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Archive
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ADSC has proudly been the dental claims administrator for many Alberta Government dental programs. Here is an archive of common questions during the transition of the Dental Assistance for Seniors Program (DASP) to ADSC in 2015.
[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container admin_label=”” hundred_percent=”no” equal_height_columns=”no” menu_anchor=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”rgba(219,217,214,0.3)” background_image=”” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” video_preview_image=”” border_size=”” border_color=”” border_style=”solid” margin_top=”” margin_bottom=”” padding_top=”50px” padding_right=”” padding_bottom=”50px” padding_left=””][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_2″ spacing=”” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” padding=”” dimension_margin=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_text]
Update #1 Q&A
[/fusion_text][fusion_separator style_type=”single solid” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” sep_color=”” top_margin=”15px” bottom_margin=”15px” border_size=”” icon=”” icon_circle=”” icon_circle_color=”” width=”100″ alignment=”left” /][fusion_accordion type=”” boxed_mode=”” border_size=”1″ border_color=”” background_color=”” hover_color=”” divider_line=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””][fusion_toggle title=”1. What should I tell my DASP clients about the transition?” open=”no”]
Dental Providers can reassure their DASP clients that this transition only changes who will be processing their claims. There are no changes to the rules for eligibility for coverage and they can expect to receive the same annual communications from the Government of Alberta that they would regularly receive each June.
[/fusion_toggle][fusion_toggle title=”2. When will ADSC take over the administration of DASP?” open=”no”]
ADSC will take over administration of DASP on July 1, 2015. Please continue to submit claims to Alberta Blue Cross until that date. ADSC will communicate more detailed information about the transition during June.
[/fusion_toggle][fusion_toggle title=”3. How will Dental Providers be paid by ADSC?” open=”no”]
ADSC will pay dental providers in the same manner it currently pays you for the various Human Services plans it administers. There will be one combined payment for Human Services and DASP clients. The payments will be direct deposited to the same bank account currently used for Human Services payments on a bi-weekly basis. The Explanation of Benefits statements will be distributed in the same manner as they are currently provided (electronically or by mail), with information for clients from all programs on a single statement.
[/fusion_toggle][fusion_toggle title=”4. Will ADSC provide the same pre-authorization services for DASP claims that they currently provide for Human Services claims?” open=”no”]
Yes, Dental Providers will be able to utilize existing web, ITRANS, or telephone processes to get information from ADSC about coverage, card eligibility, and payment amounts.
[/fusion_toggle][fusion_toggle title=”5. Can Dental Providers still balance bill DASP clients?” open=”no”]
Yes, there are no changes to the plan rules for DASP clients during the transition. Dental Providers can still balance bill DASP clients. ADSC encourages all Dental Providers to submit their claims to ADSC for direct payment and collect only the balance bill amount from the DASP clients.
[/fusion_toggle][fusion_toggle title=”6. Are the DASP fees changing?” open=”no”]
No, there will be no change to the DASP fees during the transition.
[/fusion_toggle][fusion_toggle title=”7. How can Dental Providers submit claims to ADSC for DASP clients?” open=”no”]
Dental Providers can utilize any of the claims submission processes currently in use for the Human Services programs already administered by ADSC. These processes include electronic submission through ITRANS (utilizing the existing ADSC information), fax submission to 780-426-7581 or mail submission to the ADSC office.
[/fusion_toggle][fusion_toggle title=”8. Are there any changes to the DASP exceptions process?” open=”no”]
There are no changes to the DASP exceptions guidelines or rules. The only change is that you will now submit your DASP appeals directly to ADSC for administration.
[/fusion_toggle][fusion_toggle title=”9. Who do I contact with questions about DASP?” open=”no”]
Dental Providers should contact:
Alberta Dental Service Corporation
Phone: 1-800-232-1997 or 780-426-7526 (in Edmonton); DASP will be Option 1.
Fax: 780-426-7581
Mail: #200, 17010 – 103 Avenue, Edmonton, AB T5S 1K7
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Update #2 Q&A
[/fusion_text][fusion_separator style_type=”single solid” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” sep_color=”” top_margin=”15px” bottom_margin=”15px” border_size=”” icon=”” icon_circle=”” icon_circle_color=”” width=”100″ alignment=”left” /][fusion_accordion type=”” boxed_mode=”” border_size=”1″ border_color=”” background_color=”” hover_color=”” divider_line=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””][fusion_toggle title=”1. Is there an information brochure available for seniors about the DASP?” open=”no”]
Yes. A printable brochure is available in the Quicklinks above. If you would like a supply of brochures, please contact ADSC by phone at 1-800-232-1997 or 780-426-7526 (in Edmonton); DASP will be Option 1.
[/fusion_toggle][fusion_toggle title=”2. Who should a senior contact if they have lost a cheque issued by Alberta Blue Cross prior to July 1?” open=”no”]
The senior should contact Alberta Blue Cross directly in this situation.
[/fusion_toggle][fusion_toggle title=”3. Do DASP clients need to re-apply for their coverage to continue?” open=”no”]
This transition will not cause a disruption in service. If your patient is already enrolled in the DASP, his/her information will automatically be transferred to ADSC. If your patient is not enrolled in the DASP, he/she will need to complete a Seniors Financial Assistance application and mail it to:
Alberta Seniors
PO BOX 3100
Edmonton, Alberta T5J 4W3
[/fusion_toggle][fusion_toggle title=”4. Where do I send DASP claims?” open=”no”]
Up to June 30, 2015, please continue to send your dental claims to:
Alberta Blue Cross
10009 – 108 St NW
Edmonton, AB T5J 3C5
Regardless of the Date of Service, beginning July 1, 2015, please send your dental claims to:
Alberta Dental Service Corporation
#200, 17010 – 103 Avenue
Edmonton, AB T5S 1K7
[/fusion_toggle][fusion_toggle title=”5. What will happen if I accidentally submit an electronic DASP claim to Alberta Blue Cross after July 1? Will it be forwarded to ADSC?” open=”no”]
You will receive an electronic response from ABC indicating that the coverage is no longer in effect. Your electronic claim will NOT automatically forward to ADSC. You will need to submit the claim directly to ADSC.
[/fusion_toggle][fusion_toggle title=”6. I submitted a claim to Alberta Blue Cross prior to July 1 and I haven’t received a payment yet. Who do I contact?” open=”no”]
After July 1, contact ADSC with your enquiries. ADSC will investigate whether the claim has been received and whether a payment has been issued.
[/fusion_toggle][fusion_toggle title=”7. I received a pre-authorization from Alberta Blue Cross prior to July 1. Is it still valid?” open=”no”]
Yes, all pre-authorizations will still be valid. DASP pre-authorizations will continue to function as they already do, which includes some differences from how ADSC manages the other Alberta Health pre-authorizations. For example, DASP pre-authorizations do NOT hold the procedure codes for the provider who requested them and the senior is able to visit another dental provider to complete the treatment. Please contact ADSC to confirm procedure eligibility before providing treatment.
[/fusion_toggle][fusion_toggle title=”8. Who do seniors contact with questions about DASP?” open=”no”]If their question is regarding a pre-authorization, exception or claim payment, they should contact:
Alberta Dental Service Corporation
Phone: 1-800-232-1997 or 780-426-7526 (in Edmonton); DASP is Option 1.
Fax: 780-426-7581
Mail: #200, 17010 – 103 Avenue, Edmonton, AB T5S 1K7
Web: www.albertadentalservicecorp.com
If their question is regarding eligibility, they should contact:
Alberta Supports Contact Centre
Phone: 1-877-644-9992 or 780-644-9992 (in Edmonton)
Web: www.health.alberta.ca[/fusion_toggle][/fusion_accordion][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container admin_label=”” hundred_percent=”no” equal_height_columns=”no” menu_anchor=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”rgba(219,217,214,0.3)” background_image=”” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ video_mp4=”” video_webm=”” video_ogv=”” video_url=”” video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” video_preview_image=”” border_size=”” border_color=”” border_style=”solid” margin_top=”” margin_bottom=”” padding_top=”50px” padding_right=”” padding_bottom=”50px” padding_left=””][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_1″ spacing=”yes” center_content=”no” hover_type=”none” link=”” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” undefined=”” background_repeat=”no-repeat” border_size=”” border_color=”” border_style=”solid” border_position=”all” padding=”” margin_top=”0px” margin_bottom=”0px” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” last=”no”][fusion_text]
Update #3 Q&A
[/fusion_text][fusion_separator style_type=”single solid” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” sep_color=”” top_margin=”15px” bottom_margin=”15px” border_size=”” icon=”” icon_circle=”” icon_circle_color=”” width=”100″ alignment=”left” /][fusion_accordion type=”” boxed_mode=”” border_size=”1″ border_color=”” background_color=”” hover_color=”” divider_line=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=””][fusion_toggle title=”1. With ADSC becoming the dental claims administrator, will Dental Providers be paid for DASP clients using the Human Services program fee schedules after July 1st?” open=”no”]
No. Claims for DASP clients will continue to be administered based on Alberta Health’s DASP fee schedule. The DASP fee schedule effective for July 1st is almost unchanged from the current DASP fee schedule, with only some minor changes to enhance exam codes to the benefit of DASP clients. The updated DASP fee schedule is now available in the Quicklinks above.
[/fusion_toggle][fusion_toggle title=”2. Will ADSC be recognizing the different plan rules between DASP and the low-income dental programs?” open=”no”]
Yes. ADSC will administer the DASP and the low-income dental programs (formerly known as the Human Services programs) utilizing the unique plan rules currently in effect for each program.
[/fusion_toggle][fusion_toggle title=”3. Are Dental Providers required to do eligibility inquiries and preauthorizations before providing services to DASP clients?” open=”no”]
Eligibility inquiries and preauthorizations are NOT required, but we highly recommend that you take advantage of these services. They ensure that the Dental Provider and the DASP client know exactly what will be covered and paid. These services are available electronically through ITRANS or by telephone at 1-800-232-1997.
[/fusion_toggle][fusion_toggle title=”4. Will the electronic responses to eligibility inquiries and preauthorizations show the percentage rate that the senior is eligible for through DASP?” open=”no”]
No. At this time the responses will not display the percentage rate that the senior is eligible for through DASP in a separate column or message. The percentage rate will be applied to determine the payment amount displayed, so the percentage rate can usually be calculated. We will be enhancing our responses in the near future to display this information. In the meantime, you could obtain this information from ADSC by telephone.
[/fusion_toggle][fusion_toggle title=”5. Can Dental Providers still balance bill DASP clients?” open=”no”]
Yes. There are no changes to the plan rules about balance billing DASP clients.
[/fusion_toggle][fusion_toggle title=”6. Will the DASP clients be receiving new ID cards or ID numbers?” open=”no”]
No. DASP clients will continue to use their existing Government of Alberta issued ID cards and ID numbers.
[/fusion_toggle][fusion_toggle title=”7. What changes will Dental Providers have to make to their office software for the DASP clients?” open=”no”]
Dental Providers will have to adjust the information in their office software to change which dental administrator will receive electronic claims and to adjust which fee schedule table is accessed to fill fee rates into electronic claims. The process to make these changes varies for each office software system. ADSC has reached out to the top office software vendors to advise them of the upcoming change in administrators for the DASP. Dental Providers should contact their office software vendors for assistance. A more detailed information page about this topic is available in the Quicklinks above.
[/fusion_toggle][fusion_toggle title=”8. What Carrier ID should Dental Providers send electronic claims to?” open=”no”]
Electronic claims should be submitted to Carrier ID 000105 (ADSC). This is the same Carrier ID currently used for low-income dental program claims.
[/fusion_toggle][fusion_toggle title=”9. How can a Dental Provider set up to submit ITRANS claims for the first time?” open=”no”]
The process to set up to submit ITRANS claims for the first time is not difficult. ADSC receives ITRANS claims through the instream network. Your office software vendor may be able to assist. A detailed information sheet on this process is available in the Quicklinks above.
[/fusion_toggle][fusion_toggle title=”10. Will ADSC be accepting electronic claims on July 1st even though it is a statutory holiday?” open=”no”]
Yes. ADSC will be accepting electronic claims on July 1st.
[/fusion_toggle][fusion_toggle title=”11. Can Dental Providers who choose to not accept assignment for payment still submit claims electronically on behalf of their DASP clients?” open=”no”]
Yes. Electronic claims can be submitted by the Dental Provider and ADSC will send payment directly to the DASP client.
[/fusion_toggle][fusion_toggle title=”12. What Plan Number should be used on the claim form?” open=”no”]
You can continue to utilize Plan Number 101 for DASP claims.
[/fusion_toggle][fusion_toggle title=”13. How should a paper claim form be completed to differentiate between a DASP claim and a Human Services claim?” open=”no”]
You can utilize Plan Number 101 or write “DASP” on the paper claim form for DASP claims.
[/fusion_toggle][fusion_toggle title=”14. How should a paper claim form indicate whether payment is to be made to the Dental Provider or the DASP client?” open=”no”]
In the assignment section at the top right side of the standard dental claim form, you can cross out the box with an “X” or you can write in “Pay Patient”.
[/fusion_toggle][fusion_toggle title=”15. Is a special claim form required for a DASP claim?” open=”no”]
No. You can utilize a standard dental claim form.
[/fusion_toggle][fusion_toggle title=”16. When can we start mailing paper DASP claims to ADSC?” open=”no”]
You can start mailing paper DASP claims to ADSC now as the mail time will mean that the claim will likely not arrive at our office until July 2nd. If the paper claim arrives early, ADSC will hold the claim and process it on July 2nd.
[/fusion_toggle][fusion_toggle title=” 17. If a DASP client has other dental coverage, which plan should the claim be submitted to first?” open=”no”]
DASP claims should be submitted to DASP first. This is a different plan rule from the low-income dental programs where the low-income dental programs will continue to be the payer of last resort.
[/fusion_toggle][fusion_toggle title=”18. How long after the date of service can claims be submitted?” open=”no”]
Electronic claims can be submitted up to 14 days after the date of service. Paper claims can be submitted up to 365 days after the date of service.
[/fusion_toggle][fusion_toggle title=”19. How does a Dental Provider submit a request for an exception?” open=”no”]
Exceptions should be submitted to the ADSC Review Committee. Include the treatment plan and all other supporting documentation for the request. Requests can be submitted to ADSC by mail or fax.
[/fusion_toggle][fusion_toggle title=”20. How will Dental Providers be paid by ADSC?” open=”no”]
ADSC will pay dental providers in the same manner it currently pays you for other Government of Alberta plans it administers. There will be one combined payment for the Alberta Health low-income dental programs and Alberta Health DASP clients. The payments will be direct deposited to the same bank account currently used for the other Alberta Health payments on a bi-weekly basis. The Explanation of Benefits statements will be distributed in the same manner as they are currently provided (electronically or by mail), with information for clients from all programs on a single statement.
[/fusion_toggle][fusion_toggle title=”21. Will the Explanation of Benefits show the percentage rate that the senior is eligible for through DASP?” open=”no”]
No. At this time the responses will not display the percentage rate that is paid through DASP in a separate column or message. The percentage rate will be applied to determine the payment amount displayed, so the percentage rate can usually be calculated. We will be enhancing our responses in the near future to display this information. In the meantime, you could obtain this information from ADSC by telephone.
[/fusion_toggle][fusion_toggle title=”22. Will ADSC be deducting an administration fee from the payment like Quikcard does for its private business clients?” open=”no”]
No. There are no administration fees deducted from any ADSC payments.
[/fusion_toggle][fusion_toggle title=”23. Why will payments be issued only every second week?” open=”no”]
This approach is consistent with that taken for low-income dental programs and aligns with the Government of Alberta’s approach, which is to provide the funding for the claims payments every two weeks.
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