Are you a dental student (in any country)?  Interested in getting your research papers published in an international academic journal?  The IDJSR is calling on dental students to submit research papers on a variety of topics including:

• Dental Anatomy and Oral Histology
• Oral Pathology and Microbiology
• Prosthodontics
• Pedodontics
• Community Dentistry
• Oral Medicine and Radiology
• Oral and Maxillofacial Surgery
• Conservative Dentistry and Endodontics
• Dental Materials
• Implantology

For details please visit the International Dental Journal of Student’s Research

Please Join Us for a FREE 1 credit CE course and hands on program put on by Simona Arcan, DMD, MD, Oral Surgeon, Elizabeth Bassin (Dental Billing Management), and Kerr representative, Andrew Chirgwin. We will be educating you on how certain procedures can be billed through Medical, leaving the patient’s dental benefits available for re-storative/operative procedures, and a new approach to posterior bulk-fill restorations that can add up to $300 of production per day.

Where: Office of Simona Arcan, DMD, MD. 16511 Goldenwest St, suite 109, Huntington Beach, CA 92647

When: March 29th, 6PM   FREE Food and Drinks!   1 CE Unit & a Kerr Goody Bag!

Boosting Practice Revenue with Dental Cross-Billing
The number of Americans with dental insurance coverage declined notably in the period following the economic woes of 2007.  According to the National Association of Dental Plans, dental benefits enrollment had declined 5.7% by 2009 due to economic contraction.  With 56% of the U.S. population reporting some type of benefit plan in 2012, coverage levels appear to have rebounded to pre-crisis levels.  If so, then why are dental practices still feeling the pinch?  A commonly cited reason is declining reimbursement rates.

Getting Out of the Rut
Dentists in many markets are experiencing declining reimbursement rates from dental carriers across the board.  This trend can be prohibitive to the delivery of needed services to patients, especially those procedures of medical necessity which may involve higher dollar claims.  In this climate practice owners are seeking new and innovative ways to enhance practice performance.  Staying abreast of the dizzying number of changes in the industry can be exhausting.  With demanding clinical schedules and limited time available for practice management, the most efficient strategies often are those which can be implemented with the existing procedure mix.  One of these strategies is cross-billing to medical insurance.  Many dentists leave money on the table by failing to maximize reimbursement for the procedures they are already providing. Properly coding and billing to medical insurance for appropriate procedures can increase practice cashflow while adding value to your patient base.

What is Dental Cross-Billing?
Historically, dentistry was viewed distinctly from the field of medicine.  Today there is a large body of research documenting the connection between oral health and body systems and a greater acceptance of the holistic approach to dentistry. As insurance payors embrace the medical nature of dentistry, it is prudent for dentists to re-tool their billing practices in order to be fully reimbursed for their work.  Dental cross-billing involves coding and billing dental procedures to medical insurance payors.  Many doctors are put off by this idea because they are not sure what can be billed to medical insurance and how to follow through with a sustainable course of action.  The level to which medical necessity and documentation is required varies widely by the specific procedure.  Naturally, specialists will encounter more such cases but general practitioners are commonly treating an array of conditions which can be billed medically.  There are a growing number of dentists who provide diagnostics, therapy, surgery, and oral appliances to treat conditions which may have been referred out in the past.

Benefits of Billing Medical Insurance
One major benefit of medical insurance billing is increased revenue. Reimbursement rates from medical carriers commonly are higher than those of dental carriers. For the same procedure dentists can receive significantly greater payment and may also get paid for procedures which are not covered under dental plans.  Patients can also reap the benefits by avoiding out-of-pocket payment for procedures which are billed medically.  Moreover, they will be able to preserve their annual dental plan maximums to use with other services which may previously have been unaffordable.  With this comes greater patient compliance with treatment plans and improved oral health outcomes.  Patients may be more inclined to refer friends and family when they are able to fully leverage their existing coverage and receive additional needed services.  They will also appreciate your medically-oriented approach to dentistry. 

How to Implement Cross-Billing

• Assess your practice and take an inventory of the services and procedures which can benefit.
• Generate reports based on procedure code. It is important to analyze actual data. You cannot improve what you cannot measure.
• Evaluate the effectiveness of cross-billing with the existing procedure mix before adding new procedures.  This will give you some room to work out potential difficulties.
• Invest in staff training or engage a dental billing company that specializes in dental cross-billing.  Some billing agencies will offer a complimentary assessment.
• If your efforts have been fruitful, consider a marketing program designed specifically for those services.  Use the competitive advantage to grow your market share.

The Impact on Your Practice
The role of insurance plans in the dental industry continues to grow and change.  On a national level the market is divided as follows: Private Insurance (48.6%), Patient Pay (39.9%), Medicaid (8.5%) and Medicare (0.3%) (US Census).  This is expected to progress even further in light of looming changes on the horizon as the result of health reform.  While insurance reimbursement can be one of the most financially frustrating aspects of practicing dentistry, dental cross-billing is one of many strategies which can help.  If implemented properly, practices can generate greater revenue with minimal hassle or added cost.  This can yield dividends for your practice today and tomorrow: 1) A noticeable rise in revenue and earnings in the interim, and 2) Increased practice value when it comes time to sell.  Practice value is largely determined by the financial characteristics of your business and boosting short term and long term financial strength can allow you to reap the benefits twice.

Dental cross-billing involves coding and billing dental procedures to medical insurance carriers.  With the reimbursement difficulties many practices are experiencing in today’s market, it is important to stay abreast of insurance changes.  There are a multitude of procedures offered by dentists which can be billed medically.  Failing to properly bill for these procedures can result in thousands of lost dollars to the practice.  Billing medical insurance can simultaneously increase practice cashflow and add value to your patient base.  Dental Billing Management can help you maximize payment for diagnostics, surgeries, therapy, and oral appliances used in your practice.  Here is a partial list of items we can assist with:

• Diagnostics: FMX, Exam, Bitewings, Panoramic, Perapical X-rays, 3D Imaging, Ceph (Only in conjunction with treatment of medical necessity)
• Periodontics: Some SRP cases, Gingivectomy, Gingivoplasty, Bone Graft, Guided Tissue Regeneration, Clinical Crown Lengthening, Gingival Flap
• Oral Surgery: Extractions, Removal of Impacted Wisdom Teeth, Biopsies, Excisions, Removals, Alveoloplasty, Incision and Drainage, Alveolus, Frenectomy, Occlusal Device
• Orthodontics: Treatment for specific circumstances. (Only in cases of medical necessity ie: congenital disorders, accidents, cleft palates, etc.)
• TMJ: Night Guards, Physical Therapy, Surgeries
• Prosthodontics: Oral Surgical Splints, Dentures, Specialized prosthetics
• Sleep Apnea: Appliance and other supporting evidence including Sleep Studies
• Endodontics: Drainage of Abscess, Accident related Endodontics
• Implants: Surgical Placement of Implants, Implant Removal, Surgical Splint
• Other Procedures: Arestin, Behavioral Management, Sedation, Therapeutics, Certain tests of medical necessity

Call to speak with one of our billing experts for further details

Here is a recent video posted by the Office of Inspector General regarding the importance of proper documentation.  It is critical for providers to sufficiently document and justify the services they are providing.  This is important for submitting accurate insurance claims, protecting against malpractice and other liability, and providing good quality care to patients.

In a recent podcast, Dr. Lawrence Levin from UPenn discusses orthotic appliance use for sleep apnea treatment with Reach MD Host Dr. Lee Freedman.  The link can be found here: Trends in Oral and Maxillofacial Surgery.  The segment discusses dental issues seen in a doctors office and the involvement of an oral surgeon for treatment of sleep apnea.  Discussion includes surgical and non surgical treatment.  The challenge with many of these treatments is for dentists to get paid for these treatments, which is the need for proper billing and coing.  Remainder of the podcast talks about the use of dental implants, injuries, and distraction for bone regeneration.

Are more patients leaving through the back door than coming in through the front?
One of the most common misconceptions dentists have is that patient records in the computer or in the files constitute active patients. In reality, only those patients that have been in the practice for a hygiene recall appointment in the past 12 months should be counted as active patients. The dental recall system, or lack thereof, is a huge factor in patient attrition.

Educate and communicate with your patients.
Adequate communication between doctor, hygienist and the patient must reinforce the need for ongoing follow up care. It is unfortunately common for many dental office staff to refer to the hygiene appointment as a “routine” checkup, which trivializes the importance of the recall and confirming the patient’s perception that these appointments are not important.

If there are too many open appointment times, clearly the recall system needs to be improved.
An effective recall system ensures that your practice has no more than an occasional opening in the weekly schedule. Too many dental offices take for granted that their patients will continue to return as recall patients, but when they don’t, there is no system in place to get them back on the schedule. Or, some dental practices that pre-appoint six months in advance are assuming 100% retention, but that is not the reality. Pre-scheduling six month recalls is a good start, but it is essential that patients are educated about the value of the recall and the front office staff must systematically follow-up. Call those patients with unscheduled treatment plans, those that have missed appointments, recall patients. They need to know that you care about them and you are concerned about their oral health and well-being.

Much focus has been recently placed on the use of oral cancer screening devices.  This has been highlighted extensively in media articles and television programs. What does this mean for dental practices? Patients may be more apt to seek the care of their dentist for oral screening as a preventive measure.  Additionally, they may seek care for existing growths as they develop a better awareness of this type of condition.  While biopsies are usually covered under the patient’s dental insurance, may practices have experienced a higher rejection rate for the removal of growths.  Dental insurance companies who reject these claims commonly request offices to alternatively bill under the patient’s medical insurance.  In these cases, many offices do not know how to bill the claim to medical insurance or are reluctant to request reimbursment directly from the patient.  Dentistry involves numerous medically-necessary services and procedures which many offices are well-equipped to provide, but ill-equipped to receive compensation for.  A competent billing service will have the knowledge to bill and collect from medical insurance for all the components: the oral cancer screening, biposy, and any necessary removal.  Contact one of our representatives for a complimentary assessment.

Dental Billing Management is proud to serve on the Professional Advisory Committee of Charter College Long Beach Campus.  We have the distinctive opportunity to help shape the quality of billing and coding instruction received by the students of the MICB program. The main purpose of the Program Advisory Committee is to evaluate and provide industry-current advice on curriculum updates, instructional equipment, new program initiatives, library resources and materials, and input on the dental assistant clinic.  Charter College provides comprehensive education in medical insurance billing and coding.

Many dental practices are seeking an edge in today’s saturated practice environment.  Offering a broader array of services to patients is one method of stimulating growth.  Patient retention can depend on capturing as may possible events of care.  But getting full reimbursement for these services can be challenging.  Patients are also less likely to comply with medically necessary care if their insurance won’t cover it. [Read more...]