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Important for Medicare Advantage Providers only: Fraud, Waste and Abuse Training

Completion of this training by the end of each calendar year meets the Centers for Medicare & Medicaid Services (CMS) requirement for organizations providing services to Medicare Advantage (MA) enrollees. It also meets your contractual obligation with Delta Dental.

Note: If you have already completed FWA training that was offered by another Medicare Advantage Organization, you do not need to complete our training. However, we do require you to complete the attestation form.

Please click here http://deltadentalins.com/medicare-fwa to access FWA training or to complete the attestation form.

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Policy Explanation Codes

You will notice new Policy Explanation Codes (PECs) are being used on the newly designed documents such as the Notice of Payment and Pre-determination. These codes explain why a procedure was denied, disallowed, or modified, and will replace the Adjudication Reason Codes previously used on State Government Programs (SGP) documents. For your convenience, we have provided a complete list for your viewing and/or downloading needs.

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