Due to HIPAA concerns, effective January 1, 2019, Delta Dental of Tennessee will no longer accept phone inquiries from third-party solutions such as Medusind, BPOSS, and Clinicspectrum who initiate calls to obtain benefits and eligibility information on behalf of dental offices.
Research shows that some third-party entities are not accredited with the Better Business Bureau and cannot be adequately verified. We are therefore concerned about disclosing our members’ PHI to these entities.
Per HIPAA, the Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose.
The average call length with these third-party solution vendors is in excess of 10 minutes (some more than 30 minutes) requesting benefits of up to 40 patients at times, multiple codes, run downs, plus complete claims history, which we believe may not meet the minimum necessary requirement under the Privacy Rule.
Although Delta Dental of Tennessee will no longer provide member benefits information to third-party services by phone, dental providers can still retrieve benefit and eligibility information by phone, by accessing the Delta Dental website, or by submitting pretreatment estimates. We appreciate your cooperation as we work together to protect our members and your patients.