Rose Nierman and Courtney Snow write about billingmedical insurance for dental procedures, when possible, to help patients who need some more financial help.
Rose Nierman and Courtney Snow discuss the steps you can take to help patients access care, especially for larger cases
What steps can you take to help patients access care in today’s economic environment, especially for larger cases? Dental practices are offering great financing options to make care accessible, and many are taking it a step further by filing medical insurance for patients that want to move forward. Medical insurance billing for oral surgery such as cone-beam CT, bone grafts, and implants can be the icing on the cake as patients gain extra financial help from their medical plan. Keep in mind, you can remain fee-for-service and file a patient’s medical benefits as courtesy billing. Here are three common questions we get from practices wanting to get started with medical billing:
Why bill medical insurance?
When would you file for medical instead of dental?
How do you start and make it easy for you and your team?
The Why
Case acceptance increases when patients know their insurance benefits are being maximized, reducing the out-of-pocket cost for services or helping satisfy medical deductibles. In the current economy, flexible financial options (outside financing and medical billing combined) make it more possible for many patients to afford treatment. The more affordable the treatment, the more likely patients will say “yes.” Happy patients lead to increased word-of-mouth referrals, and many are thrilled to find a dental practice that files medical. Here at Nierman Practice Management, we frequently receive inquiries via email, phone, and live chat directly from patients seeking a dental practice that knows how to file medical! Patients are increasingly asking dental providers if they can tap into their medical benefits and are even shopping around for those providers. You may also run into situations where dental insurance requires filing of medical plans first.
The When
Criteria for bone grafts and implants to qualify for medical coverage are accidental injury, cyst or tumor removal, and functional impairment. For accidental trauma, the medical plan must cover services to return the patient to pre-accident condition. If teeth need to be removed to excise or drain a cyst, some medical plans will cover the replacement of those teeth. For functional impairments, you may encounter patients whose condition limits their diet to semisolid, soft, or liquid food, and who cannot tolerate or accommodate a denture. Other billable procedures include exams, radiographs, frenectomies, mucositis, myofascial pain dysfunction (Botox®), third molar extractions, obstructive sleep apnea and TMJ appliance therapy.
The How
The first step is to obtain a verification of medical benefits. This will give us a good snapshot of their coverage and out-of-network benefits. If it looks good, then the next step is to have a conversation to set proper expectations on reimbursement. Then gather the pertinent chief complaints and document your exam findings and diagnosis in a medical necessity format (SOAP reports) and complete the medical claim. If that sounds like a lot of work, don’t worry; there is software that can do it for you. Many practices outsource the billing to make it easy, taking less dental team-member time away from patient care.
Now that you know the why, when, and how, it’s time to take action! You can incorporate medical billing in your practice with the right tools. Now is the time to transform your practice by offering another financial option to help patients move forward while setting your dental practice apart — above the rest.
Rose Nierman is the founder and CEO of Nierman Practice Management. Rose has been teaching dental offices medical billing for over 30 years through the iconic Successful Medical Insurance in Dentistry seminars. She is the creator of DentalWriter Plus+, a system for generating documentation for physician referrals and to demonstrate medical necessity in conjunction with the Nierman Medical Billing Service.
Courtney Snow is the vice president and CE faculty member at Nierman Practice Management. With 12 years’ experience in medical billing in dentistry, she constantly strives to help dental practices make medical billing easy using reliable education, support, and software solutions. Her areas of expertise include obstructive sleep apnea, TMJ disorders, oral surgery, and other services. Contact Nierman Practice Management at [email protected], or call 800-879-6468.
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Each one-hour virtual webinar moderated by MedMark Media is equivalent to one continuing education (CE) credit. Credit is available to all who register for the webinar and successfully complete a ten-question quiz through our publication’s online system.
Registrants can attend the webinar live at the specified date and time by using the GoToWebinar join link provided by email from any device with an internet connection. Using a laptop or desktop computer is recommended for best viewing the presentation. If you are using a mobile phone or tablet, we recommend using the GoToWebinar app instead of the web browser to improve ease of use for the webinar’s platform. Registrants will also have access to watch the replay at their own convenience through a link emailed to them within 24 hours of the specified live date and time which is hosted on our publication’s website.
If registrants would like to ask a question or receive further clarification, they can type their questions or comments in the question box of the webinar system. The moderator reminds the attendees multiple times before and after the presentation to use the question box. Questions are addressed at the end of the presentation for at least ten minutes. If any questions come in that are not able to be answered live in the time available, we give the question along with the registrant’s email address to the presenter for them to follow up directly.
Registrants will have to either sign in (previous webinar attendee) or sign up (first-time webinar attendee) for our CE quiz system on our publication’s website. Registrants of all CE webinars are allowed this account free of charge. The ten-question quiz is linked on the replay page below the video as well as available directly through the CE dashboard once the registrant is logged in.
Once the quiz is successfully completed, there is a button to download a PDF of the certificate. A copy of the CE certificate is also emailed to the address on file for the CE account. To ensure the deliverability of emails about CE credits, please:
Check the spam/junk folder in your email account for the email.
If the registrant is having trouble accessing either the live webinar, replay, CE quiz or certificate we are available to help by email, chat, and phone. We can provide simple steps with screenshots on how to navigate to and complete the Webinar CE quizzes.
Legal disclaimer: Webinar expires 2 years from the live date. The CE provider uses reasonable care in selecting and providing accurate content. The CE provided, however, does not independently verify the content or materials. Any opinions expressed in the materials is those of the presenter and not the CE provider. The instructional materials are intended to supplement but are not a substitute for the knowledge, skills, expertise, and judgment of a trained healthcare professional.