Dentists, Aetna Reach Deal

Representatives of 147,000 dentists, the American Dental Association and Aetna have reached agreement seeking to improve communication and collaboration, and lessen complexity in the payment of dental claims. Dentists and Aetna anticipate that these initiatives will reportedly enable them to operate more efficiently, and serve patients and customers more effectively.

If approved by the court, the agreement would settle a national dental class action that had been consolidated with a series of similar actions brought on behalf of physicians. The agreement follows a proposed settlement of the physician cases announced on May 22 and given preliminary approval by the court on June 2.

The actions embodied in the agreement are expected to result in increased predictability and speed of claims payment for dentists; creating significant value by reducing time-consuming and costly administrative burdens, and giving dentists and their office staffs more time to focus on their central mission – providing care to patients. Aetna also expects that these actions will allow it to operate more efficiently and serve its customers and members more effectively, with lower administrative costs over time.

Aetna has agreed to pay $4 million to dentists and $1 million to the ADA Foundation. The costs associated with this agreement were anticipated and already recorded in the second quarter of 2003 as part of the charge associated with Aetna’s settlement of the Physician Class Action Litigation.

Key elements of the agreement include:

*Establishing a Dental Advisory Committee to provide advice to Aetna on issues of concern to dentists.
*A commitment to timely processing of “clean” claims.
*Initiatives to reduce claims resubmissions.
*Disclosure of claims-editing policies, procedures and practices.
*Increased electronic connectivity, and direct web-enabled access to Aetna systems to verify reimbursement information and track claims.
*Contribution to Foundation to Promote Dental Health

Under the agreement, Aetna will contribute $1 million to the ADA Foundation in order to support the foundation’s initiatives to enhance dental health care for Americans.