Q4 Word of Mouth newsletter 2024
The American Dental Association (ADA) has introduced an updated and more user-friendly version of the ADA claim form to enhance the submission and processing of dental claims. This new form aims to streamline the process, making it easier for dental practices to receive payments for their services.
Effects on your practice:
Many payers are transitioning to accept only the new form, phasing out older versions. If you submit claims on outdated forms they may not be accepted, potentially delaying payment.
- UnitedHealthcare implementation:
- UnitedHealthcare Community Plans: As of Aug. 1, 2024, these plans will only accept claims on the 2019 or newer forms. However, Mississippi, Wisconsin, Michigan and Washington, District of Columbia, will continue to accept forms from 2006/2012 or newer.
- UnitedHealthcare commercial and UnitedHealthcare® Medicare Advantage plans: These plans will continue to accept any version of the dental claim form
- Provider manuals: We’ve added the updated dental claim form requirements to the provider manuals, which are available on the Provider Portal.
Key changes to the form:
- Additional information fields: New fields have been added to capture more detailed information about the patient’s condition, treatment and services provided
- Enhanced data fields for electronic submission: The updated form includes new data fields that support electronic submission, facilitating faster claim processing
- Updated diagnosis codes: The form now accommodates ICD-10 diagnosis codes, which are required by many payers
For more details, refer to the updated provider manuals on the Provider Portal.
— This article was written by Dr. Paul J. McConnell, dental director, UnitedHealthcare