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Fall 1999
Dental Committee Review
By Karen A. Whitesel
MetLifeThe dental market is one of the most popular ancillary employee benefits offered by employers today. In the dental insurance industry, underwriters face questions about medical vs. dental - how are they different? Electronic data interchange Ð what is it? Transferred Business Analysis Ð who's doing what? These questions and related topics were discussed at the June meeting by representatives from Mutual of Omaha, Ameritas, Canada Life, Delta Dental of Michigan, Guardian, CIGNA, Fortis Benefits, and HUMANA.
The Dental Committee was pleased to have Dr. Claude Padgett from United Concordia Companies present a session titled, ÒDental is Different than Medical.Ó Attendees gained insight to the changing environment of dental medicine and the diminishing number of providers in the dental industry. Did you know that 24% of dentists work less than 30 hours per week? Or, as those born since 1950 continue to age, the overall need for restorative care will continue to diminish?
Electronic Data Interchange and the advantages it brings are topical in the Dental industry today. Jane Jacob of MediAmerica presented EDI 101 - Electronic Claims for the Dental Office. EDI eliminates lag time, hassles, error, and significant costs associated with processing paper based claims. Also, providers receive their money sooner because insurance companies process and pay electronic claims before paper ones.
The dental ÒLet's Talk ShopÓ focused on issues raised by Transferred Business Analysis (TBA) for Dental. We discussed subjects such as experience - who gives it out and for what size group? Does this number vary if the prior carrier is a DHMO? Finally, what exclusions and limitations are becoming the industry standard?
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