It is a sad state of affairs when I see procedure coding taken completely out of context for the betterment of one’s own political agenda or simple lack of knowledge. So is the case with the age-old discussion of “When does perio maintenance become a prophylaxis?” Believe me when I say it has nothing to do with simply the calendar or GPS. What’s the solution?
Coming soon to a dental office near you are newly revised procedure codes and definitions for 2018. Will they make more problems or solutions? The management, reimbursement and subsequent coding of non-surgical periodontal care has, for years, been a nightmare for all segments of the dental profession. So what is the real problem and where is the hidden solution? You got it… Where is the dentist?
Monitoring your practice profitability is becoming more and more important as patients’ dollars are squeezed and patients must be savvy by maximizing their plan benefits in the present economy. If you’ve ever participated with an insurance plan or are simply considering the option, it has crossed your mind before… Are you really making money by participating with XYZ plan, or are you losing your shirt? …
No greater dichotomy exists in all the professions of healthcare than that of the love/hate relationship between doctors and the fiduciary responsibilities of today’s Insurance Benefit industry. One provides the loving compassion, while the other coldly enforces contractual financial provisions. How much time and effort do you spend fighting with the patient’s insurance? …
The old saying of “garbage in equals garbage out” is very true when it comes to your dental practice management software. If you are constantly adjusting dollar amounts to satisfy the accounting of participatory benefit plans, your software is not working for you — you are working for it. This is not good…
The reality of today’s uncertain healthcare marketplace is fueling consumers to rethink the significance of the once sovereign doctor / patient relationship. Let’s break down the transaction into its various evolutionary phases so as to better grasp the root of this growing issue.
Let’s begin to solve the ethical issue of medical/dental cross coding by simply introducing the challenge as it most often presents itself to the administrative team.
The lies and fallacies being taught by so-called “experts out standing in the field” continue to confuse and mislead those who unknowingly accept them as truth but are nothing more than smoke and mirrors.
Let’s begin to solve the ethical issue of medical/dental cross coding by simply introducing the challenge as it most often presents itself to the administrative team.
My father jokingly commented that if you wanted loyal patrons at the door each morning as well as disappointed customers when you were closed in the evening – that business was not a dental office but rather a liquor store. You see, in any type or retail establishment where widgets are marketed and sold, we face two separate and very distinct realities…
So WHEN does the actual coding of a clinical procedure take place in your office? Pretreatment is an issue unto itself for a later discussion. However, at this time, I want to address the actual delivery of dental services. That’s right, I’m talking about the patient in the chair. This is not an orthodontic case, as that too is another discussion. Let’s address at what point in the treatment you encounter the use of a procedure code…
Here we go again. The American Dental Association has yet another revision to Code on Dental Procedures and Nomenclature. Is it going to make your life any better? Will it bring you any additional revenues? Was the word “surgical” really that offensive thus requiring the redefinition of over three dozen procedure codes? Let’s move beyond the scope of NDR and address the real heart of the reimbursement challenge…