CDA Essentials 2014 • Volume 1• Issue 5

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12 | Volume 1 Issue 5
CDA at Work
opinion, this is the wrong approach for carriers to
take. While we appreciate the willingness to make
exceptions for some dentists, we strongly disagree
with the fact that carriers assume they can dictate
how a dentist runs his or her office.
We also have to make sure that carriers don’t lose
sight of the fact that payments that are sent to
dentists as a result of an assignment are actually
payments that are owed to plan members. The
cheque is only being sent to a different address.
Sending payments to plan members at no
cost—because they’re seen as customers—while
imposing a cost to dentists for the same service is
unacceptable.
How can individual dentists help CDA
resolve this issue?
We want dentists to talk to their patients, and
make sure that patients who are covered by
problematic carriers understand the situation. We
would like to make sure that dentists don’t end up
having to increase fees to patients because carriers
are changing their own internal processes. Their
changes create additional expenses for dental
offices that can impact the cost of dental care. We
want to make sure patients understand where
those costs are coming from, who is responsible
for them, and that when time comes to renew
group plans, their employer is aware of the fact
that their plan provider has created these issues,
not dentists.
What would the ideal system look like?
The ideal system would be convenient for both
patients and dentists, follow the CDAnet model to
ensure all benefit providers do things in a similar
fashion, and be as efficient as possible so that
dentists can focus on the provision of care, not the
administration of benefit plans. a
This interviewhasbeencondensedandedited.
Previously, predetermination results
were provided to plan members only,
which can result in treatment delays.
To receive predetermination results
from Sun Life, make sure your system
is now sending requests to Sun Life
with CDAnet version 4 and submit
the predetermination request
through EDI as usual:
• For simple predetermination
requests, you will receive a
response on the spot, in most
cases.
• For requests that are pending,
Sun Life will notify you by email
when a result is available. The
details can be viewed by logging
on to Sun Life Direct, a web portal
for dentists.
To take of advantage of this service,
make sure you have changed your
software settings to CDAnet version 4
(contact your software vendor if nec-
essary) and register for Sun Life Direct.
Plan members will continue to re-
ceive the predetermination results. a
Sun Lifemakes real-time predetermination results
available to dentists
To register for Sun Life Direct,
call Sun Life at 1-855-301-4786
Dentists can now receive Sun Life predetermination results in real time when requesting estimates through EDI using
CDAnet version 4.
To listen to the full interview, visit