The American Dental Association (ADA) has not updated their claim form since 2019 — until now. A new ADA claim form is available as of January 1, 2024.
It’s crucial that your dental team begins using this updated claim form immediately, or your business could face costly consequences.
We all know denied insurance claims lead to delays in reimbursement. These payment delays cause dips in your overall revenue, which can affect your operations and how you’re able to cover your expenses — all very good reasons to use the new form.
As dental revenue cycle management (RCM) service providers, the experts at DCS will also be using the new ADA form as they submit claims for dental teams like yours.
To make sure you know what to expect from this vital change, we’ll go over the importance of the 2024 ADA claim form, why you won’t get paid without it, and where you can find it with guidance on how to use it.
Let’s dig in…
Who needs the new 2024 ADA claim form?
Everyone! Okay, not everyone, but everyone who submits a dental insurance claim after December 31, 2023.
Here are a few reasons why using the current claim form needs to be your insurance team’s first priority in the new year:
- Compliance with insurance industry standards. While following the rules that dental insurance lays out for us isn’t always fun, it’s necessary to receive the payment you’ve earned, and to avoid any misunderstandings with payers.
- Improved accuracy and efficiency in claims processing. If your team doesn’t use the correct claim form, denials will pile up, and they will then have to process a stack of appeals. This is just more work for your team, and it’s 100% avoidable by using the right form.
- Streamlined reimbursement procedures. When you use the correct claim form, claims can step through payer processes without a hitch, and you’ll get reimbursed faster. This also lightens your team’s workload, giving them time to appeal claims that were denied for more complicated reasons.
Related: 5 dental claim submission mistakes that will cost you time and money
So now you know who needs the 2024 ADA claim form and why it matters: everyone filing dental insurance claims, so you can get paid quickly, prevent claim denials, minimize appeals processing, and free up time for other essential tasks.
Now let’s dive deeper into why not using the current claim form would be costly to your business.
Why you won’t get paid without the 2024 ADA claim form
We touched on this a bit before, but your claims will face immediate denials if you aren’t using the new 2024 ADA claim form. You might be thinking, ‘Yeah, yeah, I get it!’ But there’s a reason we harp on claim denials so much…
Many dental teams think denials are just a part of their everyday workflow. They submit claims while expecting a denial they’ll have to appeal, so they don’t check for errors to ensure a clean claim the first time. What those dental teams don’t realize is how harmful frequent claim denials are to your dental business.
There are many insurance claim errors that lead to denials, such as:
- Incomplete or incorrect information on the dental insurance claim
- Not reviewing patient benefits (i.e., insurance verification)
- Contractual denials: clinical and limitation
- No explanations on the claim form
- Unreadable information and files
- Outdated insurance claim forms
- Incorrect dental codes
It’s true, insurance companies don’t make it easy to receive reimbursement upon first submission, but that doesn’t mean your team should expect a denial every single time — and then skip the steps needed to avoid that.
In my opinion, expecting denials sounds like letting insurance companies win. When your insurance team easily surrenders your earnings, they’re costing your dental business tens of thousands of dollars through denials. And as discussed earlier, not only do denials lead to delays in revenue, but they also create a bigger workload for your team.
Imagine the length of your insurance aging report if every single claim is denied. Whoever is responsible for plodding through the list to assess, correct, and resubmit each claim won’t have much time for any other tasks. If you have a one-person administrative team, this is a huge time sink. It could even lead to a drop in patient satisfaction.
Related: 3 ways patient billing mistakes harm your dental business
Being bogged down by a lengthy insurance aging report takes away from your team’s ability to interact with the patients in your office. But the frequent denials can also impact your patient’s out-of-pocket costs.
If you have already collected from a patient, then receive a denial (whether it’s due to the incorrect claim form or not), you might have to send that patient another bill. They will not be happy about this, and your business could lose their invaluable goodwill.
This is why claim denials are worth harping on: Their negative impact spreads to all aspects of your business, from operations to personnel to service delivery to billing.
Where to get the 2024 ADA claim form and instructions to implement it
Now that you fully understand how using outdated claim forms will cause denials, and how those denials can harm your business, let’s get you moving in the right direction: Where can you find the 2024 ADA claim form?
Here it is, available and valid as of January 1, 2024:
Get your 2024 ADA Claim Form here.
According to the ADA—
“The 2024 version provides new spaces for reporting data that can expedite timely and accurate claim reimbursement. It is now possible to clearly identify claims for services delivered by a ‘locum tenens’ dentist, one who is standing in for another who is away from the practice for a short time.
The form also supports reporting an identifier, known as Payer ID, that when available uniquely identifies the third-party payer receiving the claim.”
The ADA website offers plenty of information on how to use this form, including a brief 4-minute video.
Here are some quick links for ADA resources with how to implement and understand the new ADA form:
- Watch the 2024 ADA claim form video
- Read the ADA News article: Dental Insurance Hub: ADA council’s actions support dentist claims and record-keeping
- Download the preview sample of the 2024 claim form and completion instructions (PDF) (for all items #1-58)
These resources ensure the new ADA claim form is easy to find and easy to use. Understanding the reasons behind the changes will help your team confidently use it at your dental practice, saving their time and your money while freeing themselves up to handle more complex issues that aren’t as easily avoided.
Collect confidently by using the new 2024 ADA claim form
To recap this important topic:
- The new 2024 ADA claim form is available for your use now on the ADA website
- It’s crucial that you begin using it immediately, as the ADA’s 2019 claim form was out of date as of December 31, 2023.
- The use of out-of-date claim forms guarantees denials, which will lead to delays in reimbursement from insurance companies, extra paperwork for your team, an oversized aging report, and inconsistent cash flow.
- Those can negatively impact the care your patients receive.
Your insurance team can avoid denials and quickly collect what you’re owed by using the new 2024 ADA claim form. Don’t let an old piece of paperwork create problems throughout your dental business.
DCS is also using the 2024 ADA claim for with all of our customers, ensuring an error as simple as an outdated claim form won’t be the reason for denials — we’re dedicated to submitting claims that fly through payer processes the first time.
Our RCM experts keep up with industry updates such as new claim forms, so your team doesn’t have to. We also help your team submit clean claims for maximum reimbursement in the minimum time.
Stay up to date and collect confidently with DCS’ services: Book a call today.
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