2019

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Auto-adjudication can expedite claims processing, but it can also confuse dentists

Today, many dental benefit plans use auto-adjudication to process a high number of their claims. While auto-adjudication can speed up claim processing, if an office is not aware that this type of technology is being used, the office can be confused and frustrated by processing errors as the result of manual claims submission. The following three examples illustrate how a plan might use auto-adjudication and how that process might affect dental reimbursement.

October 22, 2019 |2019, Dental Benefits, News Articles

Not your father’s Medi-Cal

Improvements to the Medi-Cal Dental program continue with new options for dentists who treat Medi-Cal members, including the ability to provide fluoride treatment and fluoride varnish as a benefit once every four months for patients under age 6. The increase in the benefit periodicity underscores the state’s commitment to regular preventive oral health visits for young children in California.

October 21, 2019 |2019, Access to Care, Advocacy, Dental Benefits, Medi-Cal/Denti-Cal, News Articles

‘ABC test’ is now the law, but it’s not a free ticket for independent contractors

Beginning Jan. 1, 2020, it will be more difficult for most employers in California to classify workers as independent contractors, rather than employees, and in some cases will make employees out of independent contractors. And although CDA secured an exemption for dentists, employee classification still isn’t clear-cut, and dentists will need to err on the side of caution when classifying their workers.

October 15, 2019 |2019, Employment Practices, Hiring/Firing, Laws & Regulations, News Articles

Victory for direct-to-consumer orthodontic patient protection bill

Direct-to-consumer orthodontic patients will gain new protections when CDA-supported Assembly Bill 1519 becomes the law in January 2020. The first of its kind in the nation, the new law will protect patients from DTC orthodontic companies that are putting profits before patients by taking potentially unsafe shortcuts to the accepted standards of care.

October 14, 2019 |2019, Advocacy, Legislation, News Articles

Dental practice pays $10K to settle disclosures of patients’ PHI on social media

A private dental practice in Dallas, Texas, has agreed to pay $10,000 to the U.S. Department of Health and Human Services’ Office for Civil Rights to settle potential violations of the HIPAA privacy rule. The HHS reported that the OCR completed its investigation of a complaint by a patient who alleged that the practice disclosed on social media the patient’s last name and the details of the patient’s health condition.

October 10, 2019 |2019, News Articles, Privacy/HIPAA, Regulatory Compliance

Proceed with caution when making pay deductions for salaried employees

The decision to classify your employee as exempt or nonexempt should not be taken lightly. The distinction between the two is significant, and the two are also managed very differently. Therefore, employers should understand not only how to determine an employee’s classification but how to follow appropriate pay requirements as well.

October 8, 2019 |2019, Employment Practices, Laws & Regulations, News Articles

Workers’ Compensation: Your Obligations as an Employer

The responsibilities of dental practice owners extend far beyond patient care. As an employer, you also have an obligation to ensure you are following workers’ compensation laws. Workers’ compensation insurance provides state-mandated benefits to employees who suffer an injury or illness that arose out of or occurred in the course and scope of employment.

October 7, 2019 |2019, Insurance/TDIC, Laws & Regulations, News Articles

CDA Cares San Bernardino provides nearly $1.5 million in care

Thousands of patients and volunteers flocked to the National Orange Show Events Center at the CDA Foundation’s 16th CDA Cares volunteer dental clinic to receive and provide dental care at no cost. Dentists and dental professionals performed 10,412 procedures, including fillings, extractions and cleanings, providing $1.46 million in care to 1,626 people. The event took place Sept. 27-28 in San Bernardino for the first time.

October 3, 2019 |2019, CDA Foundation, Community, News Articles

Health entity fined for failure to provide timely patient records

A medical center in St. Petersburg, Florida, is the first to face enforcement action by the U.S. Department of Health and Human Services for failing to promptly provide a patient with medical records. The HHS Office for Civil Rights announced early this year that it would vigorously enforce its Right of Access Initiative that allows patients to receive copies of their medical records promptly and without being overcharged.

October 2, 2019 |2019, News Articles, Privacy/HIPAA, Regulatory Compliance

Do you know where your data is?

Ransomware attacks on health care facilities are increasing, as are the financial losses incurred by them. In one case reported to TDIC, a dentist had to replace software in the practice due to the extensive damage caused by a virus that gained access through an email attachment. The expenses totaled $49,000 to restore the data, decrypt the data and pay the ransom.

October 1, 2019 |2019, Insurance/TDIC, News Articles

$300K opportunity for dentists who relocate, commit to Medi-Cal

California dentists who are willing to relocate, expand or establish a new practice to an area of highest patient need and commit to serving Medi-Cal beneficiaries for at least 10 years can apply in January 2020 to receive up to $300,000 in grant funding through the state’s CalHealthCares program to support related costs.

September 24, 2019 |2019, Access to Care, Advocacy, Dental Benefits, Medi-Cal/Denti-Cal, News Articles, Tobacco

Prescribers can check CURES for misuse of prescription pads

A dentist who writes controlled substance prescriptions can now review CURES (Controlled Substance Utilization Review and Evaluation System) for patients for whom the dentist is listed as a prescriber. This ability to review the list is useful when a dentist has misplaced a prescription pad or has had a prescription pad stolen or when a dentist suspects someone is misusing their DEA number.

September 20, 2019 |2019, CURES (Controlled Substance), News Articles, Patient Management, Practice Management, Regulatory Compliance
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