Thursday, November 20, 2008

American Dental Association Studies Scanning Conventional X-Ray Films for Insurance Claim Submission


Digital Dental Radiograph (X-ray)

The American Dental Assocaition is trying to help the dentist who does not have the ability to digitally submit dental radiographs for dental insurance claim submission.

Althought the ADA is urging industry standardization on radiograph requirement and return policies, third-party payers continue to use different criteria to determine when images are needed to support claims adjudication, and if and how those radiographs will be returned to dentists.

Dentists and their office staff report frustration in trying to keep track of varying policies.

Dentists who use digital radiography and file electronic claims can easily submit images electronically.

But for those who submit paper claims, recalling which payers require radiographs, which return them automatically and which don't without a specific request or a self-addressed envelope, can be a challenge.

That's why the ADA Councils on Dental Practice and Dental Benefit Programs studied whether scanned, printed images could be substituted to third-party payers for claims determinations.

"These scans would not have to be returned by the payer and would give offices that submit paper claims an option for radiograph submission," said Dr. Jeffrey Sameroff, CDP member. "We still recommend dentists file electronic claims, but this option might be the next best thing for dentists who still submit on paper."
The dental insurance company folks told dentists many years ago that the submission of dental radiograph requirements for payment of insurance claims would decrease as computerization of the field increased.

Guess not. And, then, there are some dentists who are still in the Stone Age and submit paper claims. But, since there has been no standardization in the profession who can blame them?

The images derived from scanning a conventional x-ray film and then printing them on plain paper are virtually worthless from a dental diagnostic perspective but probably good enough for a dental insurance company who probably doesn't give a damn anyway. All they want to do is place barriers to speedy payment of claims.

Does Flap sound cynical?

Good luck to the ADA on this matter but once consensus is reached on this radiograph submission issue the insurance companies will come up with another requirement to keep their money longer.

bitewing illustrated dental xray

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