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 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?
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…
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?”
How is changing a bunch of definitions going to simplify and streamline the overall reimbursement process? Answer – it won’t. We have got to understand that insurance companies and third party administrators pay, by contract, toward the overall costs for completed procedures.
Now why is the reincarnation of D4346 merely a symptom of a greater problem? Let’s look at the actual sub components of its ancestors and see if the solution does not automatically appear…