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ADA studies scanning

Paper claim filers may benefit from sending scanned, printed radiographic images

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."

Printed images of scanned periapical, panorex and full-mouth films may produce acceptable images for claims adjudication 90 percent of the time, ADA council members determined.

The ADA councils contacted four major payer groups, representing the majority of dental benefit plans, to learn if such printed images would be acceptable for benefits determination.

Delta Dental Plans Association members told the councils that printed images from scanned radiographs would be adequate for initial claim review. American Health Insurance Plans said the process "is nothing really new," and some 50 percent of radiographs already arrive from dental offices as paper prints of scanned radiographs.

"The usefulness of the image is proportionate to the original quality," the AHIP response included. Both payers said electronic files of images are preferred and original radiographs would be requested if the submitted scan was not adequate to determine benefits. (Blue Cross Blue Shield Association and the National Association of Dental Plans did not respond.)

Standard images, including single periapical films, panorex films and full-mouth films were scanned on four different scanners priced between $99 and $299. Scanners were equipped with standard requirements, including:

  • the ability to scan 35 mm slides or negatives and transparencies;
  • flatbed design;
  • connectivity via USB ports;
  • 48 bit color/16 bit grey scale bit depth;
  • a minimum 3200 X 9600 dpi (dots per inch) scanning resolution.