Last week, I wrote about how to set up medical cross-coding inside your Dentrix software. However, medical billing is not just about setting it up in Dentrix. Today, I am bringing in Christine Taxin, a medical billing and coding expert, to give you some information and resources that will help guide you through some of the insurance rules you need to know.
Dayna: If an office sees Medicare patients, what does the office need to know about the new rules with Medicare and the Affordable Care Act?
Christine: Attached is a Medicare information sheet that every dental office should have if they are billing medical. Medicare has rules, whether you are participating or non-participating, and you need to know what these rules are. For copies of these information sheets, please e-mail me directly at Dayna@raedentalmanagement.com.
Dayna: Where can offices find out more information? Where can they obtain the proper paperwork? What about all the other medical insurance rules? Is there anything new the offices should know?
Christine: If you want to start medical billing, you need to sign up for one of the Medicare formats. This allows you to bill secondary. If they have no insurance for any medical treatment besides Medicare, the legal issues are covered. I also added the Electronic Health Record (EHR) information that you can use for other information. For copies of these forms, please e-mail me directly at Dayna@raedentalmanagement.com.
Dayna: Under the Affordable Care Act, if the parents have medical coverage, their children (under the age of 19) are covered for a list of dental procedures. How does a dental office bill for these procedures? Do they bill dental or medical?
Christine: You should use the medical claim form. You can use the dental claim form, but it has to be the one with diagnostic codes (DX2012). You also have to mail or send electronically to the medical company. This is only for patients who have private insurance, not the marketplace. That is totally different and a doctor does not have to participate so he or she can refuse to either see a patient or bill for insurance. If you are already in network with an equal dental plan, such as United Health Care, then you are already signed up as an in-network provider.
Dayna: We all know that the 2014 ADA claim form has a place for dental diagnostic codes. How can the dental office learn how to use these codes correctly?
Christine: The DMB workflow sheet is how to set up for medical in-office. If you want to refer out your medical billing, you can do that through Dental Medical Billing, which specializes in dental to medical billing. You can find out more information at http://dentalmedicalbilling.com/ or contact Christine at firstname.lastname@example.org
Note from Dayna: I highly recommend Jump Start Diagnostic Coding, written by Patti DiGangi and Christine Taxin. If you e-mail me for a copy, you can get the book for discounted price of $20. You can also e-mail Christine directly at email@example.com .
Dayna loves her work. She has over 25 years of experience in the dental industry, and she’s passionate about building efficient, consistent, and secure practice management systems. Dayna knows that your entire day revolves around your practice management software—the better you learn to use it, the more productive and stress-free your office will be. In 2016, Dayna founded Novonee ™, The Premier Dentrix Community, to help cultivate Dentrix super-users all over the country. Learn more from Dayna at www.novonee.com and contact Dayna at firstname.lastname@example.org.