Study offers potential ADA solutions for dental eligibility, benefits verification challenges

Nashville, Tenn.-based Change Healthcare recently provided four recommendations to the American Dental Association for improving dental eligibility and benefits verification for dental practices.

The recommendations are based on a July study by Change Healthcare, which assessed the current state of the eligibility and benefits verification process and potential solutions for improvement. The ADA requested Change Healthcare evaluate the feasibility of a unified online portal providers can use to access eligibility information.

Based on the findings of the study, Change Healthcare did not recommend a portal solution because of cost and potential lack of participation. Instead, the company offered four alternative solutions:

  • Provider education.
  • Payer guidance.
  • Feedback on best practices for software vendors.
  • Endorsing a product or solution.

Change Healthcare also directed the ADA to explore the feasibility of creating a platform that would allow third-party payers to provide dentists with information about patients' eligibility status and dental benefits.

The study was commissioned by the ADA Council on Dental Benefit Programs.

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