Billing and insurance can be one of the trickiest aspects of running a dental practice. It requires meticulous attention to detail, knowledge of ever-changing coding, and incredible organizational skill. Unfortunately, just one error could have devastating effects for your practice, compromising your patient relationships or even leading to an accusation of fraud. Further, when patients come to you with questions about affordable dental insurance, it’s essential to have accurate information.
If you are worried about making critical billing and insurance errors, the team at Dental Practice Enhancement can help. We can take care of all insurance paperwork for you. That way, you don’t have to worry about legal ramifications and, instead, can focus on providing stellar medical care to your patients.
To learn more about our virtual administrative services, contact us today.
1. Not Verifying Coverage Ahead of Time
When you don’t verify insurance coverage in advance, providers may cover much less than patients are expecting. In some cases, they may deny the claim entirely. Even though you are not the one denying the claim, patients look to you to help them navigate the confusing waters of affordable dental insurance. When these patients are facing thousands of dollars in unexpected medical costs, they are likely to feel misled and even betrayed.
2. Listing the Wrong Procedure Code
The Code on Dental Procedures and Nomenclature, or the CDT Code, is updated each year. Every procedure has its unique code. However, it can be difficult to determine which one is appropriate, and it often requires a careful study of the CDT manual. Alarmingly, listing the wrong code, even through an honest mistake, can be considered fraud. And, in turn, a fraud conviction can result in thousands of dollars in fines, a revocation of one’s license, and even time in prison. Further, a dentist is technically responsible for any fraudulent activity, even if it was an administrative error of which he was unaware.
3. Failure to Bundle Procedures
Insurance companies will often lump two different procedures together into a single claim. This is especially common when it comes to x-rays. Insurance companies may not even make their bundling policies known until you get an explanation of benefits. This is another reason that it is essential to verify coverage in advance.
4. Not Filing Claims in a Timely Fashion
Neglecting to file claims on time opens you up to a host of problems. For one thing, Medicaid only has a 90-day claims window, though other affordable dental insurance companies may give you up to a year. Additionally, long delays in filing make it more likely that a claim will be lost. And, finally, patients want to have everything wrapped up. They don’t want to receive a bill for out-of-pocket expenses a year after they get their fillings!
Our Experts Can Help You Avoid Mistakes with Affordable Dental Insurance
Insurance mistakes are not an inevitable part of dentistry. Our team is specifically trained in this field, and we will handle every step of the process, from verification of benefits to posting payments. When you work with our virtual administrators, you will benefit from our expertise, attention to detail, and the flexibility of our hours.
To learn more about how Dental Practice Enhancement can help your practice, contact our office today.
Reach us online or call (833) DPE – FOR – U.