Hot Summertime Tips for Dental Medical Billing
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Hot Summertime Tips for Dental Medical Billing

It’s halfway through the year and the heat is on! If you’ve not started billing medical for applicable dental procedures, now’s the time and we have some tips for you. 

  1. Proper medical billing setup must be done first or claims will be denied.
  2. Obtain a business NPI #
  3. Set up an account with CAQH so you can let the medical plans know who you are.
  4. Understand that billing both types of plans at one time is not wise. Learn the insurance laws.
  5. Gather a list of insurance rules for your State
  6. Compliance rules for both dental and medical is the most important part of all patient information, chart notes and billing.
  7. Understand that an audit is not only done when an office is not in network or is full fee for service. It can happen to everyone.
  8. Learn the ICD-10 Codes for Dentistry.
  9. Learn the SOAP format for documentation.
  10. Understand how to document the clinical note to use it for a letter of medical necessity.
  11. Medical plans may require a letter of medical necessity to pre-approve the treatment being recommended.
  12. Learn the correct way to find the cross code for a dental treatment. There is no way to do a one-to-one cross code. Even using a computer system requires training in this category.
  13. Use available online tools for pre-verification, pre-authorization, and some of the medical billing you will provide.
  14. Understand how to resubmit a claim when needed.
  15. Understand how to appeal a claim.
  16. Treatment planning issues are different when dealing with medical insurance. The up-front fees are higher since the deductible is higher. There are explanations to use when a patient is asked for $3,000.00 down.
  17. Review and understand assignments of benefits.
  18. Ask Medicare Advantage questions
  19. Check for overpayments in aging files. This is a must for all offices.
  20. Providing patients with flexible payment options will drive greater treatment acceptance.
  21. Learn how to bill dental if certain procedures are not covered by medical.
  22. Understanding the rules of a HIPPA Form.
  23. Know the rules around charging insurance companies interest past the timeline in your state per applicable laws.
  24. Keep a spreadsheet of medical claims paid by the treatments for a stronger understanding of the extra work. Building your own knowledge base of what works will be critical to your team’s success.

Need assistance? Consult the experts at Dental Medical Billing University for help getting started with billing medical in your dental practice.

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