Dentists – where would the world be without them?
They’re always there when we need them, whether it be a cracked tooth, a dental cleaning, or oral surgery – there they are, making the world a brighter place, one tooth at a time, with a smile on their face.
Behind the scenes, things look a little different. While being a dentist is one of the most rewarding careers in the world, it can also be one of the most stressful – in large part due to the billing department.
It’s not what dentists went to school for or what they’re passionate about, but dental billing is essential to ensuring your dental practice can survive.
Unfortunately, this is where most dental practices fall short – but why?
It’s time-consuming. Standards and regulations are constantly changing. Claims are getting delayed, denied, and rejected left and right. Codes are getting misused. Collections are adding up.
These are some of the most common reasons dental practices fail, but we believe brighter days are right around the corner – especially with Millenium Medical Billing by your side. With our expert help, you can return to doing what you do best – treating your patients and giving them something to smile about.
Dental Billing vs. Medical Billing: Are They the Same Thing?
Many people use the terms ‘dental billing’ and ‘medical billing’ interchangeably, but don’t let them fool you. They might share the same goal – maximizing profits by submitting error-free insurance claims and billing uninsured patients – but they’re two completely different procedures used for different things.
Medical billing is the process of retrieving patient information and submitting claims to health insurance providers to ensure proper reimbursement for medical services.
Dental billing is the process of retrieving patient information and submitting claims to dental insurance providers to ensure proper reimbursement for dental services.
As a general rule of thumb, dental insurance is proactive (preventive), while medical insurance is reactive (remedial). That’s why we use dental billing for teeth cleanings, imaging, exams, and fluoride treatment, but medical billing for oral surgery, broken teeth, and emergency services.
CDT, CPT, ICD: Knowing When to Use the Right Codes
Another major difference between dental and medical billing is the coding system used when submitting claims. These codes help tell the story of that patient’s visit – the diagnosis, treatment, and overall cost.
There are four primary coding systems dentists need to be aware of:
CDT codes. Stands for ‘Current Dental Terminology’ and was developed by the American Dental Association (ADA). Primarily used for billing dental insurance providers for dental services.
CPT codes. Stands for ‘Current Procedural Terminology’ and was developed by the American Medical Association (AMA). Primarily used to identify medical services and procedures.
ICD-10 codes. Stands for ‘International Classification of Diseases’ and was developed by the World Health Organization (WHO). Primarily used for diagnostic coding of diseases and medical conditions, as well as inpatient hospital procedures.
HCPCS codes. Stands for ‘Healthcare Common Procedures Coding System’ and was developed by the Centers for Medicare and Medicaid Services (CMS). Primarily used for claims processed by Medicare and Medicaid.
Knowing how (and when) to use these codes is essential to getting reimbursed in a timely manner. Any errors or misuse of codes will result in delays, denials, or rejections – meaning the patient is responsible for paying the bill in full. As you can imagine, this only results in further delays and headaches.
So, what is cross-coding?
This is where things can get tricky. We know that dental billing refers to reimbursement for dental services, and medical billing refers to reimbursement for medical services, but what do dentists do when their dental services are deemed medically necessary?
That’s where cross-coding comes into play.
Cross-coding is when dentists bill medical insurance companies for dental services. It requires using CDT codes alongside ICD-10 codes – and HCPCS codes if billing for Medicare or Medicaid. This is important because it increases reimbursement potential for the dentist and limits the amount billed to the patient.
The problem is most dentists don’t implement a cross-coding strategy – either because they aren’t aware or don’t know how to do it properly. Don’t worry – that’s where our team can help your practice succeed!
Why Should Your Dental Practice Outsource Billing?
Dentists shouldn’t spend most of their workday sitting down at a desk, submitting insurance claims, and following up with patients on past-due bills. The more time they spend doing that, the less time they spend in front of their patients – where they’re most needed.
At Millenium Medical Billing, we believe there’s a better way.
Here are some of the services we provide to help you optimize revenue and profits:
- Dental and medical billing
- Dental and medical coding
- Patient billing and payment posting
- Accounts receivable (AR) management and collections
- Reporting and credentialing
- Verifying insurance coverage and patient information
- Consulting and training other medical billing teams
Our team of dental and medical billers are proficient in CDT, CPT, ICD-10, and HCPCS codes. We follow all the best practices and stay up-to-date on all the latest standards – that way, you can rest easy at night knowing your billing department is in good hands.
Millenium Medical Billing: Your One-Stop Shop for a Brighter Billing Department
Is your dental practice struggling to stay afloat? Is your accounts receivable department getting worse by the month? Are your dental insurance claims getting denied, rejected, or delayed? Do you want more time to spend with your patients? If you answered ‘yes’ to any of those questions, you came to the right place!
Millenium Medical Billing has been helping dental practices maximize their reimbursement potential and optimize their revenue streams for over 15 years. Our masterful blend of knowledge and technology helps ease the process for everyone while minimizing errors and denials.
Contact our office today to learn more about how our talented dental and medical billers can help save your practice from losing money – we can’t wait to speak with you!