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Administrative Efficiency Summit seeks solutions to help dentists prioritize patients over paperwork

August 27, 2018

By David Burger

Photo of Dr. Snyder and Bulnes at the Efficiencies Summit
Leadership: Dr. Steven Snyder, left, and Dr. Christopher Bulnes listen to a presentation on the latest CAQH Index report during the Administrative Efficiencies Summit on Aug. 17 at ADA Headquarters. Dr. Snyder is chair of the ADA Council on Dental Benefit Programs, while Dr. Bulnes is the vice chair.
Administrative burden and paperwork is ever-increasing and the ADA is working to help members navigate these changing times.

"The council is sensitive to offices needing to hire full-time staff to simply be on the phone with the insurance carrier to get information for each patient," said Dr. Steven Snyder, chair of the ADA Council on Dental Benefit Programs. "In this day and age of reducing reimbursement rates, we are seeking ways to help dental offices become more efficient."

Dr. Synder recognized the problem. "This needs to be solved," he said.

In this vein, the first-of-its-kind Administrative Efficiencies Summit brought together ADA member dentists with other stakeholders in the dental benefits landscape whose activities and products affect the administrative costs of a dental practice. The goal was to bring practical solutions to existing inefficiencies.

The ADA Council on Dental Benefit Programs and the ADA Practice Institute's Center for Dental Benefits, Coding and Quality convened the one-day summit on Aug. 17 to help smooth the adoption of automated and standard electronic transactions to deal with dental benefit plans.

Dr. Brett Kessler, a member of the Council on Dental Benefit Programs, acknowledged the collaborative spirit of the meeting. "We addressed gaps in communication and made it apparent that everyone can play in the sandbox together," he said.

More than 30 attendees came together in the same room to find solutions and included representatives from varied sectors of the dental community, including dentists, dental benefit plans, dental practice management system vendors, clearinghouses and financial institutions.

Besides identifying ways to help dentists, the summit focused on patients and their experiences with dental plans and benefits so that dentists can spend more time providing care. "The bottom line is caring for the patient," said Dr. Craig Ratner, chair of the Council on Dental Practice. "That is the most important to me."

The group discussed seven topics after a presentation on the CAQH Index report, which tracks the progress in the shift from manual (e.g., phone, fax or mail) to electronic business transactions between heath plans and providers. The seven topics — patient eligibility and benefits verification; pre-determination; claim submission; reimbursement; reconciling account receivables; coordinating benefits; and dentist credentialing — acknowledged obstacles that kept dentists from easing into electronic transactions and ways in which they can be overcome.

The basis of discussions was the situation descriptions as described to the ADA by members. Each described the current situation faced by the dentist and the potential ideal state that could be achieved when a practice is able to implement a consistent and automated solution. These descriptions were, in essence, gap analyses with recommendations on possible solutions that to achieve require collaborative actions.

The members of the summit, led by Dr. Steven Snyder, were consistent in their beliefs that this meeting shouldn't be one-and-done.

According to the Council of Affordable Quality Healthcare — better known by its acronym CAQH — full adoption of electronic processes for the transactions could save the dental industry nearly $2 billion in direct costs each year, with most of these savings accrued to provider offices.

There were four immediate action areas identified and responsible persons or entities were identified at the meeting and initial findings, conclusions and recommendations are due in November. Feedback will be reviewed with the Center for Dental Benefits, Coding and Quality and be used for planning and scheduling additional next steps.

"We are pushing out more education through webinars and online material and encourage members and their office staff to learn more about these solutions as we develop them," said Dr. Chris Bulnes, vice chair of the Council on Dental Benefit Programs.

"This meeting is a good example of how the ADA works for its members," said Dr. Mary Lee Conicella, ADA member and Aetna chief dental officer who represented the National Association of Dental Plans.

"I don't think it could have gone any better," said Dr. Snyder.

The council wants to continue to hear from members about the burdens they face in their offices. Office managers can too highlight problems that the council needs to address within the industry. Dentists and their staff are encouraged to send their thoughts to dentalbenefits@ada.org.