength at the dental school level.

Dr. Courtney Alexander chaired the meeting with Drs. Josh Austin and PaulKennedyIIIattending.Dr.LisaMastersalsoattendedascommitteeboardliaison.ExternsMeganHolmeandBlakeJohnstonattendedfromUTHealthScienceCenterinSanAntonioandSummerKetron-Adkinsattended from the UT Dental Branch at Houston.

The ADA’s Mr. Richard Green conducts mock interviews with CODE chair Dr. Delton Yarbrough of Fort Stockton.

November 2009 / TDA Today / 2

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 served 150 patients, establishing two Smiles on Wheels records for charitable dental care value provided and serving the largest percentage of pediatric cases.

LAST CHANCE! TDASF Holiday CardsConsider 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 OneLogontotdasf.org,letusknowyourgiftrecipients,andleavetheresttous.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,TX78704).

Option TwoMail 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!

Questions and Answers about DentalQuick — Part 2 of 2 ExcitementhasbeengeneratedbyDentalQuick,thenew 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,likemostdentalplans,limitscleaningsto 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,thereisnodeductibletopayinanyDentalQuickpolicy.

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.DentalQuickhasagraduatedscheduleofbenefitsthatincreases 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.

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 choosetoreferpatientstoaDentalQuickphonenumberortotheDentalQuickwebsitetocalculatepremiumsfor 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 participateintheDentalQuickprogramatall.

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

dental office if a TDA member chooses to do so. The DentalQuickstaffwillbepleasedtoprovidetheinformation 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 37-year-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 permonthforthesame$1,650inannualbenefits.Eachcan 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.

The Freedom-of-Choice Dental Insurance Plan Endorsed by the TDA Perks Program

Dr. Richard Gibson of Texarkana hugs one of his pediatric patients after 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 to a Cass County resident.

Dr. Jon Williamson from Cedar Hill and dental assistant Jessi Leuba work side by side in the Dallas County Dental Foundation’s van to serve pediatric patients.

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.

SpecialrecognitiontoDr.JohnWiseofMcKinneyandthestaffofWiseOrthodontics 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.

TDASF Supports Dental Education Eachyear,theTDASFrewards$1,000scholarshipsfromtheFelixCrawfordEndowmentFundtotwostudentsateachdentalschoolacrossthestate.TexasA&MHealth Science Center Baylor College of Dentistry’s scholarship recipients are first-year dentalstudentsAlissaNguyenandKimberlyLaurenRogers,picturedwithAssociateDeanforStudentAffairsDr.JackLongandDeanDr.JamesS.Cole.

EachyeartheTDAhostsaluncheonforitstenantstoshowappreciationfor 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.

Tenants Fred Perez of Mex-Latin Imports and Richard Galbraith of Galbraith Construction Inc. have both leased space in the TDA building since 1986.

Grady Basler and Melissa Mims of Dental Oncology Education Program (DOEP).

Tenant Luncheon

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.

References1. Chlorhexidine gel reduces incidence of alveolar osteitis after extraction of the mandibular

thirdmolars.SmithKG.EvidBasedDent.2009;10(2):54-5.2. 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 PatholOralRadiolEndod.2009Jan;107(1):30-5.

3. Effectivenessofchlorhexidinegelversuschlorhexidinerinseinreducingalveolarosteitisinmandibularthirdmolarsurgery.Hita-IglesiasP,Torres-LagaresD,Flores-RuizR,Magallanes-AbadN,Basallote-GonzalezM,Gutierrez-PerezJL.JOralMaxillofacSurg.2008Mar;66(3):441-5.

4. Effectivenessofantibioticprophylaxisinthirdmolarsurgery:ameta-analysisofrandomizedcontrolled clinical trials. Ren YF, Malmstrom HS. J Oral Maxillofac Surg. 2007 Oct;65(10):1909-21.

5. Preventionofalveolarosteitiswithchlorhexidine:ameta-analyticreview.CasoA,HungLK,BeirneOR.OralSurgOralMedOralPatholOralRadiolEndod.2005Feb;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 mandibularthirdmolarextraction.Pleasesendcommentstosmatteson@satx.rr.com and let me know if you are willing to allow me to post them in a future TDA Today.

Evidence-Based PracticeTip of the Month

Stephen R. Matteson, DDS, Editor

November 2009 / TDA Today / 3

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.

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.

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.

In The Loop

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

The TEXAS Meeting — May 6–9, 2010Frank 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 decidewhatyouwilldoforNewYearsEve.Next,youwillneedtohaveagoodplanforValentines’Dayoryouaretoast—only74days!

Themostimportantdateinyourfuture,however,istheTEXASMeeting,May6-9,2010.Itseemssofarinthefuture,butitisonly160daysaway.Whenyouthinkaboutit,whatthingsdoyoudoatthelastminute?Likemanypeople,Iamagreatprocrastinator.Thiscanbringlotsofstressandanxietytoone’slife.Wetendtojudgehowwellourattendancewillbeattheannualmeetingbyourpreconferenceregistration numbers.

AtriptotheTEXASMeetinginbeautifulSanAntoniothisMaywouldbeagreatrewardforyouandyourstaffforajobwelldone.ConsiderhowgreatyouwouldfeelbycompletingtheTEXASMeetingregistrationforyouandyourstaffearly.Greatcontinuingeducationopportunitiesaboundforalldentalprofessionals.TheTexasStateBoardofDentalExaminerseducationalrequirementscanbecompletedatthisoneevent.PreconferenceregistrationnumbershelpyourTDACouncilonAnnualSessionprojectTEXASMeetingattendancenumbers,sessionroomassignments,andsocialeventparticipationtomakeyourTEXASMeetingexperienceproductiveandmemorable.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. MeetingregistrationwillopenonJanuary1,2010fortheearlybirds—whichshouldincludeyou!Registereveryoneandregisterearly!Welook forward to seeing you in San Antonio.

Integration v. Coordination of BenefitsCouncil on Dental Economics Inourfastpaced,high-costsociety,manymarriedcoupleshavejobsoutsideofthehome.Becauseofthis,bothspousesoftenhavehis/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 resultinginapaymentof$0.Thismeansthepatienthastomakeupthe$500differenceoutofpocket.Thisissignificant—$0outofpocketwhen 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.

Ifyouhaveissuesorquestionsyouwouldlikethecounciltoaddress,pleasecontactCassidyNealatcassidy@tda.orgorcallat(800)832-1145 ext. 152.

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

Board Policy Resolutions (10)

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—withareportattheNovember2010TDABoard 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 TEXASMeetingtoencourageTDAmembership.CoursefeeswillberequiredforparticipationinCEsessions.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 referredbacktotheCouncilonDentalEducation,Tradeand Ancillaries.32-2010-B (P): Approved“ExcellenceinPatientAdvocacy” awards to Sen. Florence Shapiro (R-Plano), Sen.CarlosL.Uresti(D-SanAntonio),Rep.CharlesL.“Chuck”Hopson(D-Jacksonville),andRep.LoisW.Kolkhorst(R-Brenham)toacknowledgeoutstandingcommitment to insuring access to quality dental care in Texas;andlegislativestaffawardstoMs.LindsayMullins,Ms.CherylLively,Ms.RachelJohnston,andMs.JenniferDeegan.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 andadjustallaspectsoftheAssociation’scurrentstrategicplan.”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.

Non-Policy Resolutions (8)

APPOINTMENTS (1)36-2010-B (NP): ApprovedDr.BurtonJ.Kunik,Ms.PaulaOwens,Dr.DonA.Lutes,Dr.RichardM.Smith,andDr.W.KurtLovelessastrusteesoftheTDASmilesFoundation, June 1, 2009 through May 31, 2010.

MISCELLANEOUS (10)26-2010-B (NP): DirectedthatTDAjointheTexasMedical Association in filing an amicus brief in the case styled TMA versus Texas Board of Podiatric Medical ExaminersnowintheTexasSupremeCourt.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 ManagementCommittee;andauthorizedthetreasurerand executive director to open a discount brokerage accountwithCharlesSchwab&Company,Inc.andtoact 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): ApprovedpurchaseoftheEZ-Fliponline application program, allowing readers to read the Texas Dental Journal online and flip the pages on their computer screens.

MK’s Board Notes

Mary Kay Linn, TDA Executive Director

PCI Standards Compliance

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.

November 2009 VOLUME 10, ISSUE 11 AVAILABLE ONLINE AT TDA.ORG

EDITORIAL STAFFDr. Stephen R. Matteson, D.D.S., Editor

Edwina J. Shires, Director of PublicationsNicole Scott, Publications Coordinator

Barbara S. Donovan, Art Director

BOARD OF DIRECTORSMatthew B. Roberts, D.D.S., President

Ronald L. Rhea, D.D.S., President-ElectHilton Israelson, D.D.S., Immediate Past President

Vice PresidentsCraig 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 DirectorsR. 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

DirectorsKaren E. Frazer, D.D.S., SoutheastLisa 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-TreasurerGlen D. Hall, D.D.S., Speaker of the HouseMichael L. Stuart, D.D.S., Parliamentarian

Stephen R. Matteson, D.D.S., EditorMary Kay Linn, Executive DirectorWilliam 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 affili-ated, $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 Associa-tion 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.

aade

In the NewsDr. 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.

FTC Postpones “Red Flags” Rule Implementation until June 1, 2010Due 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 oftheHouseFinancialServicesCommittee,tosignontoalettertoFTCChairmanJonLeibowitz,urginghimtoissueanotherenforcement 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.

TSBDE Rule UpdateThis 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: ThisissueisaddressedinTexasStateBoardofDentalExaminers’(TSBDE)Rule116.10—ProstheticIdentification.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.”

Rule116.10,whichappliestoremovabledevicesorappliancesdeliveredtoanypatientsunderthedentist’scare—notjustthoseinnursinghomes—requiressuchdevicesorappliancestoincludethepatient’slastnameandfirstinitialand/orsocialsecuritynumber. 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 prescribingdentistthattheprosthesisorappliancewaseither:manufacturedentirelybytheregisteredlaboratory;manufacturedinpartorwholebyadomesticlaboratoryinsidetheU.S.;ormanufacturedinpartorwholebyaforeignlaboratoryoutsidetheU.S.

FormoreinformationcontactDianeRhodesatdiane@tda.orgor(512)443-3675.