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The Association for Claims Exchange (ACE) provides a vehicle for dentists and pharmacies to submit claims electronically to insurance carriers.
The Association's purpose is to create a national communications network for electronic transmissions of health related claims directly from the health care providers (dentists and pharmacists) to the insurer who pays the claim. Mr. Bill Topfer, past Chairman of ACE stated that: "Even though all the ACE member companies compete with each other in the health benefits marketplace, it doesn't make practical sense for each company to try to set up its own national claims network. Instead, we chose to create a level playing field by which all insurers and third party administrators, both large and small could take advantage of this new technology". ACE has contracted with National Data Corporation Canada Ltd. (NDC) to provide network services. Under this arrangement, claims are sent from provider locations out over public packet switching networks to NDC. NDC routes the claims to the insurance company for adjudication. Those companies with the capability to adjudicate these claims in an online real-time manner have dedicated lines to NDC and respond to provider locations immediately. Other companies have elected to have NDC capture these claims for them and batch them (via tape or RJE) for processing later. Batch capture optionsexist as well for carriers who are offline/down temporarily. As of today, a number of software vendors have been certified to submit transactions electronically. Dentists and pharmacists throughout Canada are using ACE to submit claims, some in a production mode, some in a test mode. Everyday, more and more health care providers are "getting onto the ACE bandwagon".
For information on ACE, complete the membership information form or contact the ACE office at:
Phone: (416) 598-4223 | ||||||||||