Top 3 Reasons To Take A Medical Billing For Dentistry Course

A common misconception when hiring a medical billing service for your dental practice is that the dental practice team doesn’t need to learn anything about medical billing in dentistry. Everything is all taken care of, and that’s what you are paying the third-party medical biller to handle. Right? As copasetic as this sounds, this train of thought can be costly and risky! Medical billing is different than dental billing and learning the ropes, including what the dental to medical billing service needs from you, will save you time in the long run.

Here are the top 3 reasons why you should participate in a medical billing in dentistry seminar – even if you already utilize or are considering hiring a third-party medical biller.

 

1. Understanding Medical Insurance vs Dental Insurance

A basic understanding of medical benefits is key to setting patient expectations regarding their out-of-pocket costs. Most third-party medical billing services do not interact directly with your patients, although they provide you with detailed information regarding your patient’s medical benefits.

Knowledge of how medical billing works is helpful when you are called on to explain the benefits to your patient! While many patients understand that copayments are part of medical insurance plans, they may not know deductible amounts and how much of the deductible is met for the year.

Countless patients don’t know what coinsurance and out-of-pocket maximums mean, for example, so learning how these differ in medical vs. dental billing is helpful. Also, some patients may not understand that out-of-network providers can balance bill the patient up to the usual fee. The ability to confidently present & explain these medical benefit details to your patient is often the difference between treatment acceptance or “I’ll have to think about.”

 

2. Documentation is Needed when Medical Billing as a Dental Office

You need to be aware of and familiar with medical documentation requirements. While submitting the medical claim form is a vital task, supporting documentation must be supplied to the third-party biller to get the job done successfully.

The claim form alone is simply not enough! Supporting documentation such as SOAP notes and clinical findings showing the need for treatment, diagnostic testing report (i.e., sleep study report, and a letter of medical necessity are typical examples of supporting documentation a medical insurer may request to approve a pre-authorization or process a medical claim.

A third-party medical biller can submit this documentation for you but cannot be the one to create the documentation – that should always be supplied by the practice.

 

3. Know the Cross Codes for Dental to Medical Billing

The liability is still on you – so know the codes! You may be surprised to learn that even if you utilize a third-party medical biller, the dentist/practice is responsible for the coding used on the medical claim form. Unfortunately, if improper coding practices are used, that can result in an unfavorable result (in other words, you may owe that money back in the event of an audit!).

You do not need to be an expert in medical coding, but an understanding of the correct ICD-10 diagnosis codes and CPT procedure codes will help you be successful in medical reimbursements and avoid potentially costly coding issues.

 

Educate yourself for success! Ensure your dental practice team knows the basics about medical billing coding & documentation and what questions to ask your patients and the billing service. A comprehensive medical billing in dentistry seminar covers the basics essential to a smooth, successful & ethical medical billing process in your practice. Nierman Practice Management offers Cross-Coding Successful Medical Billing in Dentistry seminars with both live in-person and virtual online attendance options. Take a billing course to learn what you need to do upfront to make it EASY to work with a dental to medical billing company and reap the benefits of reimbursements from medical insurers for your patients.

Stay Informed of Our Upcoming Dental CE Courses

See our schedule of Nierman dental CE seminars for medical billing for dentists, dental sleep medicine, and TMD.

Article by: Rose Nierman and Courtney Snow, Nierman Practice Management