Wednesday, June 4, 2014

Help patients say "YES" to treatment


When I was working in the dental practice, my doctor became passionate about treating the whole body and learning about how occlusion affected the rest of the body. With this continuing education, my office took a path of treating patients for head, neck and facial pain, as well as general dentistry. It was fascinating and, not only did I learn a lot about the human body, but also the world of medical billing.

What I loved most was being able to say “YES” to helping patients receive benefits from their medical insurance companies. This helped many patients be able to say “YES” to treatment because the financial burden was being spread out between medical, dental and the patient. Even though I found it very satisfying to help the patients, billing medical can be a little time-consuming and tricky.

If you are willing to jump in and learn something new, here are the steps to a successful implementation to billing medical insurance out of Dentrix.

In Dentrix G6.1 you will notice that the software has been pre-loaded with the ICD10 DX codes that are relevant to dental.  If you are on an earlier version of Dentrix you will no longer be able to bill medical and will need to upgrade your software. 

Now you can start to do the setup in Dentrix. Go to the Office Manager > Maintenance > Practice Setup > Procedure Code Setup. Here, you will see six tabs across the top (the first two are for dental billing and the next four are used for medical billing). After you have installed the medical cross coding CD, you will find information downloaded in these last four tabs. If you have not purchased the CD, this is where you will go to add the billing codes. On the ADA-CDT code tab, open one of the dental procedure codes that you will be billing to medical insurance. In the edit window, you must check mark “flag for medical cross coding.”
Next, go to the Office Manager > Maintenance > Practice Setup > Medical Cross Coding Setup. This is where you will tell the system which dental codes match up with which medical codes and the diagnosis that would be associated with it. You will need some knowledge of matching up the appropriate dental code with the correct medical code. If you want an info sheet on common cross coding in dentistry, please email me directly at Dayna@raedentalmanagement.com.

Now that your medical coding is set up in the Office Manager, you can add the medical insurance to the patient’s family file just like you would a dental plan … but make sure you are entering it under the Medical Insurance tab and you will select the HCFA claim format. You are ready now to send a claim. Double click on the procedure code you have posted on the patient ledger and you will now notice a new medical cross coding section on the procedure code box. You must select the appropriate codes for each box. When you click OK, you will notice there is a blue solid triangle next to the procedure code and this indicates it is cross coded for medical billing. Now click on create insurance claim and it will send out a medical claim first. After the medical insurance pays, Dentrix will automatically prompt you to send a dental claim.

Be patient. Medical reimbursement requires a lot more documentation, re-submissions and follow-up than a dental claim, so be prepared and make sure you keep your patients in the loop on the status. Don’t be afraid to ask your patients for help with follow-up or calling their insurance company (you might need it). With that being said, though, I feel that medical billing can be a huge value-added service for an office and your patients will be so happy you went the extra mile for them.

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