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Volume 3 Issue 5
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CDA
at
W
ork
In the “olden days” my front office procedures
for submitting dental claims for patients were
complicated. Every insurance company had
its own forms that were completed by the
patient and then mailed by the dental office.
The carrier processed the form by transferring
the codes from the claim to the adjudication
engine. Eventually a cheque was mailed to the
patient or the office, along with a printout of
all the patient’s transactions for that month.
The process consumed significant staff time
and was a liability because of the potential for
errors and delays. My office had to keep hun-
dreds of claim forms or pay to print forms that
more than one insurance carrier would accept.
To try and fix this mess, a CDA committee
was formed. With the insurance carriers, the
committee solved two major problems: (1)
they eliminated the problem of too many
forms by creating the Standard Dental Claim
Form, and (2) they ended the dependence on
“snail mail” by creating CDAnet, which defined
the standards and protocols for sending
claims electronically to the insurance carri-
ers. Dental software vendors implemented
CDAnet standards to allow the creation of an
electronic equivalent to the paper claim form.
The practice management system could now
accept patient information, dental procedure
codes and fees. Now, a completed claim form
could be sent electronically to the insurance
carrier, where the information fed directly
into their system and facilitated payment. To
imagine the impact of this improved process,
try taking a patient treatment record and then
manually fill in a paper claim form!
The claims process has evolved as technology
evolves. Twelve years ago, CDA introduced
ITRANS to allow dentists to send CDAnet
claims securely over the Internet; until then,
modems and phone lines were the only way
to transmit claims electronically. Two years
ago, the dental benefit industry began a
new communication protocol that allows for
transmission of claims on the Internet without
going through ITRANS. The software that
implements this protocol is called CCD-WS
and is now included in a number of practice
management software packages. Is ITRANS
still needed? In my opinion—YES! It offers
services to dentists that CCD-WS cannot,
including the ability to send claims to ALL
carriers and support from a reliable Help Desk.
ITRANS is supported by all software vendors
and I know that I would insist that ITRANS be
the primary protocol on my practice manage-
ment program.
Now, compare this to the U.S., where the lack
of standardization has resulted in individual
carriers adopting their own solutions, creating
a tangle of procedures that are difficult to
manage for dental practices. Offices must use
clearinghouses to send their claims at costs
that vary between $0.50 and $1.25 per claim,
depending on the services selected. The most
recent statistics show that roughly 30 million
dental claims are sent annually in Canada. At
$0.50 a claim, that’s a savings of $15 million for
dentists each year. One of the biggest reasons
to thank CDA every day is the fact that we use
CDAnet and ITRANS
free of charge as a CDA
member benefit
.
You can see that these old guys who didn’t
have an iPad or Cerec machine were still
pretty sharp, and we should be very thankful
that they, and CDA, took the chances they
did 25 years ago. They’ve saved us hundreds
of millions of dollars over the years, so if you
happen to meet some of these visionaries,
shake their hand.
a
From my perspective
CDANET AND ITRANS ARE
BENEFITS EXTRAORDINAIRE!
Dr. Brian Barrett
Dr. Barrett is
executive director
of the Dental
Association of
Prince Edward
Island.
I attended the 2016
CDA Annual General
Meeting (AGM)
in April, where the
25th anniversary of
CDAnet was celebrated.
Attendees recognized
the efforts of dentists and
other folks who worked
diligently to create
CDAnet, despite the
doubts of a lot of skeptics.
CDAnet was created to
allow dental offices to send
dental claims seamlessly to
third parties. The AGM
chairman remarked that
those younger than
age 50 would be
unaware of the reason
for this CDA member
benefit. Since I was there
when it all happened,
here are my perspectives
on life before CDAnet.
The most recent statistics show that roughly 30 million
dental claims are sent annually in Canada. At $0.50 a
claim, that’s a savings of $15 million for dentists each year.