Important News— The ADA announces new Dental Claim Form in 2024
Important News— The ADA announces new Dental Claim Form in 2024
Estela Vargas, CRDH, CEO Remote Sourcing
The American Dental Association(ADA) has announced that as of January 1, 2024, a new dental claim form will be available to submit claims to dental payers. Will dental payers still accept the 2019 claim? In most instances, the answer is yes. However, using the most current form is wiser to guarantee acceptance from all payers. Updating your dental software after January 1, 2024, should update the claim form also. Check with your dental software provider for verification.
Why did the ADA change the claim form? The ADA makes changes to improve reporting of services rendered to patients after reviewing many requests from dental providers. After reviewing it, I concur that the additions will improve claim filing for dental personnel and billers.
The sixteen pages covering the 2024 claim form explain explanations, instructions, and justification. Please take the time to familiarize yourself and your team with the additions and changes to the claim form.
Here are some key points to consider with the new form:
Please view the 2024 claim form to see the related boxes.
Box 3.a. Payer ID Completion instructions for the new field to report Other Insurance
Company/Dental Benefits Plan Payer ID.
Box 11. b. Other Payer ID
Box 39.a. Date Last SRP Completion instructions for the new field to report the date of the patient's last Scaling and Root Planing procedure (MM/DD/CCYY format).
Box 53.a. Locum Tenens Dentist Amended instructions applicable when a Locum Tenens Dentist delivers treatment
Boxes 54 55 56a 57 58 National Provider Identifier License Number Provider Specialty
Code Phone Number Additional Provider ID Correction to Provider Specialty Code list (for Oral and Maxillofacial Radiology) and instructions.
Box 56.a. Provider Specialty Code Addition
Box 28. Tooth Surface NOTE that addresses surface identification when restoration involves the anterior tooth's incisal angle (aka incisal edge).
The 2024 ADA claim form addresses a problem encountered when filing claims for services delivered by a "locum tenens" dentist -- one who is substituting for another dentist while away from the practice temporarily. Prior versions had no box on the claim to report this provider and the NPI number causing delays for more information from the dental practice.
The form also provides space for reporting other data that can expedite timely claim adjudication and reimbursement and the national identifier assigned to third-party payers, known as payer ID. The 2024 claim has a box designated to report the last scaling and root planing date of service. Including this information on the direct claim form will help adjudicate claims for periodontal services.
We at Remote Sourcing are updated daily on the changes coming to dental claim billing, adjudication, and reimbursement. We are working diligently to ensure you receive every dollar you are entitled to. Please feel free to ask any questions about the changes coming to the new claim form.
