When it comes to oral health, we know some people need more care than others. Delta Dental of Oregon's Health through Oral Wellness® program offers extra benefits and related care to members who have a greater risk for oral diseases.
The program uses an oral health assessment to help determine your risk of tooth decay, gum disease and/or oral cancer. Based on your risk score, you may qualify for enhanced benefits* that include additional cleanings, fluoride treatments, sealants and periodontal maintenance.
*All enhanced benefits are subject to meeting your plan's annual maximum and other limitations. The enhanced benefit feature is only available if your employer participates in the program. The enhanced benefits feature is available to patients whose employer participates in the program.
To determine your oral health risk score, Delta Dental has partnered with PreViser™, a third-party dental risk and periodontal disease analysis tool. If you score between 3-5 (on a 5-point scale), you may be eligible for enhanced dental benefits. In order to qualify, your dentist must sign up for the program.
Depending on your group's policy, the frequency of extra dental services and care will be measured at least once in the plan year, following your clinical assessment. Enhanced benefits and standard policy requirements, including coinsurance percentages, copayments and plan maximums, may be subject to change.
Health through Oral Wellness encourages an open, collaborative patient-dentist relationship to help improve your oral health. By seeing your dentist and taking an oral health risk assessment, you can see if you are at a greater risk for tooth decay, gum disease and/or oral cancer. Based on your risk score, you may qualify for additional cleanings, fluoride treatments, sealants and periodontal maintenance. All enhanced dental benefits are subject to meeting your plan's annual maximum and other limitations.
After completion of your oral health assessment by a dentist who is registered for the Health through Oral Wellness program, PreViser uses a set of algorithms to determine your risk score. If your risk score is between 3-5, you may be eligible to receive additional dental benefits. All enhanced benefits are subject to your plan's maximum and other limitations. Additional benefits may include extra cleanings, fluoride treatments, oral hygiene or nutritional counseling, sealants and periodontal maintenance based on your risk for oral disease.
Delta Dental collects and securely stores your oral health risk assessment data and other personal information to improve our ability to help us communicate with you and your family about oral health. We also use the data to help us improve the benefits we provide to help your dentist deliver the care you need. Oral health risk assessment scores submitted by a registered dentist may authorize enhanced benefits for members at greater risk for oral diseases like tooth decay and gum disease. Delta Dental may use de-identified data to generate reports, analyses or educational materials as needed to improve plan designs, wellness offerings and educational materials.
Your oral health risk scores are never shared with your employer. Your data is securely stored in a HIPAA compliant data hub called the Prevention Management Console or PMC, which is located behind Delta Dental's firewall. Access to information stored in the PMC is authorized only for the purpose of improving dental plan designs, wellness offerings and educational materials; to provide you with the oral health information and resources that you request; and to authorize enhanced benefits based on your risk for oral disease. As with claims data, information in the PMC can be used to generate trend analyses, reports and educational materials. Data used for these purposes will always be de-identified. Persons who are granted access to see your oral health data may do so only for the purposes of assisting you in getting information or services needed to maintain or improve your oral health.
It depends on your annual risk score. To continue qualifying for enhanced benefits, your dental provider will need to conduct your Oral Health Assessment at least once in the plan year. Based on your risk score, and being enrolled in a plan with Health through Oral Wellness, you may qualify to continue receiving extra benefits. If your oral health improves, you may no longer qualify for enhanced benefits.
Yes. To find out if they are eligible, family members covered on your dental plan may request a clinical assessment by their dentist to determine if they are at a greater risk of oral diseases. Their personal risk scores will determine whether they qualify for extra benefits.
When a dentist registered for the program has completed your clinical risk assessment, they will be instantly notified if you are eligible for enhanced benefits. Based on your individual needs, you can discuss the best treatment plan during the same appointment.
We're here to help. Contact our Delta Dental customer service team toll-free at 888-217-2365. TTY users, please call 711.
Delta Dental is part of the Moda, Inc. family of companies. Our mission is the same as it was more than 60 years ago — to find a better way to health, every day, for the people and communities we serve. As a founding member of the Delta Dental Plans Association, we offer affordable, quality dental coverage to people in the Pacific Northwest and beyond.
