Limoli & Associates | P.O. Box 420505 | Atlanta, GA 30342 1-800-344-2633 [email protected]
To PPO or Not To PPO? That Is The Question

To PPO or Not To PPO? That Is The Question

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? …

Three Parts to Consider — You Can’t Have One Without the Others

Three Parts to Consider — You Can’t Have One Without the Others

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? …

What Puts the Patient in the Chair — Delta’s “Premier” is not “PPO”

What Puts the Patient in the Chair — Delta’s “Premier” is not “PPO”

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.

Submitting to the Medical Plan: It’s Not About Hiding the Truth!

Submitting to the Medical Plan: It’s Not About Hiding the Truth!

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.

Basics of Myth-Busting Practice Management – November 2016

Basics of Myth-Busting Practice Management – November 2016

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…

When Coding Has Nothing to Do with Code Numbers, Part 3 – Sept 2016

So exactly WHAT procedure code number do we use? One would think this would be the easiest part of the equation. However, this is not always the case if the first two parts of the previously discussed equation are not followed. The application of Rule #5 is always to be paramount. You have to act accordingly, and code for exactly the specific procedure that is completed. Completed when? Completed today. In other words, the patient walked out the door with (having received) WHAT procedural treatment?

When Coding Has Nothing to Do with Code Numbers, Part 2 – Sept 2016

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…

When Coding Has Nothing to Do with Code Numbers – Sept 2016

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…

D7465: It’s a Laser, Now What? – August 2016

The laser has continually evolved into becoming one of the most powerful operative tools available to dentistry. Its many variations and flexibilities allow for today’s clinician to not only simplify, but also streamline most facets of specialty and general dentistry. It’s a hot topic of late as more dentists are considering the purchasing of lasers but yet are wondering, “Where do I go from here?” This is a broad question that when broken down really asks, “What is the best way to bill and see a return on my investment, AKA the laser?”