Dental offices that are providing services such as neuromuscular rehabilitation, implant surgery and oral surgery inevitably seek to bill their services to the patient’s medical insurance. Most of the services are reimbursable under the patient’s medical plan but you have to know how to fill out the right claim form, use the correct diagnostic codes and use the correct procedure codes. One of the services I offer is how to do this correctly. My good friend Christine Taxin also consults on this so we tend to bounce ideas and news off of each other.
During one of our recent brainstorming sessions, the subject of medical billing came up and we came to the same conclusion: offices that are asking for help in medical billing often do not have dental billing under control. In other words, an office that does not have a firm understanding of the dental codes and how to file for reimbursement should not even consider medical billing. You will get it wrong. There’s fines for that too … I hear they’re steep.
Some of the questions we both hear at seminars or on phone consultations include:
- Can I use a dental claim form to bill to medical? (no, use the CMS 1500 form)
- Which codes do I use? (CPT, not CDT or dental codes)
- Which insurance do I bill to first? (I advise billing to medical first)
- What about Medicare? (I will tell you to run, as fast you can but Christine will tell you it’s not that bad)
- Do I need to be a preferred provider? (probably not, unless your volume is huge and you think it will help you market your services – but that is a completely different conversation. Final answer – not really.)
These questions are pretty routine. But when we start hearing questions such as ‘why can’t I get deep cleaning paid?’ or ‘do I alternate between D4910 and D1110?” then we know that we need to dig a bit deeper. We need to get to the foundation of their coding knowledge. If exams are not being billed and claims are being rejected more than being paid then we have to start from scratch.
We’ll get you to the point of medical billing but we can’t do it unless you’re coding for dental services successfully. It’s a waste of your money to pay us to do this and a huge frustration for the team members to learn a skill set that will seem like third-level Latin. Crawl before you run.
