Specialty dental billing may appear intimidating. General dental billing already has its complexities, and incorporating specialty procedures can lead to added stress. In this ongoing series, we will offer insight into the nuances of specialty billing practices, continuing with oral surgery billing.  What is Oral Surgery?  Oral surgery is the surgical treatment of the teeth, jaws, gums, and any other soft or hard oral tissue. An oral surgeon completes this treatment, although occasionally, a general dentist may complete a simple extraction. According to the American Association of Or ..read more

Dental medical coding is a complex maze, but unlocking its intricacies is becoming more and more crucial for dental practices. This knowledge facilitates efficient billing, seamless insurance processing, and an overall improved patient experience. In this article, we’ll dive into 8 tips for implementing dental medical coding in your dental practice. What is dental medical coding? Dental medical coding involves a standardized system of alphanumeric codes used to report dental procedures and diagnoses for dental treatment deemed medically necessary to medical insurance payors. These cross-codes ..read more

Dental billing is essentially submitting a dental claim to an insurance company in order to be reimbursed for treatment completed. It may sound like a simple process but in our current era of ever-evolving CDT codes, increased insurance regulations, and medical-dental integration there’s a lot more to it than meets the eye. In the following we’ll review several aspects of dental billing so you may better understand its process.  Credentialing  Any time a new doctor joins a practice, it’s important that they’re properly credentialed before billing insurance claims for treatment they c ..read more

Depending on the office, oral surgery can take up a large amount of the dental billing workload. Though seemingly straightforward, there are several details to consider when billing claims, and these can lead to a number of roadblocks in getting them resolved. Here we will review a few of these details and offer some tips on how to overcome any potential delays and get oral surgery claims paid. Pre-authorizations and Referrals Before beginning oral surgery treatment, it’s always best to review the patient’s insurance plan requirements. If they have an HMO plan, any specialty treatment, includi ..read more

Dental billing requires a lot of effort. Between credentialing doctors, verifying insurance coverage, applying correct CDT codes, completing ADA claim forms, and attaching documents, it takes up a lot of the workday. So, it can be incredibly frustrating when a claim has been denied and all that effort has been wasted, but, with a little extra knowledge you can reduce dental claim denials and, instead, increase revenue. In the following, we will review common denial scenarios and ways to avoid them.  Treating Doctor is Out-of-Network  This one can sneak up on you because, often, if th ..read more

On the surface, CPT and CDT codes appear to be the same. After all, they’re only one letter apart. But the reality is that they are two very different coding systems used in the healthcare industry. The argument can be made that they are related, but they’re certainly not interchangeable. That being said, as dental care and medical care become more symbiotic, chances are you will grow familiar with both.  What is a CPT Code?  Current Procedural Terminology, or CPT, was developed by the American Medical Association in 1966. According to the AMA, “…CPT codes provide a uniform nomenclat ..read more

Dental insurance is complicated and regulated. Dental billers collect patient payments and process health insurance claims for dental clinics. Dental billers must verify patient insurance coverage and submit all necessary documentation to receive accurate and timely insurance reimbursement. This guide covers dental insurance claims processing basics like insurance coverage verification, prior authorization, and supporting documentation. Dental claims and billing are complex. Simple mistakes can cause denials and cash flow interruptions. Fixing and submitting claims is costly and time-consuming ..read more

Do you ever wonder what goes into the dental billing process from start to finish? We have broken down the process into 8 simple steps to help you gain a better understanding of it. Every step plays a significant role in the process, despite appearing insignificant. Although every dental office may have its own individual approach, these steps are vital in guaranteeing an effective dental billing process and maximizing your income. Step 1: Intake call The first step is when the patient calls to schedule their appointment. In this stage, it is very important for the office to gather as much inf ..read more

Dental insurance claims processing involves a host of standard procedures that must be followed properly in order to ensure full reimbursement. Many dental offices do not document as thoroughly as they should. No matter the reason — and usually the reason is not having enough time — this can become a major revenue cycle management roadblock. Insurance providers are constantly changing their mandatory guidelines for reimbursement, making accurate clinical documentation even more critical. Do you feel that your current level of dental clinical documentation is helping or hurting your insurance r ..read more

It is a surprising fact that many offices do not document as thoroughly as they could. This is a major roadblock in the dental billing process that keeps offices from collecting 100% of what they are rightfully owed. How would you rate your office’s current clinical documentation? It may not be up to par, but you aren’t sure how to improve it. If you are unable to use it to support or appeal claims, we will break it down so you can get those clinical notes to rockstar status. An easy acronym for clinical notes that dentists learn in dental school is SOAP, which stands for Subjective / Objectiv ..read more