COVID-19 Next Steps & Practice Resources    Learn More…

Pandemic Recovery Guide

PPE

Gowns, gloves, masks, and respirators – all the PPE items you need to convey the safety of your practice.

  • Where do you start? The CDC and the ADA address their recommendations for PPE in their interim guidance to minimize COVID-19.
  • But what happens when supplies are limited, like they are now? The CDC has detailed a number of Strategies to Optimize the Supply of PPE and Equipment on their website addressing what to do when supplies are stressed, running low, or absent.
  • PPE will be a necessity for all team members including administrative workers. To understand what level of PPE will be needed to suit any risk level, OSHA has detailed Guidance for All Workers and Employees.
  • A PPE Burn Rate Calculator has been created by NIOSH to help you track your inventory and know how long your supply will last.

 

Face Masks

  • Resources are increasingly difficult to find right now – CDC, NIOSH, and ADA have offered guidance on Extending the Use of N95 Masks.
  • Can you describe how a surgical mask, an N95 mask, or a KN95 mask get their testing and approval? Do you know the basic intended use or purpose of those masks? The ADA has developed a straight-forward guideline for Understanding Mask Types and the CDC has developed a resource specific to Understanding the Difference between a surgical mask and an N95 respirator. Now, when you’re asked, you will know the fast facts to reassure your patients their safety is your priority.
  • Dental practices can sign up to have their N95 masks sterilized for free at a Battelle site in connection with FEMA guidelines.
  • NIOSH has also answered a number of potential questions in “Filtering out Confusion: Frequently Asked Questions about Respiratory Protection.”
  • One of the first recommendations to convey safety is to get your team scheduled for their N95 fit tests. OSHA has a detailed video on Respirator Fit Testing requirements. (You can also read the transcript.)
    • Employers must ensure fit testing and record-keeping requirements of OSHA’s respiratory protection standard are met before staff can use an N95 mask for protection against hazardous exposures at work. (Please note, if your state is not governed by OSHA regulations, check your specific state regulations to ensure compliance.) There is no OSHA guidance available for testing KN95 masks. Organizations who can complete qualitative fit tests in your area may be found through your local hospitals, fire departments, or occupational health testing facilities (such as Concentra or MobileHealth).
  • As you know, to work properly, respirators must have a tight seal. OSHA’s video on “How to Perform a User Seal Check with an N95 Respirator” details how to don and doff a respirator, how to perform a seal check, and the importance of following the manufacturer guidelines.
  • NIOSH also created a resource page with Respiratory Protection Infographics with quick reads for topics like “Facial Hairstyles and Filtering Facepiece Respirators.”

Counterfeit Respirators

Keep an eye out for Counterfeit Respirators and Misrepresentation of NIOSH-Approval, as detailed by the CDC. We’re seeing a number of products are being falsely marketed and sold. Learn more on the CDC’s Healthcare Respiratory Protection Resources.

 

PPE Reimbursement

The safety of your team, patients, and yourself is at the forefront right now. With that concern comes the added costs of those now necessary PPE safety measures. The ADA is currently advocating for additional PPE Reimbursement under the code D1999. Below are a handful of the takeaways.

  1. May not be paid by insurance – and you’ll need to inform the patient prior to treatment
  2. Delta of CT/NJ are paying $10 per patient, for a 2-month period only
  3. These additions will need to be added to chart note templates
  4. Calculate cost based on added PPE fees
  5. ADA asking carriers to reimburse for a limited time, and if they are going to deny, don’t disallow or bundle, so patient can be charged (sample letter to managed care provider)
  6. Historically, the ADA has not agreed with charging for PPE
  7. Out-of-network – charge out the fee
  8. In-network – historically they disallow (can’t charge patient)

So, can I pass on a PPE fee to patients when I am in-network?
It depends on the contract terms with each carrier. Some carriers consider your PPE fees to be a part of the procedure and will not allow you to bill separately. This process is called “bundling.” When this occurs, the dental insurance company will consider your request either disallowed or non-covered. If the fee is disallowed by the carrier, you cannot balance bill the patient. If the fee is non-covered, you must follow the non-covered benefit laws in your state, but can most likely bill the patient. Non-covered benefit laws prohibit dental insurers from interfering when a contracted dentist agrees to provide a non-covered service to a patient, when the patient understands it is not covered by their dental plan. Currently 36 states have non-covered benefit laws. If you are not in-network as a contracted provider, you may bill the patient a PPE fee. (See the sample patient letter regarding the billing code and PPE fee.)

 

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