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Our certified dental billers and coders have deep knowledge about the American Dental Association (ADA)- mandated Current Dental Terminology (CDT) codes. Banking on this knowledge, we deliver accurate dental billing and coding services to our clients. Our team has experience billing for the regular to the most complex of procedures, such as preventive, restorative, maxillofacial prosthetics, implants, oral and maxillofacial surgeries, etc. Here is how our team will do it for you:
- Integrate digital systems like electronic medical records (EMR), electronic health records (EHR), and electronic data interchange (EDI) into dental-specific billing software to replace manual processes with highly streamlined electronic claims processing.
- Collect complete patient details (demographics, medical history, physician referrals) and verify complete insurance information (coverage type, prior authorization status with effective dates and expiration dates, and claims address) to ensure accurate claims documentation.
- Verify whether pre-authorization is needed for any services and seek approval in advance if necessary.
- Adhere to code specificity and regulatory guidelines while handling diverse dental billing models like value-based care billing, point-of-service billing, billing for discount or referral plans, direct reimbursement billing, etc.
- Implement multi-level quality checks to ensure dental code precision while billing for claims. Our approach guarantees the assignment of the correct codes and modifiers to capture dental diagnosis (D0100-D0999 CDT diagnostic codes/ ICD 10 K05.3 code denoting periodontal disease ), services (D6200-D6999 CDT code range for prosthodontics), and equipment (HCPCS Level II codes).
- Stay updated on changes in payer fee schedules and payment regulations. This includes Medicare, Medicaid, PPOs, DHMO, indemnity plans, and private insurers like UnitedHealthcare, Cigna, Humana, and more.
- Compare claims with Explanation of Benefits (EOB) received from payers to identify reasons for claims denials, address disputes, and initiate the appeal process.
- Dedicate certified patient accounts representatives for accurate electronic payment processing against the corresponding patient accounts.
- Follow up with payers for patients’ benefits verification to get clarity on deductibles, copayments, and coinsurance and inform patients about their paying responsibilities to avoid unpaid bills.
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