When billing dental insurance claims there are so many rules and regulations that things can get confusing. Especially when there are two carriers involved. When a patient has two insurance plans, it can sometimes be unclear how the second plan functions. In the following, we will provide an answer to the common question, “How does secondary dental insurance work?”  What is secondary dental insurance?  A patient can be covered by more than one dental insurance plan. When this occurs, one plan will be primary and one plan will be secondary. The primary plan will be billed first and th ..read more

Insurance denials are frustrating, especially when they are the result of a claim that was billed incorrectly. Incorrect claims directly contribute to increased A/R in dental practice. With a little practice, they can be avoided. Here are eight ways to avoid incorrect claims.  1) Verify your patient’s information before starting treatment  Claims may be denied due to “patient not found” or “patient’s name and date of birth do not match our records.” That’s why it’s so important to make sure your patient information is correct. Make sure their name is spelled correctly, their correct ..read more

Dental insurance plans are complex, making it difficult to understand all their rules and regulations. From clauses and limitations to restrictions and regulations, there’s much to learn and understand. Since dealing with insurance plans is a daily dental office task, it’s important to understand their many nuances. One area that many dental professionals struggle with is dental insurance annual maximums. The following are responses to some commonly asked questions about them.  Dental Insurance Annual Maximum Basics  What is a dental insurance annual maximum?  A dental insurance ..read more

All of the moving parts of insurance verification necessitate a steady, consistent hand. Your front office staff must ensure that each patient walking in through the door has the correct coverage amounts for treatment, each and every time. Without this, surprise bills can keep patients from ever coming back, all the while carrying a balance that can balloon to the thousands. What’s the best way to prevent this without incurring additional workload and staffing? Dental insurance verification outsourcing. Let’s look at the role of insurance verification in your practice and ways to remedy this c ..read more

When it comes to dental coding, things are ever-evolving. In fact, 16 code changes are coming in 2024 so it’s no surprise that a common reason for dental denials is incorrect coding. In this ongoing series, we discuss common coding errors, this time focusing on D4341 & D4342.   What is the difference between D4341 & D4342?  D4341 is the dental code for scaling and root planing, four or more teeth per quadrant and D4342 is the code for scaling and root planing, 1-3 teeth per quadrant. The only difference between the two is the amount of teeth involved in the treatment.&nb ..read more

The number one priority for any dental office is the patient. To keep them healthy and happy it’s essential to give them proper care throughout all steps of their treatment, from the moment they make their appointment until well after they’ve left the office. When they call to make an appointment, a proper pre-appointment readiness plan will ensure their satisfaction throughout their entire experience. In the following, we will discuss key tips on how to ensure a positive patient experience through pre-appointment readiness.  Appointment Confirmation Pre-appointment readiness begins when ..read more

Dental billing can be an overwhelming task thanks to continually updated CDT codes, ever-changing insurance regulations, and rapid advancements in dental technology. When you add in specialty treatments like endodontics, orthodontics, and periodontics, it can be even more overwhelming and you may not even know where to begin. But, with a little guidance, specialty dental billing can become much less intimidating and much more manageable. In this ongoing series, we will offer insight into the various nuances of specialty billing practices beginning with periodontal billing.  What is Period ..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

In dental billing, things are ever-evolving, especially regarding coding. Did you know that in the last 3 years, there have been 160 CDT code changes? That’s a lot to keep up with for any dental biller. It’s no wonder then, that a common reason for dental denials is incorrect coding. In this ongoing series, we will discuss common coding errors beginning with D1110 (adult prophylaxis) and D1120 (child prophylaxis).   What is adult prophylaxis?  According to the ADA, adult prophylaxis (D1110) is “the removal of plaque, calculus, and stains from the tooth structures in the permanen ..read more

Insurance verification is deceptively simple. At first, it appears to be merely contacting an insurance company to confirm the patient’s coverage matches their insurance card, but, in reality, it’s so much more than that. Just as insurance plans are complex entities filled with provisions and restrictions, insurance verification is a detailed, multi-stepped process that requires a number of questions to be asked in order to ensure your claim is billed correctly. Here are examples of just what to ask when verifying insurance.  What are the plan’s effective dates?  Don’t assume the den ..read more