ADA Insurance form 2012 - anything newer?

[richf]

Is there a newer version of the ADA insurance form than 2012 that we should be using ?

[Anon]

I think this is the latest but @ayman should be able to confirm.

[mdunham]

There is a 2019 ADA Dental Claim form.  This claim form is noted on the bottom that the J430 (2019 claim form) is the same as J431.432.433.434 and 430D 

https://www.ada.org/~/media/ADA/Publications/Files/2019ADADentalClaim%20Form_2019May.pdf?la=en

[Anon]

Correct, currently the 2012 ADA form is the current insurance form in SoftDent. The 2019 ADA form will be available soon.  

[pksaari79]

How will the 2019 be integrated in the system?  Will we have to do an update or that feature can be updated in a current version we are using??

Kay

[Anon]

Hello Kay, 

You can be on any version of SoftDent and get the current ADA form once it is available.   I did check with SoftDent support about the 2019 ADA form, the estimated release date is January 2020.

The 2012 ADA form is current, I reached out to the ADA and asked if the 2019 form was mandatory for the carriers to use, her response was "we encourage insurance companies to start using the new forms now, but we can not require them to do so".

Wendy 🙂

[pksaari79]

As is with so many things.....insurance will probably drag it's heels, yet we are to be accountable for codes and such.  Sigh.....

Thanks!!

Kay

[pksaari79]

Wendy....based on your response about insurance carriers not using the new form once we get it updated.  Does that mean claims will be denied if they don't use/recognize the form?

[Anon]

no, they will not be denied because it is not mandatory

[richf]

Thank you!

[cromfs]

There's now a 2019 form.  WinOMS needs to update with it.  Here's the info from 5Lakes:

ADA Dental Claim Form As many of you are aware, a 2019 version of the ADA claim form was released this year. The ADA Dental Claim Form was last structurally revised in 2012 to incorporate key data content changes that enables diagnosis code reporting that was also incorporated into the now current version of the HIPAA standard (837D v5010) electronic dental claim. This version of the ADA form incorporates editorial changes to further its consistency with the 837D.

[cromfs]

[cromfs]

https://support.fivelakespro.com/hc/en-us/articles/204139809

[richf]

Thank you 🙂

[pksaari79]

In what version of Softdent can this new version be downloaded?  When do you have to start using the 2019 version - is there a mandatory start date?  Do new versions, like !8, have that part of the install??

Kay Saari

[danelle_canales]

The 2019 claim form is coming but it isn't being widely released until October.  There isn't a push to start using it quite yet.  Our developers are building them into each program as we speak at it will be available by the time you need it.  

[bausdental]

There is information on the claim form that are not available for edit on the SoftDent claim screen, such as Missing Teeth Information; Diagnosis Codes; and there is a lack of space for writing remarks.  Is this something SoftDent is working on updating?  Such as for bridgework claims, the Missing Teeth Information is necessary.  We are having to submit these via paper, which is very frustrating.  Is there anything in the works for this?

[danelle_canales]

@bausdental, there is a way to enter diagnosis codes.  Not sure if the instructions are in the help files, but a trainer can help instruct you on this. 

Regarding remarks - can you give me an example of something you need to say that doesn't fit?  Box 35 on the claim form is small, so there isn't a lot of room for remarks, but if we are limiting too much then we should mark it as a requested enhancement.  

I agree being able to mark missing teeth would be very helpful and have tagged our product line manager in this post.  

[danelle_canales]

@Anon - is this on our road map?

[ayman · Accepted solution]

Yes , the last ADA form we have is 2012