Frequently Asked Questions

Find answers to commonly asked questions about our dental plans. If you can’t find the answer to your question here, please contact our Customer Service team at (808) 529-9248 or call toll-free at 1-844-379-4325.

Category

What is teledentistry?

Teledentistry is a general term for any virtual dental visit that is not a specific service, but refers to a variety of technologies and tactics to provide dental care remotely. Members typically connect with their dentist over the phone or through video chat applications like Zoom, Facetime, Skype, etc. Your dentist may ask you to email or text a picture of the outside and the inside of your mouth as part of your exam.

 
Your regular dentist may offer services using teledentistry technologies to provide remote dental care. It’s best to contact your dentist directly to find out if this option is offered and to answer any billing questions you may have.

 
If you do not have a regular dentist, are experiencing an emergency after hours, or are travelling outside of Hawaii, HDS offers virtual dental visits via Teledentistry.com. To initiate a virtual visit using Teledentistry.com, HDS members can click a link on the HDS website or by calling 1-866-302-0114 to access remote dental care.

What equipment or devices do I need for a teledentistry call?

You may need a smartphone, tablet, or a computer with a camera and Internet connection. Sometimes your dentist may request for you to take a picture, email or text it to them, and then discuss it over the phone.

What dental procedure code will my dentist use to bill for teledentistry?

Both your personal dentist and Teledentistry.com are familiar with how to bill for teledentistry. Depending on your plan, your dental benefits would apply to the exam itself, with no additional charges for teledentistry – procedure code D0140 will be used for billing regardless of how you access teledentistry services.

Does my HDS plan offer teledentistry for virtual dental visits?

Yes, HDS offers teledentistry for HDS members, whether you receive a virtual dental visit directly from your dentist or through the Teledentistry.com service.

However, Teledentistry.com is currently not available to Medicaid and Medicare beneficiaries.

Is this virtual visit with Teledentistry.com covered under my dental plan?

Plans typically cover one (1) exam per 12 months for problem focused exams, with or without teledentistry. Please refer to your dental plan for details, consult with your dentist, or contact Teledentistry.com.

How does Teledentistry.com work?

Simply call 1-866-302-0114 to access remote care and schedule a virtual visit with Teledentistry.com. You’ll be asked for some required information and will be connected to a dentist via videoconference within minutes.

How long does Teledentistry.com take to connect to a dentist?

You will be connected to a Teledentistry.com dentist within 6-8 minutes of launching a request for a virtual visit.

How long does an average visit with Teledentistry.com take once I’m connected with a dentist?

An average consultation time with the Teledentistry.com dentist is 3-5 minutes.

What types of services are normally performed via Teledentistry.com?

Most virtual visits offer an evaluation or consultation on tooth pain due to cavities, gum disease, impacted wisdom teeth, or trauma from a chipped or broken tooth.

How do I initiate a virtual visit using Teledentistry.com?

A virtual visit can be initiated by calling 1-866-302-0114 or by accessing the Teledentistry.com link on our HawaiiDentalService.com website. Follow all instructions on screen and you will then be connected to a remote dentist via videoconference.

Does the Teledentistry.com virtual visit count toward my annual benefit max?

Yes, the cost of the virtual visit will count toward your annual benefit maximum.

Can my covered dependents use Teledentistry.com?

Yes, dependents are eligible to use the service.

Do I need to be present online if my covered dependent is under age 18?

Yes, the same guidelines apply to virtual visits as when going to a traditional visit in a dentist’s office.

Will I get an Explanation of Benefits (EOB)?

EOBs are available online by visiting HawaiiDentalService.com and registering for or logging into your HDS online member account or you can contact the HDS Customer Service team to request a copy.

If I use Teledentistry.com, what will it cost?

The virtual visit will be covered by your HDS dental plan one (1) time during a 12-month period. Additional visits during the same 12-month period are billed directly to you and can be paid via credit card – the cost is $50.00 per consultation from Teledentistry.com.

Can Teledentistry.com prescribe medication?

Yes, appropriate medication can be prescribed. However, no opioids, controlled substances or other narcotics will be prescribed.

Does my HDS plan cover prescription medication prescribed via Teledentistry.com?

No, prescription medications are not a benefit under HDS plans.

If I don’t have a dentist today, will Teledentistry.com help me find a dentist for follow-up care?

Yes. If you need follow-up care, Teledentistry.com can help you find an in-network HDS dentist.

If I have a dentist, will Teledentistry.com send them a copy of the virtual visit information?

Yes, if you supply your dentist’s name and contact information, a report regarding the virtual visit will be sent to them.

I’m having a problem with the Teledentistry.com website during my virtual visit; who do I call for help?

If you have a problem initiating connectivity or lose connectivity during your Teledentistry.com call, simply call back 1-866-302-0114.  You will not be charged for the virtual visit until the consultation is completed and services have been rendered.

How do I comment on the Teledentistry.com service provided?

A survey will be sent after the virtual visit or you can call 1-866-302-0114 to provide feedback.

Are virtual visits via Teledentistry.com available in other languages?

Yes, a translator can be available for almost any language.

Teledentistry-Members

What is DentaQual®?

HDS has partnered with P&R Dental Strategies, utilizing their DentaQual® system to provide quality ratings of our participating dentists, based on an objective statistical analysis of their fee-for-service dental claims data in relation to their peers within the same dental specialty and geographic area (defined by three-digit zip codes). DentaQual® measures quality based on multiple metrics scored within five categories, which result in an overall DentalQual® score for each dentist:
 

  • Commitment to best practices
  • Treatment outcomes
  • Treatment recommendations
  • Patient retention
  • Cost-effectiveness


Ratings are listed for most of HDS participating dentists in our "Find a Dentist" tool on our website.

Does DentaQual® include member reviews?

The DentalQual® ratings system does not include member reviews. The DentaQual® ratings system was developed to deliver a dental claims-based and statistical approach to dentist ratings. DentaQual® provides an objective score using treatment data only.

How can I see the DentaQual® rating for my dentist?

By using the HDS "Find a Dentist" tool, DentaQual® ratings (using a 5-star rating scale) can be found on the right bottom corner of the dentist's profile listing, next to HDS's Member Ratings of that dentist. Clicking on the DentaQual® rating graphic will show a detailed explanation of that dentist's rating. Note that not all dentists will have a member rating and/or a DentaQual® rating listed.

What can I do if I am not satisfied with a dentist’s service?

If an HDS member is not satisfied with a service performed by an HDS participating dentist, we recommend that the member contact the dentist and explain the reason for dissatisfaction. If the member does not want to speak with the dentist, we suggest that the member write a letter to the dentist and provide a copy to HDS. If the dentist’s response is not satisfactory, the member can request that HDS follow up and attempt to resolve the matter. The member may also file a complaint with the Hawaii State Department of Commerce & Consumer Affairs' RICO Consumer Resource Center by calling (808) 586-2653.

Can I see a dentist on the Mainland and still be covered by my HDS plan?

Yes, whether it’s an emergency or regular visit, your HDS plan covers you while on the Mainland as long as you receive services from a Delta Dental participating dentist. To find a Delta Dental participating dentist near you, click here, select “Delta Dental Premier” as your dental plan and search for a dentist.

 

Be sure to present your HDS/Delta Dental membership card on your first visit to the dentist. You can print your membership card from the HDS website. Log in at the top left of this page and go to “Members,” then “Membership Card.”

Why should I choose an HDS participating dentist?

There are three reasons why we encourage our members to seek dental services from an HDS participating dentist. More than 95 percent of all licensed, practicing dentists in Hawaii participate with HDS. To find a participating dentist, click here.

 

Save Money

HDS participating dentists have agreed to accept a discounted rate (eligible fee) as payment in full for services to our members unlike a non-participating dentist who can charge you any amount. See example below.

 


FOR EXAMPLE PURPOSES ONLY

Retail Amount for Services

HDS Participating Discounted/ Eligible Fee

Non-
Participating
Eligible Fee

HDS Benefit

HDS Pays

Member Owes

Participating
Dentist

150.00

100.00

 

80%

80.00

 $20
($100-80) 

Non-
Participating
Dentist

150.00

 

75.00

80%

60.00

 $90
($150-60) 

 

Participating dentists agree to processing policies and are prohibited from billing and collecting fees in excess of the agreed upon schedule even in the event you exceed your annual plan maximum. Non-participating dentists will continue to charge the full retail rate. You may visit any dentist, but visiting a participating dentist offers you additional savings. 

 

Pay Copayment Only

Because HDS pays the participating dentist directly, the dentist will only bill you for the difference between the eligible fee and the amount HDS is expected to pay. A non-participating dentist may require that you pay the retail amount of all services in advance.  

 

HDS Credentials Participating Dentists

HDS credentials all participating dentists and has an ongoing audit program for fraud and abuse. None of these controls apply to non-participating dentists.
 

HDS Dentist Network

As an individual plan member, what is a grace period and what happens to my claims during this period?

You are required to pay your premium by the scheduled due date. For each premium payment after your initial premium payment, a grace period will apply. A grace period is a time period when your plan will not terminate even though you did not pay your premium. HDS provides a general 30-day grace period before your coverage will be canceled. If you receive federal Advance Premium Tax Credits for the dental plan through HealthCare.gov, you have a 90-day grace period before HDS terminates your plan due to non-payment. HDS will pay claims for covered services that are properly submitted during the first 30 days of that grace period. During the unpaid 31st through 90th day of the grace period, HDS will not pay for any claims that you incur. If you pay your full outstanding premium before the end of the 90-day grace period, HDS will pay all claims for covered services that are properly submitted for the 31st through 90th day of the grace period. Claims may be resubmitted by the dentist and will be reprocessed according to the enrollment status provided that it is received no later than 12 months from the date of service. If you do not pay all of your outstanding premium by the end of the 90-day grace period, your coverage will terminate, and HDS will not pay for any claims submitted for you during the 31st through 90th days of the grace period. Your provider may balance bill you for those services.

Will HDS call me for payment or other financial information?

HDS will never contact you to request personal or financial information over the phone or text. HDS will however return member calls, emails, and inquiries and may request for the member to update or submit new financial or payment information through formal channels, i.e. by filling out an HDS bank account, ACH or other payment form, or by following payment guidance via our public website and/or member portals. If you receive an unsolicited call or text from an individual claiming to be with Hawaii Dental Service, do not respond. If you know of, or suspect fraud, unethical or improper conduct, you can anonymously report any concerns by contacting the HDS Ethics and Compliance Hotline toll free at 1-866-505-9227 or submit a report online at: hawaiidentalservice.ethicspoint.com

Billing and Payment

Why do I have to pay more for white fillings on my back teeth?

HDS plans cover white (composite) fillings on the front teeth and silver (amalgam) fillings on the back teeth. If you and your dentist determine that white fillings are preferable on your back teeth, HDS will allow you to use the amount HDS would have paid for a silver filling towards the amount your dentist charges for a white filling. You will have to pay the difference between your dentist’s retail charge for the white filling and the amount paid by HDS for a silver filling.

I just changed from one HDS plan to another. Why do I have a wait period with my new plan?

Each employer determines the parameters of the dental benefit plan offered to its employees. In some cases, in order to reduce the cost of the plan, an employer group elects to have a wait period before certain major services are benefited. However, no wait periods apply to diagnostic and preventive services such as cleanings, exams, fluoride treatments and X-rays.

Due to the current COVID-19 pandemic, do I have to pay for the cost of additional PPE or protective gear used at my dental visit?

Hawaii Dental Service's policy is that separate fees for infection control and OSHA compliance (i.e. costs for additional personal protective equipment) used during a patient's visit, are not billable to HDS members.

What is a plan maximum?

The plan maximum is the total amount that HDS will pay for a member’s dental services during a specified period. Normally, a plan maximum follows a 12-month calendar year from January to December, but the plan maximum period can begin in any month and some plan maximum periods are shorter or longer than 12 months.

How is tax calculated on my dental services?

Your dentist calculates the tax on dental services. Tax is not an HDS plan benefit. Please discuss the calculation of taxes with your dentist.

Are silver fillings (amalgam) dangerous to my health?

HDS is aware that the issue of dental amalgam has been in the news due to publicity surrounding groups concerned about risks associated with exposure to mercury. The American Dental Association states that dental amalgam remains a safe, affordable and durable cavity filling choice for patients. HDS members who are concerned about the safety of amalgam should consult with their dentist.

Why does the dentist do a procedure if it is not a covered benefit?

HDS dental benefit plans include coverage for designated benefits as specified in the dental contract or brochure. Other services may be necessary and recommended by your dentist. The fact that the services are not covered by HDS does not indicate that they are not clinically necessary.

Are at home invisible aligners or do-it-yourself (DIY) orthodontic treatment systems covered by HDS?

While these alternatives may seem like a quick, convenient, and cost-effective way to straighten your teeth, re-aligning your teeth is a complex and dynamic process that changes your bone and gum structure in your mouth. If not done correctly by a trained professional in designing, executing and overseeing your teeth straightening process that often takes several months and in most cases years, problems may occur down the road. For these reasons, to help protect you and your family from unforeseen consequences, orthodontic DIY treatments are not a covered benefit.

Does HDS require prior authorization for any covered dental services?

HDS does not require prior authorization for any covered dental services. If you are concerned about coverage or the cost of a service, you may submit a request for a preauthorization to obtain coverage information and an estimated benefit amount.

What is an Explanation of Benefits (EOB) Statement?

HDS provides its members with Explanation of Benefits (EOB) statements which summarize the services you received from your dentist and lists payment information.

EOBs are available electronically and are accessible through your HDS website account. If you choose to receive EOBs through the mail, you will not receive an EOB for services with no patient share or when only tax is due.

It is important to note that the EOB statement is not a bill. Depending on your dentist's practice, your dentist may bill you directly or collect any portion not covered by your plan at the time of service.

Benefits

HDS Know Your Benefits Series

HDS Snackable Video Alternative Benefits

HDS Snackable Video Waiting Periods

HDS Snackable Video The Power of Preventive Care

HDS Snackable Video Preauthorizations

HDS Snackable Video Diagnostic & Preventive Waiver