TMD Billing


You will learn how to bill medical insurances for TMD Therapy. All modalities included: orthotics(splints), Botox and Laser Therapy. This item is free for members and no purchase is necessary.

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What you will learn

  • Learn how to use a template that you use to add the specific patient’s information, health and specific details with clarifications when appealing.
  • Appeals are an opportunity to request disclosure from the payer regarding the specific policy of plan language used to make the decision.
  • Always adding a disclosure request embedded within an appeal letter puts the payer at risk for non-compliance with certain disclosure laws regarding adverse benefit determinations. And adding a disclosure from the patient to appeal the claim.
  • Learn– A lack of authorization appeal requires customization because there are several different scenarios which trigger the denial.

What you will be able to provide after this course:

Writing an appeal for any of the reasons that are put on the claim.

  • Timely filing – Any timely filing appeal letter should be customized to cite the date of initial submission along with documentation of the original submission.
  • Medical Necessity – Medical necessity appeals should be customized with extensive information from the patient medical record.
  • Benefit Reduction/Down coding – Benefit reductions/discounting are often ambiguously applied to claims without sufficient explanation.
  • It is good to start the letter by stating basic claim information and giving the denial reason. This paragraph should also indicate your desire to appeal the denial. Further, if you have obtained specific instructions in the denial letter, reference this information.


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