ADA News

Dental claims denials were among the most frequent concerns ADA members complained about to the ADA during 2005. This series of ADA News articles examines dentists' "Top 10" concerns submitted to the ADA about their dental claims.

These articles include perspectives from ADA members, National Association of Dental Plan members and the Council on Dental Benefit Programs on specific issues such as bundling, processing delays, lost attachments, overpayment requests, post utilization review, provider contract issues and more.

Part 1:

• D4341, D4342 coding for periodontal scaling and root planing (SRP), per quadrant or partial quadrant
• D4910 coding for periodontal maintenance

Part 2:

• D2950 core buildup, including any pins
• Pre-authorizations

Part 3:

• Claims processing delays

Part 4:

• Claims payment concerns

Part 5:

• Bundling and downcoding

Part 6:

• Least expensive alternative treatment clause

• Overpayment/refund requests

Part 8:

• Coordination of benefits

Part 9:

• Provider contract issues

Part 10:

• Assignment of benefits to participating dentists only

Part 11:

• Post-utilization review

Part 12:

• Single claim form

Part 13:

• Education of dental office staff