Dealing with Dental Insurance Consultants

Accuracy and Completeness

This is a good rule to remember regardless of if the claim is for simple services (exams, prophys, direct restorations, etc.) that are automatically processed or large cases that need consultant review. Not only should the patient/doctor information be complete and up-to-date but the body of the claim, where you explain what treatment you’ve performed or intend to perform, must be accurate. Any omission or inaccuracy can cause that claim to suspend and a “Need More Information” letter sent to you for clarification. And this will delay benefits being paid.

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.

Dealing with Dental Insurance Consultants – The BIG Secret

It’s Friday afternoon and the day has not been going well. Mrs. C cancelled her 2 hour 6-veneer appointment at the last minute this morning because her little girl has strep. The occlusion on Mr. S’s full denture wasn’t on the money so you need to do a new occlusal analysis. And to finish up the day, XYZ Insurance Company’s dental consultant denied your request for a crown on your neighbor and gave you an alternate benefit of an amalgam!

“Why do they do this to me!” You scream to the dental gods. “Don’t they know that the lingual cusp on # 20 is fractured subgingivally?”

The truth is that if it’s not obvious on the x-ray (assuming you sent one) and you didn’t tell them, then they probably didn’t know.

So, let’s back up a minute and see what can be done to speed up your claims through the dental consulting review process so the only thing contributing to your increasing baldness is genetics.

We are going to start a series of posts that will assist you in dealing with these perceived converts to the “Dark Side of Dentistry”.

Comments/War Stories are always welcome!

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.

Free Tour

Take a free tour.........around your office.......see what your patients' see.

Sit in the treatment chair. Put the chair back and turn your head from side to side to see what the patient sees. Is there dust underneath the edge of your countertop that you wouldn't notice in a million years? If you never look up, is your cleaning crew making sure there are no dead bugs in the florscent lights?

Can the patients in the waiting room see that pile of unfiled charts sitting on top of your filing cabinets?

Perception is reality and your office may be perceived as unclean by these simple observations even though you observe every CDC edit ever issues.

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.

New CDT code set

Are you ready for a new set of CDT (Current Dental Terminology)?

CDT-2007 will be released later on in the year with it becoming the required code set, effective 1/1/07, for all offices that must be HIPAA compliant. (If you or a third party submit your claims electronically, you will be required to use it).

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.

Local Anesthesia - To Bill or Not To Bill

CDT-4 states that local anesthesia is included in dental procedures. CDT-5 states that it is usually included. Why the change and what are the ramifications?

Certain insurance plans allow for a separate benefit for local anesthesia. Most do not and consider it an inherent part of the primary procedure performed.

Posted by The Huskin Group for JR-NJ. To have your questions posted, CLICK HERE

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.

International Accreditation

International accreditation will be the topic on March 20 at ADA headquarters.

Registration forms may be obtained from the AADE.

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.

NPI - National Provider Identifier

By May of 2007 (or sooner) if you submit your claims electronically, you will have to obtain a ten digit NPI from the government.

The application can be made over the web and usually takes only short time to process and receive. Or you can download and commplete a paper form and mail it in,

Data you will need when you apply is any tax ID's you use, state license number, home and practice address.

More information can be obtained by going to the ADA website www.ada.org.

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Visit us at The Huskin Group about our dental insurance and practice management services.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.