By Rose Nierman, RDH

Did you know that dental practices have been getting reimbursed by medical insurance for over 30 years? In fact, I wrote my first manual for cross coding and billing medical insurance in a dental office in 1988 – 28 years ago! (I just so happened to be 12 when I wrote it!) Even back then, we worked with hundreds of leading-edge dental practices and pioneered a protocol for getting their dental office up-and-running with cross coding.

We helped dentists get paid for TMJ disorder treatment, implant related procedures, oral surgeries, accident cases, periodontal treatment, and later sleep apnea appliances and treatment.

30 years later, policies, trends, and codes have changed, however the fundamental principles and protocols behind cross-coding and dental medical billing have remained the same.

  • You need the proper diagnosis codes and procedure codes.
  • If it wasn’t documented, it didn’t happen.
  • Don’t get discouraged or give up when dealing with the medical insurance company.

cross coding dental to medical

So what are the benefits of cross coding? And why does it seem like more and more dental practices are accepting medical insurance? What’s in it for them?

Increased Case Acceptance – This is a big one! You are making the treatment easily obtainable to your patients. Patients who have a consultation for a procedure may opt against moving forward because of cost of treatment. What if you could verify that the patient’s medical insurance would cover a majority of the treatment, significantly lowering their out-of-pocket cost? They are much more likely to move forward with treatment knowing they are covered.

Shift Towards Dentists as Oral-Systemic Health Providers – Within the last decade, dentistry has become increasingly involved in the patient’s total health and wellness. Many dental practices now provide nutrition counseling, oral cancer screening, headache and orofacial pain treatment. It just so happens the fastest growing field in dentistry, dental sleep medicine (sleep apnea dentistry), is commonly covered under medical insurance.

Standing Out From the Crowd- With over 200,000 dentists in the U.S.alone, it seems like there is now a dental practice on every street corner. How do you maintain an edge over your peers? You may be the most qualified, experienced, and friendly dentist in your area, but if a patient has to pay out-of-pocket for a service the dentist next-door will bill to their medical insurance, you may find yourself losing out.

Next Steps: Getting your dental practice implemented for cross coding and medical billing is a matter of proper training and education. Our renowned course – CrossCoding: Unlocking The Code to Medical Billing in Dentistry is our seminar to get you up-and-billing!