15
Volume3 Issue5
|
CDA
at
W
ork
In the “oldendays”my front officeprocedures
for submittingdental claims for patientswere
complicated. Every insurancecompanyhad
itsown forms thatwerecompletedby the
patient and thenmailedby thedental office.
Thecarrier processed the formby transferring
thecodes from theclaim to theadjudication
engine. Eventuallyachequewasmailed to the
patient or theoffice, alongwithaprintout of
all thepatient’s transactions for thatmonth.
Theprocess consumed significant staff time
andwas a liabilitybecauseof thepotential for
errors anddelays.Myofficehad to keephun-
dredsof claim formsor pay toprint forms that
more thanone insurancecarrierwouldaccept.
To tryandfix thismess, aCDAcommittee
was formed.With the insurancecarriers, the
committee solved twomajor problems: (1)
theyeliminated theproblemof toomany
formsbycreating theStandardDental Claim
Form, and (2) theyended thedependenceon
“snailmail” bycreatingCDAnet,whichdefined
the standards andprotocols for sending
claims electronically to the insurancecarri-
ers. Dental softwarevendors implemented
CDAnet standards toallow thecreationof an
electronicequivalent to thepaper claim form.
Thepracticemanagement systemcouldnow
accept patient information, dental procedure
codes and fees. Now, acompletedclaim form
couldbe sent electronically to the insurance
carrier,where the information feddirectly
into their systemand facilitatedpayment. To
imagine the impact of this improvedprocess,
try takingapatient treatment recordand then
manuallyfill inapaper claim form!
Theclaimsprocesshas evolvedas technology
evolves. Twelveyears ago, CDA introduced
ITRANS toallowdentists to sendCDAnet
claims securelyover the Internet; until then,
modems andphone lineswere theonlyway
to transmit claims electronically. Twoyears
ago, thedental benefit industrybegana
newcommunicationprotocol that allows for
transmissionof claimson the Internetwithout
going through ITRANS. The software that
implements thisprotocol is calledCCD-WS
and isnow included inanumber of practice
management softwarepackages. Is ITRANS
still needed? Inmyopinion—YES! It offers
services todentists thatCCD-WScannot,
including theability to sendclaims toALL
carriers and support froma reliableHelpDesk.
ITRANS is supportedbyall softwarevendors
and I know that Iwould insist that ITRANSbe
theprimaryprotocol onmypracticemanage-
ment program.
Now, compare this to theU.S.,where the lack
of standardizationhas resulted in individual
carriers adopting their own solutions, creating
a tangleof procedures that aredifficult to
manage for dental practices. Officesmust use
clearinghouses to send their claims at costs
that varybetween$0.50and$1.25per claim,
dependingon the services selected. Themost
recent statistics show that roughly30million
dental claims are sent annually inCanada. At
$0.50aclaim, that’s a savingsof $15million for
dentists eachyear. Oneof thebiggest reasons
to thankCDAeveryday is the fact thatweuse
CDAnet and ITRANS
freeof chargeasaCDA
memberbenefit
.
Youcan see that theseoldguyswhodidn’t
havean iPador Cerecmachinewere still
pretty sharp, andwe shouldbevery thankful
that they, andCDA, took thechances they
did25years ago. They’ve savedushundreds
ofmillionsof dollarsover theyears, so if you
happen tomeet someof thesevisionaries,
shake their hand.
a
Frommy perspective
CDANETAND ITRANSARE
BENEFITS EXTRAORDINAIRE!
Dr.BrianBarrett
Dr. Barrett is
executive director
of theDental
Association of
PrinceEdward
Island.
Iattended the2016
CDAAnnualGeneral
Meeting (AGM)
inApril,where the
25thanniversaryof
CDAnetwas celebrated.
Attendees recognized
the efforts of dentists and
other folkswhoworked
diligently to create
CDAnet, despite the
doubts of a lot of skeptics.
CDAnetwas created to
allowdental offices to send
dental claims seamlessly to
thirdparties.TheAGM
chairman remarked that
those younger than
age 50wouldbe
unaware of the reason
for thisCDAmember
benefit. Since Iwas there
when it all happened,
here aremy perspectives
on life beforeCDAnet.
Themost recent statistics show that roughly30million
dental claims are sent annually inCanada.At $0.50a
claim, that’s a savings of $15million fordentists each year.
