are filing dental claim forms on the correct form.
Although HIPPA has required a standardized format for electronic claims, there has not been any such requirement with paper claims. The ADA estimates that forty-nine percent of dental claims are still submitted on paper. When these paper claims are processed at the insurance companies, the claims are quite often converted to an electronic format. There are, at present, close to fifty different dental claim formats, so the problems develop when the format of the paper claim does not match the format of their electronic claim. Claim processors have to spend extra time searching for the required data with the many formats that they receive. The result is that extra time and costs are created for the insurance carrier with the resultant delays in the receipt of benefits by the dental practice.
There are several situations in dental practices that may be contributing to this problem and they are as follows:
- When was the last time that your practice updated its practice management system? If it has not been updated since the beginning of 2006, your insurance claim will not be the current ADA claim form. If you are unsure if your practice management software is using the current ADA claim form, you should contact the software company to inquire. If it is determined that you are not using the current claim form, they can lead you through the updating process.
- Practices that still file on their own paper claim forms may have built up a stockpile of forms which may be outdated. You will need to check the form type at the lower left corner of the claim form to make sure that it reads ©2006 American Dental Association. Using those older forms may appear to be a cost saving idea but it actually is costing the practice due to the delays that it causes
- Certain patients may provide employer specific claim forms. You will need to explain to the patient that the insurance companies will accept the standard claim form and that submitting a non-standard form such as theirs will only delay payment.
The answer to these situations is easy. Converting your insurance processing system to electronic submission is the best method to seamlessly handle your claims filing. Yes, there is a cost to electronic claim filing but there are many hidden costs to paper filing in the form of paper, ink, postage, and extra staff time that are eliminated with electronic filing. In addition, electronic claim filing reduces the chance for errors which eliminates the additional delays caused by those errors. If your practice will continue to file on paper, simply make sure that you are using the correct claim form.