Thursday-Saturday, October 24-26, 2013 • Delta Grand Okanagan Resort • Kelowna, British Columbia
TODS AGM, Luncheon & Keynote Speaker
Thompson Okanagan Dental Society
Annual General Meeting and Elections
Saturday October 26, 2013 12:30pm
Keynote Speakers: Mr. David Crumpton, Compliance & Chief Privacy Officer, Pacific Blue Cross
and
Mr. Dennis Sorensen, Head Of Pacific Blue Cross’s Dental Claims Division
Dennis Sorensen, Manager, Dental Claims and David Crumpton, Director, Compliance and Chief Privacy Officer for Pacific Blue Cross (PBC) will speak on the topic of common mistakes, dental trends, and auditing dental claims at Pacific Blue Cross.
Dennis will discuss trends with claim/pre-authorization submission that include:
- Bundling of codes
- Misuse of codes towards conditions that are not a benefit under PBC plans
- Lack of appropriate, diagnostic, quality documentation to support the necessity of treatment from a contractual perspective
- Future enhancements with PBC – 2013 and beyond
David will discuss the role of Internal Audit in monitoring the billing and payment of dental claims in order to assure Pacific Blue Cross plan sponsors/employers and members that benefits are paid in accordance with plan provisions. He will describe the audit process which includes:
- Initiating a review
- Communicating with dental office
- Patient consent
- Reviewing patients’ dental records
- Findings/recovery
- What do we do when we find evidence of Inappropriate billings/unprofessional behaviour
About Pacific Blue Cross
Pacific Blue Cross has been British Columbia’s leading benefits provider for over 70 years. Together, with its subsidiary BC Life, it provides health, dental, life, disability and travel coverage for approximately 1.5 million British Columbians through employee group plans and through individual plans for those who do not have coverage with their employer.
Biography
Mr. David Crumpton has the following responsibilities:
- as Director, Compliance he manages a team of auditors who evaluate and improve the effectiveness of risk management, control and governance processes. This team also assists in the prevention, detection and deterrence of fraud;
- as in-house counsel he provides legal advice on contractual, health, insurance and corporate matters; and
- as Chief Privacy Officer he offers leadership, training and guidance on the protection of personal and confidential information.
David has degrees from Royal Military College, Queen’s University, and Simon Fraser University.
Mr. Dennis Sorensen - Prior to assuming his role as the Head of Pacific Blue Cross’s (PBC) Dental Claims Department, Dennis Sorensen acquired a diverse portfolio in customer service delivery and offshore operations for large organizations such as TELUS and International Data Solutions (IDS). Dennis brings a strong operational and customer service focus to PBC’s Dental claims processing area. Dennis’s operational background included a strong analytical mind set which lends itself well to researching and identifying opportunities for improvements with dental claiming trends and forecasts. Dennis is also a key contributor to the annual PBC Dental Fee Schedule and has greatly enjoyed learning about the dental insurance industry since joining Pacific Blue Cross.
|
|
Thompson Okanagan Dental Society Annual General Meeting
The following positions on the Board of the Thompson Okanagan Dental Society are available for nominations and election.
- President-Elect
- Secretary/Treasurer
- Director (2013-2015)
Each Executive position is a one year term and is eligible for re-election for a second consecutive term. The Thompson Okanagan Dental Society’s Director position is a two year term and is eligible for re-election for a second consecutive term.
Please contact Dr. Jordan Noftle, President of the Thompson Okanagan Dental Society (250) 498-2323, if you wish to be nominated for any of these positions.
