Signs of Hope, Even as Dentists Lag Doctors in Electronic Claim Payments

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Michael W. Kahn

Michael W. Kahn

Nacha

Many dentists have yet to experience the benefits of receiving insurance claim payments by ACH, but there are encouraging signs, a new report found.

“Although the majority of dental payments are made via a paper check, the industry is seeing an uptick in the number of electronic dental payments, specifically for dental providers who have historically been hesitant to trust the exchange of electronic funds,” noted the 2020 CAQH Index.

The eighth annual Index, released Feb. 3, tracks adoption rates of and cost savings from the switch from manual to electronic transactions for claims processing by dental and medical providers. 

The 2020 Index shows an estimated 23% of dental claim payments were made electronically, nearly double the 12% from the 2019 Index. 

“This increase in dental provider electronic volume may be due to continued promotion of electronic payments from dental industry partners,” the report said. It cited the American Dental Association, which Nacha has worked with, and the National Association of Dental Plans for their efforts to “encourage enrollment in electronic claim payments for quicker and easier reimbursement.”

But at the same time the 2020 Index showed 70% of medical claims were paid electronically. Why the disparity? Kristine Burnaska, CAQH Director of Research and Measurement, told a Feb. 10 webinar that this has been discussed with members of the CAQH Index Advisory Council as well as dental plans and providers. 

“Anecdotally, what we’re hearing is that dental providers tend to be more fearful of electronic transactions or the exchange of funds,” said Burnaska. 

“Many dental providers have actually told us that they feel more comfortable with a check in hand,” she said, adding that “they have no issue going to the bank to deposit a check.”

“As the dental industry works to inform providers that there are a lot of benefits to using electronic payments, such as efficiency in payments and also that they can be trusted, we hopefully see that adoption rate increase,” added Burnaska.

Brad Smith, Nacha Senior Director, Industry Engagement and Advocacy, said dentists are leaving a lot of money behind by sticking with checks.

“The Index found that each manual claim payments costs a dental practice $3.37 compared to $1.57 for electronic. That’s $1.80 lost each and every time, and it can really add up,” said Smith.

“The Index estimated the dental industry alone could save $472 million a year by going all in on electronic claim payments,” said Smith. “Add in the medical industry’s potential $426 million in savings, and that’s nearly $900 million left behind annually by continuing with paper.” 

Data for the 2020 Index is for calendar year 2019, and so researchers noted that it excludes any impact from the pandemic. But Smith said the impacts of the coronavirus should encourage the holdout doctors and dentists to make the switch to EFT.

“The pandemic has raised many issues, including delayed mail, offices and bank branches that were closed, and health concerns about handling paper,” said Smith. “With electronic claim payments those become non-issues, as the money goes directly from the insurance company into a practice’s account.”

Nacha has a trio of case studies looking at dentists from smaller practices who have had great success with accepting electronic claim payments. The case studies are available for complimentary download.