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Active Duty Dental Plan (ADDP)


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Active Duty Dental Plan (ADDP)

  1. 1. Active Duty Dental Plan (ADDP) Remote Dental Care 1
  2. 2. Am I Eligible? <ul><li>If you are an Active Duty member or SELRES member (on orders for 31 days or more) and you live AND work 50 miles from a Coast Guard clinic or DoD Dental Treatment Facility (DTF), then you are eligible </li></ul><ul><li>Once enrolled in TPR, you are automatically enrolled in the Remote Active Duty Dental Plan (ADDP) </li></ul><ul><li>ADDP enrollment letter, additional information & Remote ADDP Identification card will be mailed to you </li></ul><ul><li>You must be enrolled in TRICARE Prime Remote (TPR) </li></ul><ul><li>NOTE: There may be some units that are not TPR but will be considered remote for dental. If you are unsure whether you are considered a remote member, please call United Concordia's Dental Care Finders at 1-866-984-ADDP (2337) or email [email_address] </li></ul>2
  3. 3. How do I schedule an appointment for routine care such as exams, cleanings and fillings? <ul><li>PREFERRED METHOD: Call 1-866-984-ADDP (2337) </li></ul><ul><li>OR </li></ul><ul><li>Complete On-line Appointment scheduling </li></ul><ul><li>by going to the ADSM portal of the ADDP Web site </li></ul><ul><li>www. addp - ucci .com </li></ul><ul><li>See slides 8 through 13 </li></ul>3
  4. 4. Receiving specialty care and other private sector dental care: <ul><li>Your dentist will need to obtain an authorization prior to you receiving dental care for: </li></ul><ul><ul><li>Specialty care (e.g. crowns, bridges, dentures, root canals, periodontal treatment) </li></ul></ul><ul><ul><li>Dental care in excess of $500 per procedure or appointment </li></ul></ul><ul><ul><li>Dental care with a cumulative total greater than $1,500 for treatment plans </li></ul></ul>4
  5. 5. <ul><li>To receive authorization, have your civilian dentist complete an Authorization Request Form. </li></ul><ul><li>This form is available on the ADDP Web site in the Civilian Dentists portal for electronic completion and submission by the dentist. It can also be downloaded from the ADDP Web site and submitted via mail or fax. </li></ul>How Do I Request Authorization for Specialty Care? 5
  6. 6. <ul><li>Upon authorization approval, you & the civilian dentist will be notified and an appointment can be scheduled to initiate specialty care. The determination of the authorization request can take from to three to five business days. </li></ul><ul><li>Procedures that are performed without authorization approval will not be covered by the ADDP. </li></ul><ul><li>You & your dentist should include your Appointment Control Number (ACN) on any communications and/or form submissions that are sent to United Concordia regarding your authorized private sector dental care. </li></ul>Authorization Approval – Next Steps … 6
  7. 7. What if I have a dental emergency? <ul><li>Emergency dental care for ADSMs may be obtained from any civilian dentist if their participating dentist is not available. However, follow up care with a non-network dentist is not authorized. </li></ul><ul><li>Emergency dental care includes any treatment necessary to relieve pain, treat infection or control bleeding . Root canal treatment may be needed to relieve pain and infection and is considered emergency dental care. Permanent filling, crown, bridges, and denture services are not considered emergency dental care and therefore are not covered under emergency care. </li></ul><ul><li>ADSMs who elect to receive non covered services as part of an episode of emergency dental care are responsible for payment of those additional services. </li></ul><ul><li>It is recommended that the ADSM use a United Concordia Network dentist for emergency dental care whenever possible. </li></ul>7
  8. 8. On-line Scheduling of a Routine appointment <ul><li>STEP 1 - You must get an Appointment Control Number (ACN) by completing an Appointment Request Form. The ACN is provided by United Concordia and must be obtained prior to receipt of all private sector dental care. </li></ul><ul><li>The Appointment Request Form is available in the ADSM portal of the ADDP Web site in the Forms and Materials section. </li></ul>8
  9. 9. <ul><li>It is your responsibility to complete the Appointment Request Form in its entirety. </li></ul><ul><li>All required fields are marked with an asterisk (*) and must be completed before the form can be submitted. </li></ul><ul><li>You may fill in the non-required fields with as much information as you have available, or simply leave them blank. </li></ul>On-line Appointment Request Form Completion 9
  10. 10. <ul><li>The Appointment Request Form provides two options for appointment scheduling. </li></ul><ul><li>The “Who will be responsible for scheduling the appointment?” field allows you to note whether you (ADSM) or United Concordia will make the appointment. </li></ul>10 On-line Appointment Request Form Completion
  11. 11. What are my on-line scheduling options? <ul><li>OPTION 1 – UNITED CONCORDIA </li></ul><ul><li>If you select the United Concordia option in the “Who Will be Responsible for Scheduling the Appointment” field, United Concordia’s Dental Care Finders will make the appointment for you </li></ul><ul><li>You can enter the name and contact information of the dentist you would like to utilize or leave that area blank </li></ul><ul><li>United Concordia will then call to make the appointment with you and a network dentist within two business days of the request </li></ul><ul><li>If you would like to make an appointment immediately , call United Concordia at 1-866-984-ADDP (2337) upon form submission </li></ul><ul><li>United Concordia will ensure you are seen within 21 calendar days of request for routine care and within 28 calendar days for specialty care </li></ul>11
  12. 12. <ul><li>OPTION 2 – ADSM </li></ul><ul><li>You can personally make an appointment with a United Concordia network dentist by selecting the ADSM option in the “Who will be responsible for scheduling the appointment” field on the form. </li></ul><ul><li>You can enter the name and contact information of the dentist you would like to utilize or leave that area blank. </li></ul><ul><li>You can also call United Concordia at 1-866-984-ADDP (2337) for the list of three network dentists in your area. The list provided by United Concordia will also include your Appointment Control Number (ACN) . </li></ul><ul><li>You must wait until you receive the ACN from United Concordia before you can make your own appointment. </li></ul>What are my on-line scheduling options? 12
  13. 13. <ul><li>Upon form submission, you will receive an Appointment Request Confirmation page which you should print for your records. </li></ul><ul><li>United Concordia will then provide you with a list of three dentists, to include any that you requested, within three business days of form submission. </li></ul>On-line Appointment Request Form Submission 13
  14. 14. United Concordia Contact Information <ul><li>ADDP Web site: </li></ul><ul><li>Dental Care Finders/Customer Service </li></ul><ul><li>1-866-984-ADDP (2337) </li></ul><ul><li>8 a.m. to 8 p.m. (ET) Monday through Friday </li></ul><ul><li>8 a.m. to 5 p.m. (ET) Saturday </li></ul><ul><li>[email_address] </li></ul><ul><li>Inquiries </li></ul><ul><li>United Concordia Companies, Inc. </li></ul><ul><li>ADDP Unit </li></ul><ul><li>P.O. Box 69430 </li></ul><ul><li>Harrisburg, PA 17106-9430 </li></ul>Claims United Concordia Companies, Inc. ADDP Claims P.O. Box 69429 Harrisburg, PA 17106-9429 Appeals United Concordia Companies, Inc. ADDP Unit – Appeals P.O. Box 69430 Harrisburg, PA 17106-9430 Grievances United Concordia Companies, Inc. ADDP Unit – Grievances P.O. Box 69430 Harrisburg, PA 17106-9430 14