Our Services
Dental Billing Services
Dental billing services play a crucial role in maintaining the financial stability of a practice by ensuring that payments are processed accurately and on time.
Dental Billing
The process of billing in dentistry involves coding, submitting insurance claims, and processing payments to recover unpaid amounts, which helps the practice receive the correct reimbursements. Proper billing practices help prevent revenue loss and contribute to the efficient operation of the dental office.
Dental billing demands accurate documentation and coding of the services provided to guarantee that patient insurance companies are charged accurately. Unlike other areas of medical billing, dental billing is unique as it incorporates both medical and dental codes, adding to its complexity.
Main Components of Dental Billing
Dental billing includes many different parts that require the utmost attention level in that it must be accurate concerning the information to be submitted.
1. Patient Verification & Pre-Authorization
The patient’s insurance eligibility must be verified, and prior approval obtained when necessary, before any dental treatment can take place. This verification process assesses the patient’s benefits, limitations, and coverage specifics. Following proper verification protocols helps to prevent unexpected claim denials, and when procedures are covered, the insurance plan will cover the costs.
2. Procedures for Coding with Precision
Dental medical billing requires precise coding using the current dental terminology CDT codes, which specifically refer to dental procedures. Additionally, the ICD-10 system may require the use of medical codes for certain dental treatments necessary to address a medical issue. These codes are crucial for insurance companies in order to approve claims.
Some of the major coding categories are:
- Preventive Care: Exams, cleanings, fluoride treatments, sealants.
- Diagnostic Care: X-rays, diagnostic tests, consultations.
- Restorative Care: Fillings, crowns, bridges, and implants.
- Endodontic Procedures: Root canals and so forth related to the inner tissues of the teeth.
- Periodontal Procedures: Gum disease, scaling, and root planing treatments.
- Prosthodontics: Dentures, partials, and repairs.
- Oral Surgery: Extracting, surgical removals, and other extensive procedures
3. Submission and Follow-Up of Claims
Once the claim has been accurately encoded, it should be submitted to the insurance company. It is crucial to adhere to the procedures that each insurance company stipulates for submitting claims in order to avoid rejection. This stage of the process, following the submission of claims, emphasizes the significance of monitoring claims; when rejections or delayed payments arise, cash flow must remain uninterrupted.
4. Posting the payment and billing to patients
After a claim is processed, it is credited to the patient’s account as payments are received. If the remaining amount is not fully covered by insurance, the bill may need to be sent to the patient. Transparency in patient billing is the most critical factor to ensure there are no disputes and to facilitate prompt payments. Statements should be clear and detail the services provided, the amount insurance covered, and the remaining balance owed.
5. Handling Denials & Appeals
Additional reasons for issues can include incorrect codes, absent information, or lack of prior authorization. A competent dental billing company has a dedicated team for handling denied claims. They identify the reasons for denials and subsequently proceed with filing appeals to recover lost revenue promptly. The appeal process necessitates clear communication with insurance providers, supplying all required documentation along with corrections for any errors.
Dental Billing Challenges
Dental problems are unique in billing compared to other medical billing. Among the common problems are:
Alignment with Dental and Medical Coding
Most dental procedures use a combination of CDT and ICD-10 codes, hence one requires evident coding skill in that aspect.
Insurance Policies
The different types of insurance policies may carry highly divergent types of policy provisions, exemptions, and restrictions that the patient has to deal with.
Coordination of Benefits
To the patients who have two insurances, the first one and the second one must be coordinated in a way that will benefit the most to the healthcare provider.
Constant Changes in Codes and Policies
In the dental field, billing codes and policies change day after day. In this respect, a dental billing service provider should always remain updated about the changes in billing codes and insurance policies to provide an excellent billing service.
Advantages of Outsourcing Dental Billing
It would be much better to have a professional billing service for the management of dental billing services:
Claim Denials for Mistakes will be Reduced
A well-trained dental coding biller minimizes the likelihood of errors, which can lead to fewer denials based on mistakes.
Rapid Payment Collection
This leads to quicker claim processing, resulting in faster payment collection when lenders must identify the insurer.
The Office Staff Load
Outsourcing administrative duties lightens the workload for dental office staff, enabling them to dedicate more time to patient care.
The Cost of Employment
For many small practices, outsourcing is generally more cost-effective than hiring and training an internal billing team.
Reports & Analytic
Outsourcing firms provide regular reports and analytics, which can help dental practices assess their financial situation and support them in making informed decisions.
We maintain a strict process to ensure that transparency is present in our dental billing.
Application of Best Practices in Dental Billing
Insurance Verification
The procedure by which the coverage for patients is thoroughly and proactively verified, enabling patients to avoid the anxiety and complications of last-minute appointment denials.
Accurate Coding
Correct CDT and ICD-10 codes are consistently applied in accordance with the services rendered.
Clean Claim Submission
Claims must be submitted with accurate details and full information, as any gaps will cause delays in processing.
Denial Management
This involves actively monitoring and following up on denied claims to improve collection success rates.
Specialized Dental Billing Services We Offer
We provide an array of services designed to enhance your dental billing systems and improve your practice management, including:
Patient Billing Services
Establish a centralized system for all patient bills, ensuring they are dispatched in a well-organized, integrated, and timely manner — including statements at 30, 60, and 90 days. In specific cases, patients might receive either a soft or hard collection notice.
Dental Claim Submission
We simplify the dental claim submission process by gathering and submitting claims daily. Our team of specialists reviews each claim for mistakes prior to submission to ensure that a complete and accurate claim is sent.
Payment Posting
Our dental insurance experts will process insurance payments every day and ensure that all payments are logged within 24 hours after the explanation of benefits (EOB) is received in your office. To enable precise end-of-day balancing, all payments will be posted three hours before your dental practice closes.
Denied Dental Claims
Although our procedures significantly reduce errors in dental billing, they can still happen. If a dental claim is denied, our dental insurance professionals will promptly investigate and appeal, working diligently to resolve any outstanding balances requiring collection.
Improved Cash Flow
Dental practices have a significant opportunity to enhance their cash flow. When your focus is frequently divided between patient care and practice management, critical tasks like collectible claims can be neglected. Do not continue to forfeit revenue! Access comprehensive insurance aging reports that improve claim recoveries by offering daily updates on both worked claims and those already collected.
Dental Insurance Verification
As a dental provider, it is essential to guarantee that your patients receive outstanding care and service; however, if they encounter difficulties with dental insurance, it can threaten their loyalty — potentially driving them to other practices. You can easily prevent this by verifying insurance coverage prior to their appointment or on the day of the appointment to avoid unnecessary changes and confirm that all services will be covered.
Additional Billing Services
Dentists and other dental professionals are licensed healthcare providers, and certain procedures may indeed be billed as medical services. Many dental practices may be reluctant to pursue this due to fears of reimbursement denial or concerns regarding audits for medical insurance fraud. With our extensive expertise in dental billing, we can provide you and your team with the necessary training to navigate this intricate process and effectively employ additional billable services.
Why Choose Our Dental Billing Services?
Expertise
A team that is well-versed in the latest dental codes and knowledgeable about required insurance details.
Efficient Revenue Cycle Management
Well-structured processes designed to enhance cash flow while minimizing revenue losses.
Compliance Assurance
Compliance with the industry and regular updates with changes in codes and guidelines to be compliant.
Customized Solutions
All solutions are adjusted according to the dental practice’s needs, therefore; quality service is the highest level.
FAQs
Dental billing is basically the same process but using different codes and terms more specific to dental treatment rather than for medical insurance.
Indeed, we handle claims for different dental procedures such as routine check-ups to complex surgeries with correct coding and within a very short time frame of reimbursement.
We watch the annual changes of the CDT and ICD codes and keep an eye on the insurance rules to use the codes properly and in compliance.
