Anthem has notified doctors and other providers that the timely filing window for professional claims is being shortened to 90 days. “Effective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. 1, 2019, …
If you or your hygienist is now aware of the Oral connection and the changes being made you should consider sending them to the Insurance Extravaganza which is in Las Vegas. There are so many new codes that should …
Question: What do I do when a Medicare patient refuses to sign an ABN? Answer: That depends on whether the patient is still demanding to have/receive the service/supply. If they aren’t demanding the service, then there is no need to …
Maintaining Defined Scopes of Practice There are specific Medical and Dental Licensing Laws and Practice Acts, which dictate the scope of practice for physicians and dentists (http://www.aasmnet.org/resources/pdf/AADSMJointOSApolicy.pdf). As per individual state law, laws only a licensed physician can make a …
How might I get Medicare dental coverage for dental implants? Maybe you’re still wondering, “Does Medicare pay for dental implants – ever?” If you want to get Medicare dental coverage for dental implants and routine services, you might want to …
What are we waiting for? Most dentists are afraid to make the all-important choice to treat or not treat when it comes to a pregnant woman. Science has shown us the importance of treating women even before they become pregnant …
When teaching at NYU Dental students wrote small books for notes, directly after joining the world of dentistry in a practice they started to use text messages as Dr. Studley would say!!! Are you writing a text message that leaves …
1. ANY traumatic injury to the mouth – all associated oral and dental procedures 2. Exams and consultations when oral cancer screening is done, and in preparation for any other medically billable procedure 3. Emergency treatment of oral inflammation and …
Proof of Delivery 42 CFR 424.57(c)(12) requires suppliers to maintain proof of delivery (POD) documentation in their files. POD documentation, as well as claims documentation, must be maintained in the supplier’s files for 7 years (starting from the DOS). Suppliers, …
Modifiers are valuable coding tools that explain to payers the specific work that was done by a physician during treatment of a patient. They’re important for representing the medical decision-making (MDM) a physician must demonstrate in order to bill, and …