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Medical Forum / General / Dentistry / December 2004CDT-5
Has everyone run out and bought their copy of the new CDT-2005 standards yet? Anyone beside me annoyed that the ADA uses our dues money to develop this standard, but charges us to obtain a copy of the standard once completed. Then, we pay again to have out PMS licensed to incorporate it into the software. Am I alone in expecting the ADA to send dues paying members a copy of the standard as a benefit of membership? At least, just a list of revisions for the new standard. Even a Password protected link to the standard or its revisions.  Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > Has everyone run out and bought their copy of the new CDT-2005 standards > yet? Anyone beside me annoyed that the ADA uses our dues money to develop [quoted text clipped - 11 lines] > Stephen Mancuso, D.D.S. > Troy, Michigan, USA Just wrote a check for $1070.00 to *not* receive it from the ADA. carabelli > Has everyone run out and bought their copy of the new CDT-2005 standards > yet? Anyone beside me annoyed that the ADA uses our dues money to develop [quoted text clipped - 6 lines] > the new standard. Even a Password protected link to the standard or its > revisions. I agree 100%...only I am not an ADA member, so it wasn't my dues money. Perhaps I am too cynical, but now that the ADA has found a nice little profit center, does it seem these revisions are coming with greater frequency? And does it seem like a good number of the changes are rather insignificant? There isn't much choice in complying with the new codes, because when they were last revised, I learned that the insurance companies applied the revisions immediately, and if you used an old code, it was a reason for them to deny the claim or send it into the black hole of claims. This kind of crap is just another one of the reasons I feel the ADA is useless. Sorry if that offends anyone. There are many good people in the ADA, but as a whole, I am no fan. T >> Has everyone run out and bought their copy of the new CDT-2005 standards >> yet? Anyone beside me annoyed that the ADA uses our dues money to develop [quoted text clipped - 22 lines] > >T Say there are 20 or 50 changes .... and you learn about the changes from discussing with your friends. Can't you make the "edits" yourself? Joel Just ASKIN' not conspirin' You will want the exact wording. I would not trust conversational discussions for this. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>> Has everyone run out and bought their copy of the new CDT-2005 standards [quoted text clipped - 43 lines] > > Just ASKIN' not conspirin' >You will want the exact wording. I would not trust conversational >discussions for this. I usually checked Delta Dental on the 'net to see the exact wording (CDT-4) Joel CDT-4 until January first, then all insurance carriers must switch to CDT-5. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>You will want the exact wording. I would not trust conversational [quoted text clipped - 4 lines] > > Joel I have no problem with new codes coming out every couple of years to improve the definition of what we do and standardizing how we bill insurance carriers for it. I just take issue with how we pay for the information. Keeping up with the new codes and the revisions is very easy as not that many codes change each time. Each revision makes the codes better defined, as well. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> Has everyone run out and bought their copy of the new CDT-2005 standards [quoted text clipped - 32 lines] > > T > I have no problem with new codes coming out every couple of years to improve > the definition of what we do and standardizing how we bill insurance > carriers for it. I just take issue with how we pay for the information. > Keeping up with the new codes and the revisions is very easy as not that > many codes change each time. Each revision makes the codes better defined, > as well. While I agree that fine tuning of the codes is useful to a degree, when I read through the changes for CDT-5 I find very few that justify the investment in time, dollars, and effort in changing over to a new code set. The vast majority of changes will have little or no application in the average general practice. In my opinion it is more a change for the sake of change than a real need. Then again, I am a cynic. T I would not argue with Tony on the fact that the changes are not huge this time around. The CDT-4 had greater significance to the changes. However, Bill's point holds true in this case--that the ADA sets precedent by revising and improving the codes every two years. This way, the insurance carriers cannot get together and force the industry to use weird codes designed to deny patient access to care. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> I have no problem with new codes coming out every couple of years to [quoted text clipped - 19 lines] > > T It is bull that the insurance carriers force anyone to use any codes. They need to pay the claims based on what is done. for example you did a crown on #19 they need to pay for it regardless of what their software says. To simply sit back and say it is up to them to deny a claim based on incorrect coding is a bunch of crap and should not be tolerated period. I do not have all these codes memorized, my staff does not know all of them the insurance input person does not know them all, especially if the definitions keep changing every year. Everyone knows the discription and they use it to associate to some CDT-5 code both at the dental office and the insurance company end. So please do not tell me that it takes more effort for everyone to follow the discription than the code. And I am a little ticked off that our staff are doing the insurance company's job at our expense, this is the insurance company's job and they are passing it on to us so they can cut costs. Where is the ADA in standing up for our rights? all they want to do is make a profit from us so that they can spend it on themselves with their lavish parties airfares and hotel accomodations for their delegates and staff not to mention all the spam mail that they print. Which insurance company or Bank is the ADA going to help sponsor this year which one of these companies is going to get all the dentist clients, which one will go under as a result of the competitor getting the mail list? Its a vicious world out there and the ADA is in the middle of it. > It is bull that the insurance carriers force anyone to use any codes. > They need to pay the claims based on what is done. > for example you did a crown on #19 they need to pay for it regardless > of what their software says. I found out recently that a lot of the data entry on these claims is done overseas! The claims are "read" by someone who may not even read english, and all they understand is the code. I have forgotten the "d" that is now supposed to proceed every code and got the claim back because it was "not a current code". Also, don't bother writing any notes on the claim, because the claims are often tossed out after the data entry people are done. I found this out when I asked someone at MET, well, didn't you read my note? Grumble, grumble... T exactly my point outsourcing jobs. Electronic submission is much better. The claim is never looked at by human eyes, unless the claim does not meet eligibility requirements, or includes a CDT which requires documentation. Errors are eliminated. Of course, JLT (Jardine) has to get more creative to deny claims, so they will randomly kick back an electronic claim saying the client id does not match their record. So, those have to printed to paper and mailed. This stalls payment for a week or two, so the computer finds the client ID # just fine then. In the old days of all paper claims, the carriers would train the staff to actually throw out a few claims out of every pile. That was why so many claims would get lost, but never come back in the mail. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> It is bull that the insurance carriers force anyone to use any codes. [quoted text clipped - 17 lines] > > T > Electronic submission is much better. The claim is never looked at by human > eyes, unless the claim does not meet eligibility requirements, or includes a [quoted text clipped - 12 lines] > Troy, Michigan, USA > .................................................... I have my disability insurance from JTL (Jardine) I did not know they processed electronic claims for dentists. > This posting is intended for informational or conversational purposes only. > Always seek the opinion of a licensed dental professional before acting on [quoted text clipped - 23 lines] > > > > T purple is me ever since this google change it messed everything up. Hey PurpleHaze, Get up on the wrong side of the bed, or does it just sound angry because we cannot see you facial expressions? Why do you need an insurance input person? You buy a decent software, tie your billing codes to the CDT codes, and as you bill the patient, the carrier gets billed electronically. The check either goes to the patient or to your office. No effort at all. Want to argue about how the ADA only sends us advertisements to buy life, death, disability, etc insurance which is over-priced for the product? That would be agreeable to me. If one is honest and not trying to cheat the patient, then one would welcome the ability to standardize billing. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > It is bull that the insurance carriers force anyone to use any codes. > They need to pay the claims based on what is done. [quoted text clipped - 21 lines] > the mail list? Its a vicious world out there and the ADA is in the > middle of it. every time they come out with new codes you need to train your staff to use them check to make sure the right code comes up in the computer with the correct fee etc... Like I said before the ADA is on the insurance company side making it easier for the insurance to get out of payment counting on the patient to give up. The ADA did nothing to prevent the HIPPA requirement to use current codes etc,,, Also you guys are understating the membership fees its more like $1500 per year including the state and local components. I am not afraid of offending anyone at the ADA the fact stands for itself. The other thing I do not like is that our government relies of the ADA for advice. ADA is a private organization it certainly does not make them an authority on anything. Membership in the ada IS NOT REQUIRED TO BE A DENTIST so it is wrong and UNETHICAL for the government to solely rely on the ADA for regulation decisions. There are many other branches of dental organizations out there and they need to be heard as well. The thing to do is to give the patient a discription of what was done or needs to be done estimate and have them go to their insurance company for claim filing just like the auto insurance industry. And if the insurance companies refuse to help in claim submission then the patient should contact the department of insuranceand they will get the insurance company to change attitude. Pretty soon the department of insurance will be swamped with so many complaits that they will pass regulation to make their live easier. Government employees do not like to be overworked. Dear PurpleHaze, :-) <purple543210@yahoo.ca> wrote in message > every time they come out with new codes you need to train your staff to > use them check to make sure the right code comes up in the computer > with the correct fee etc... Ummmm, your software should be set up so that all this comes up automatically. My staff has zero idea what CDT stands for or how to use any codes. It is all handled seamlesslyl by a good PMS. > Like I said before the ADA is on the insurance company side making it > easier for the insurance to get out of payment counting on the patient > to give up. Huh? > The ADA did nothing to prevent the HIPPA requirement to use current > codes etc,,, Hey Purp, the ADA made a fuss when the HIPAA standards were proposed and made sure they were ahead of the game so that dentists were creating the code set, not insurance carriers. Without the CDT codes, you would be looking at hundreds of different codes for the same procedure. It would be nightmare for both us and the patients. But,,,,, the insurance carriers would be making their stockholders very happy. > Also you guys are understating the membership fees its more like $1500 > per year including the state and local components. Varies from place to place. Mine is about $1200. > I am not afraid of offending anyone at the ADA the fact stands for > itself. Me neither. > The other thing I do not like is that our government relies of the ADA > for advice. Would you rather the goverment went to Jan Drew? Hulda Clark? The Hydra? Gail? > ADA is a private organization it certainly does not make them an > authority on anything. The ADA is an authority on being a unified voice for many dentists. You could argue (and I often do) that the voice is not consistent with what most dentist want, but at least it is a voice. >Membership in the ada IS NOT REQUIRED TO BE A > DENTIST so it is wrong and UNETHICAL for the government to solely rely > on the ADA for regulation decisions. Should they rely on the Hydra? Would you want Hillory Clinton adviseing on dental policy ? > There are many other branches of dental organizations out there and > they need to be heard as well. They do get heard. > The thing to do is to give the patient a discription of what was done > or needs to be done estimate and have them go to their insurance > company for claim filing just like the auto insurance industry. Okay, a R&R right front fender on a Ford Fairlane is going to be identical across the line. Same number of bolts, clips, chrome trim removed in the same sequence with the same amount of paint applied when done. Perhaps some variation in the work done to the fender well. But, even that onlly has a few variables. A gold restoration on a lower second molar has many more variables involved. Plus, there is no standard restoration to buy from Ford which will fit every second molar. >And if > the insurance companies refuse to help in claim submission then the > patient should contact the department of insurance and they will get the > insurance company to change attitude. Actually, the carrier does not care about the patient. They care formost about the stock holders, and secondarily about the premium payers. You must get the people who buy the policy involved to create any change. >Pretty soon the department of > insurance will be swamped with so many complaits that they will pass > regulation to make their live easier. Okay, sure............... You don't want me to hold me breath waiting do you? >Government employees do not like to be overworked. Neither do any other employees. Every spent a day in a stamping plant? How about a forge? Spend a summer in a chemical plant that distills coal tar? Ever work on a high-rise building 70 stories in the air with no protection from the elements in 50 MPH wind, next to a frozen international waterway and the ambient temperature is ten below zero (without the wind chill)? We can talk about not wanting to be overworked if you like. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... "Dr Steve" <nospam@home.net> wrote............. My staff has zero idea what CDT stands for ............. Did they all show up an hour early for work on Nov. 1 ? carabelli We are on EST. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > > "Dr Steve" <nospam@home.net> wrote............. [quoted text clipped - 4 lines] > > carabelli Dear PurpleHaze, :-) <purple543...@yahoo.ca> wrote in message > every time they come out with new codes you need to train your staff to > use them check to make sure the right code comes up in the computer > with the correct fee etc... Ummmm, your software should be set up so that all this comes up automatically. My staff has zero idea what CDT stands for or how to use any codes. It is all handled seamlesslyl by a good PMS. You appearently enjoy setting up your software every year. > Like I said before the ADA is on the insurance company side making it > easier for the insurance to get out of payment counting on the patient > to give up. Huh? > The ADA did nothing to prevent the HIPPA requirement to use current > codes etc,,, Hey Purp, the ADA made a fuss when the HIPAA standards were proposed and made sure they were ahead of the game so that dentists were creating the code set, not insurance carriers. Without the CDT codes, you would be looking at hundreds of different codes for the same procedure. It would be nightmare for both us and the patients. But,,,,, the insurance carriers would be making their stockholders very happy. You call that a fuss? It's an illusion of a fuss or pure stupidity. I think they knew what they were doing why do you think you are paying for the ADA codes being a member???? > Also you guys are understating the membership fees its more like $1500 > per year including the state and local components. Varies from place to place. Mine is about $1200. > I am not afraid of offending anyone at the ADA the fact stands for > itself. Me neither. > The other thing I do not like is that our government relies of the ADA > for advice. Would you rather the goverment went to Jan Drew? Hulda Clark? The Hydra? Gail? How about The AACD??? How about having their own voluntary elected commitee. How about staying out of our lives period? > ADA is a private organization it certainly does not make them an > authority on anything. The ADA is an authority on being a unified voice for many dentists. You could argue (and I often do) that the voice is not consistent with what most dentist want, but at least it is a voice. Then it is not unified. I do not own an amalgamator why does the city come to my door with a video made in conjuction with the ADA on proper management storage and waste disposal of amalgam? and an application for a permit???? Most of my patients do not have any amalgam in their mouths and my building owns and maintains the central suction for all tenants. >Membership in the ada IS NOT REQUIRED TO BE A > DENTIST so it is wrong and UNETHICAL for the government to solely rely > on the ADA for regulation decisions. Should they rely on the Hydra? Would you want Hillory Clinton adviseing on dental policy ? They need to let the profession regulate itself we are not children that need babysitting. I do not know anyone who specifically becomes a dentist with the intent to harm the public for a living. Sure crap happens but we adjust take CE classes to improve. > There are many other branches of dental organizations out there and > they need to be heard as well. They do get heard. REALLY??? > The thing to do is to give the patient a discription of what was done > or needs to be done estimate and have them go to their insurance > company for claim filing just like the auto insurance industry. Okay, a R&R right front fender on a Ford Fairlane is going to be identical across the line. Same number of bolts, clips, chrome trim removed in the same sequence with the same amount of paint applied when done. Perhaps some variation in the work done to the fender well. But, even that onlly has a few variables. A gold restoration on a lower second molar has many more variables involved. Plus, there is no standard restoration to buy from Ford which will fit every second molar. SO. You think the insurance company will pay for all your variables to them a crownis a crown whether done by you or the shlep next door. what separates you and the shelp is the fee and ultimatly the difference gets passed to the patient. >And if > the insurance companies refuse to help in claim submission then the > patient should contact the department of insurance and they will get the > insurance company to change attitude. Actually, the carrier does not care about the patient. They care formost about the stock holders, and secondarily about the premium payers. You must get the people who buy the policy involved to create any change. OK patient's employer or the patient if they have their own policy or aquire it if the leave the company. >Pretty soon the department of > insurance will be swamped with so many complaits that they will pass > regulation to make their live easier. Okay, sure............... You don't want me to hold me breath waiting do you? Ever call the department with a complaint about an insurance carrier??? I did you would not believe how fast the insurance copmany replied with "i'm sorry, why did you not call us first.?" Until then I did not think mail moved that fast. >Government employees do not like to be overworked. Neither do any other employees. Every spent a day in a stamping plant? How about a forge? Spend a summer in a chemical plant that distills coal tar? Ever work on a high-rise building 70 stories in the air with no protection from the elements in 50 MPH wind, next to a frozen international waterway and the ambient temperature is ten below zero (without the wind chill)? We can talk about not wanting to be overworked if you like. -- ????????? ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA Alex, Are you the PurpleHaze guy? If so, please figure out how to make your posts readable. This is as confusing as trying to figure out who said what in a post from the POI. [interject friendly punch in the shoulder here]. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > Dear PurpleHaze, :-) > [quoted text clipped - 11 lines] > > You appearently enjoy setting up your software every year. You only have to delete codes which you are no longer using, add in the 4-5 codes you want to add, and you are done. What does it take, ten minutes every 2-3 years? >> Like I said before the ADA is on the insurance company side making it >> easier for the insurance to get out of payment counting on the [quoted text clipped - 20 lines] > think they knew what they were doing why do you think you are paying > for the ADA codes being a member???? Huh? >> Also you guys are understating the membership fees its more like > $1500 [quoted text clipped - 17 lines] > How about having their own voluntary elected commitee. > How about staying out of our lives period? Too many beers today? >> ADA is a private organization it certainly does not make them an >> authority on anything. [quoted text clipped - 11 lines] > Most of my patients do not have any amalgam in their mouths and my > building owns and maintains the central suction for all tenants. Why are you so bitter? >>Membership in the ada IS NOT REQUIRED TO BE A >> DENTIST so it is wrong and UNETHICAL for the government to solely [quoted text clipped - 86 lines] > -- > ????????? This insurance-free dental practice is not working out so good huh? "Would you rather the government went to Jan Drew? Hulda Clark? The Hydra? Gail?" Absolutely not. But any questions the government would like to ask about Crohns, they can come to me. Heard they are setting up a committee to look into the situation. Too many disability requests? Well, what a surprise. Gail This insurance-free dental practice is not working out so good huh? Insurance free dental is working out just fine, I am just tired with all the crap we have to deal with. As much as I try to separate myself from insurance it still comes up. I work 4 days a week and I still do not have enough time in a week to get all the stuff I need to get done. I do not like the fact that in this profession everyone just sits back and lets insurance and government to walk all over them. It's an ethical issue and it is troubling. Figure out the system, automate it through your software and forget it. It is NOT an issue. Just a parameter to work around. Life will never be perfect. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > > This insurance-free dental practice is not working out so good huh? [quoted text clipped - 7 lines] > and lets insurance and government to walk all over them. > It's an ethical issue and it is troubling. >This insurance-free dental practice is not working out so good huh? > [quoted text clipped - 6 lines] >and lets insurance and government to walk all over them. >It's an ethical issue and it is troubling. We agree. Once again its dentist vs. dentist ......... Forget insurance .... do you know how many of your colleagues routinely forgive patient co-pays and deductibles? Joel >Has everyone run out and bought their copy of the new CDT-2005 standards >yet? Anyone beside me annoyed that the ADA uses our dues money to develop >this standard, but charges us to obtain a copy of the standard once >completed. Then, we pay again to have out PMS licensed to incorporate it >into the software. How much are they chargin'? >Am I alone in expecting the ADA to send dues paying members a copy of the >standard as a benefit of membership? At least, just a list of revisions for >the new standard. Even a Password protected link to the standard or its >revisions. The book is about $40. The license for your PMS to use it is another $50 *per user license*. So multiply $50 by how many customer licenses the PMS has and you get a huge number. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>Has everyone run out and bought their copy of the new CDT-2005 standards [quoted text clipped - 10 lines] >>the new standard. Even a Password protected link to the standard or its >>revisions. >The book is about $40. The license for your PMS to use it is another $50 >*per user license*. So multiply $50 by how many customer licenses the PMS >has and you get a huge number. Seems like they are nickel and diming the dentists ...... Joel Part of the problem is that this drives up the cost of the PMS by the cost of each license of the CDT codes. Each software vendor ends up paying hundreds of thousands of dollars to the ADA for these licenses. You never hear about it unless you ask. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>The book is about $40. The license for your PMS to use it is another $50 [quoted text clipped - 4 lines] > > Joel I'm sure the money is used to keep our dues lower. ;-( Fawks > The book is about $40. The license for your PMS to use it is another $50 > *per user license*. So multiply $50 by how many customer licenses the PMS > has and you get a huge number. >I'm sure the money is used to keep our dues lower. True, how else wuold they keep the dues so ridiculously low? Joel >;-( >Fawks > >> The book is about $40. The license for your PMS to use it is another $50 >> *per user license*. So multiply $50 by how many customer licenses the PMS >> has and you get a huge number. What dues ? >I'm sure the money is used to keep our dues lower. > [quoted text clipped - 4 lines] >> *per user license*. So multiply $50 by how many customer licenses the PMS >> has and you get a huge number. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >What dues ? American Automobile Club ....... better pay up before your battery dies ..... >>I'm sure the money is used to keep our dues lower. >> [quoted text clipped - 4 lines] >>> *per user license*. So multiply $50 by how many customer licenses the PMS >>> has and you get a huge number. Steve wrote: Has everyone run out and bought their copy of the new CDT-2005 standards yet? Anyone beside me annoyed that the ADA uses our dues money to develop this standard, but charges us to obtain a copy of the standard once completed. Then, we pay again to have out PMS licensed to incorporate it into the software. Am I alone in expecting the ADA to send dues paying members a copy of the standard as a benefit of membership? At least, just a list of revisions for the new standard. Even a Password protected link to the standard or its revisions. -- ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA Bill's reply: Back in the 1970s, many insurance companies wrote their own revisions to the first ADA code set. The result was a mishmash of various codes and subcodes. A dentist had to use a different revision for each insurance company. I found this to be very frustrating and inefficient. By the early 90s the ADA published their own code set in the ADA Journal, and started legal proceedings to assure their copyright to the CDT codes. (That in itself is a reason to support the ADA. If the code set and its revisions weren't in the hands of dentists through the ADA, you can bet that forty different insurance companies would still be using forty different procedure code systems. They would still be revising them at whim, as they always did before, so you couldn't even be sure that any of the forty different complete code sets you kept on file would be valid for any of the insurance claims you tried to file each day. I do NOT want to go back to those days again.) As the federal government started writing the HIPAA regulations in the 1990s, the ADA was savvy enough to realize that if you don't lead the government where you want to go, they will simply steamroller over you. So a permanent committee and sizeable resources were devoted to establishing a credible means of input into code writing and revisions, with the result that the ADA has been able to coordinate code revisions without undue governmental impositions. Just imagine the dental profession suffering under a diagnosis-related code system similar to that which the government devised for Medicare. It's not far-fetched to think the government would impose a system that would say to dentists: "No more itemized billing. Just use the diagnosis code for caries, for example. If the diagnosis is caries, we will pay $100 per patient for the total case, regardless of the amount or extent of caries." That is the general approach the government has taken to the medical profession. Don't think they wouldn't do the same to dentistry if they had the chance. Yeah, I would like to get the CDT-2005 free too. But I don't think that forty bucks will break any dental practices these days. And if you are as thrifty as Joel and I are, you can still get the code free from Delta or from the many PPO's who have to send out revisions anyway. I won't even mention a Google search . . . ;-) - dentaldoc Bill, You "partially" misunderstand me. I am very much in favor of the ADA creating the code standard. I think it is helpful and useful. My point is that my money was used to create the codes, now I have to pay again to look at them, then pay again to have them in my software (per machine). No, I do not pay the ADA directly for the licensing costs of the CDT code standard on the computer, but the PMS vendor has to pay it, which becomes either a higher monthly maintenance cost, or less money the software vendor can use on enhancing the software. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > Steve wrote: > [quoted text clipped - 66 lines] > > - dentaldoc | Bill, | [quoted text clipped - 6 lines] | higher monthly maintenance cost, or less money the software vendor can use | on enhancing the software. I partially agree with you Steve. We get one copy of annual fee guide update which is released upon paying our membership fees. That cost is built into our annual fees and is listed as a feature of being a member. That is fair and reasonable. If we want an extra copy we have to pay for it. I also think that there should be a difference of the cost for hard copy or electronic versions. As for the PMS vendor, I consider that a reasonable cost for both of you. Per machine charges for the CDT code are unreasonable, per site would not be. Charging for updating each machine is reasonable and could be or should be part of your maintenance fees. Automatic deployment over a network such as yours should not be much more difficult that installing on a single machine. (comments Adenosine?) I am not familiar with your software, but any PMS I have investigated allows one to manually add fee codes or alter fees. Consider how much it would cost you to do that manually in your office. How does that compare to what you are being charged. Then consider the potential for data entry errors. I update mine manually as I am not using a PMS currently (explained below). With about 400 codes and fees, I usual make a few errors and spend valuable time doing it. Once it is done though, I don't have to worry about it until a year later. Typically I do it in blocks, adding what I can when I can. With the occasional one on the fly if I have not gotten to it yet. Why don't I have a PMS, you say? I've been waiting for the electronic claims system to be completed and operational. They have been telling us for years it is coming in the very near future. Something always seems to crop up. I've been avoiding dropping some big bucks and the learning curves until I am sure I know which software is going to be compatible with the electronic claims. Plus I overheard some of our association executive mention specific problems the proposed system was creating with the code of one vendor. My ears perked up because that was the one PMS I thought I was most interested in. I feel that electronic claims submission to be a major component in the software. -- Roy My feelings are, if they use our dues to develop the code, than dues paying member should get a copy for free. Non-members should pay a fee. Dues paying members should not be billed again to have the code on the software. It would be a benefit of membership to get the codes on time and at no additional cost. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > | Bill, > | [quoted text clipped - 69 lines] > -- > Roy don't get me started on the per computer licence crap that is another problem. Fortunately my PMS has unlimited multi-users. I thought you said your PMS is out of business. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > don't get me started on the per computer licence crap that is another > problem. > Fortunately my PMS has unlimited multi-users. > I thought you said your PMS is out of business. menopause? carabelli >> I thought you said your PMS is out of business. >> > menopause? > > carabelli could be >> I thought you said your PMS is out of business. >> >menopause? > >carabelli YUP, I cannot see a post about about PMS without thinking, yeah its a huge problem in the dental office. >> I thought you said your PMS is out of business. >> >menopause? > >carabelli Forgot to take her Midol ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > I thought you said your PMS is out of business. It still works the problem is Kodak now owns it and they are not making any more new versions. I'll bet they did not like the fact that there are unlimited multi-users and it was hard for them to cash in so they do the next best thing and make the software extinct. Unfortunately for them it is going to take a while. Unfortunate for me is the ADA is speeding up that process. > -- > ~+--~+--~+--~+--~+-- [quoted text clipped - 11 lines] > > problem. > > Fortunately my PMS has unlimited multi-users. That's one of the reasons I quit the ADA. It used to be that they came up with the codes every 5 years now it is every year. My problem is my PMS is no longer being developed and I paid a lot of money for it. I think a boycott against the ADA is overdue. If anything the codes should be available to members. I refuse to buy these codes, if insurance companies have a problem with this then that is between them and the patient. I collect my fee upfront. > Has everyone run out and bought their copy of the new CDT-2005 standards > yet? Anyone beside me annoyed that the ADA uses our dues money to develop [quoted text clipped - 19 lines] > your health. > ...................... The codes come out every two years right now (that is the extended plan). Personally, I like the standardization of the codes. As long as we are billing by code rather than by time and material used, we need standardization. Each revision of the code improves the standardization. However, it should be a benefit of membership if it was developed with dues money. Just my opinion,,,,,,, we need to make it convenient as possible for the patient to get reimbursement from the carrier (if you do not accept assignment of benefits). Yes, the policy limitations are the patient's responsibility. But, the patient has no idea what codes to use to get their own money back after having dental care done. Since ALL insurance carriers are required (by HIPAA) to accept the most recent CDT code set, you certainly know which codes to use. I think there are lots of valid reasons not to want to belong to the ADA. There is also a list of reasons to be a member. It all depends on which way your list of reasons leans. A good PMS is far too important a part of a dental practice. If your PMS is no longer in business, you need to convert to good PMS who will support you for many years to come. You will not be able to stay out of the loop with digital records that much longer. [You will be assimilated] <g>.. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > That's one of the reasons I quit the ADA. > It used to be that they came up with the codes every 5 years now it is [quoted text clipped - 39 lines] >> your health. >> ...................... Lets back up here. CDT codes are now annual. up to 2003 it was CDT-3 2004 it was CDT-4 2005 it is CDT-5 want to bet on next year??? As long as the office does not accept assignment the are not bound by HIPPA with respect to billing style and use of codes. Unless the industry stays quiet and lets them change that. The insurance company has an ethical obligation to help their client with claim submission. I realize is some states legally that has changed because nobody stood up for what is right. When my PMS stops printing claim forms, I will either find a software that will either macro out the information to a current output or abandon claim submission altogether. I do not need the aggravation to be in that loop and I hope more dentists will follow that path. We will do our best to help the patient with or knowledge but for a lousy $1000 (with deductable and special rules )out of a 7000K or more treatment plan it becomes more work then benefit. PS how did you guys get your name to appear vs email in this new google set-up? My name disappeared and now the email shows up. Never mind I think I found the place. lets see if it worked. > Lets back up here. > CDT codes are now annual. [quoted text clipped - 11 lines] > up for what is right. > When my PMS stops printing claim forms You might want to check on that yesterday!!! We were informed that several of our patients insurers would not be accepting anything except the 2005 version starting January 1. Our PMS is *not* upgrading at this time to generate those forms. Last time we tried to upgrade to electronic submission there was some unidentifiable glitch and it was not successful. Fortunately, I'm an ortho and our printed claims are pretty repetitive and some only need to be submitted once for a 24 month course of TX. This time (less than a month ago) we tried the upgrade to electronic submission again. It pretty much went seamlessly. The only option was to purchase blank CDT-5 2005 forms from (guess who) the ADA and fill the printer with them. carabelli , I will either find a software > that will either macro out the information to a current output or > abandon claim submission altogether. I do not need the aggravation to [quoted text clipped - 6 lines] > set-up? > My name disappeared and now the email shows up. talk about a grace period to get things in effect at year end. I have to reconcile my books for 2004 so I can file and pay my city tax they do not wait for the feds you know. In three weeks, all insurance carriers MUST utilize the CDT-5 code set, the paper claim form for CDT-5 is still the 2002 version. This is law. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> Lets back up here. [quoted text clipped - 40 lines] >> set-up? >> My name disappeared and now the email shows up. > In three weeks, all insurance carriers MUST utilize the CDT-5 code set, the > paper claim form for CDT-5 is still the 2002 version. This is law. Huh, really. That's what was relayed to me. Ins co. - staff - me. Oh well, I'm happier with the E-claims anyway. carabelli Look in the manual, The paper form has not changed. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> In three weeks, all insurance carriers MUST utilize the CDT-5 code set, [quoted text clipped - 7 lines] > > carabelli > Look in the manual, The paper form has not changed. Manuals?? We don't need no stinkin manuals. Real men can put anything together without the manual. Actually, we only use about 6 codes anyway and several ins. co. sent us the updated codes they wanted. I don't think any of the ortho codes changed. And now the software handles it. carabelli CDT-3 was in 2000 CDT-4 was in 2002 They skipped a year and CDT-5 is for 2005 I have the manuals in front of me if you want to see photos of the covers and dates, give me your real email address. HIPAA is a complicated subject. You must abide by the electronic security portion of it if you do ANY billing electronically (claims or statements through a clearinghouse count here). The other parts of HIPAA apply to everyone. I suggest you do some more research. Google? How do you use google? [kidding] I use OE or Agent depending on where I am. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > Lets back up here. > CDT codes are now annual. [quoted text clipped - 21 lines] > set-up? > My name disappeared and now the email shows up. Well we were using CDT-3 up to end of Dec 2003 then the insurance were sending claims back for incorrect coding and asked us to use CDT4 in 2004 which I inputed manually this year. Before these were updated every 5 years CDT2 was 1995-2000 CDT3 was supposed to last 5 years and then this was changed. CDT3 was when they added a D infront of the numbers instead of the zero. I still fail to see the significance of this D. CDT4 they changed the codes and definitions quite a bit. It's possible they release the book 1 year early so that everyone can have 1 year to upgrade. |
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