A resource that provides up-to-date information on which procedures require documentation, broken down by payer.
Obtaining and documenting a thorough dental history is essential to maintaining proper patient records.
RAC audits are performed to identify the overutilization of services or services that are not medically necessary. While this may seem like a sensible, necessary program, it has great potential to negatively impact state Medicaid programs and their providers.
Non-covered services are specific services not reimbursed under the terms of the dental benefit contract.
One major concern for a patient when electing to receive orthodontic treatment is whether or not the treatment will be covered by insurance.
Different organizations have different definitions of medical necessity and this can impact the payer's definition as it relates to a particular dental procedure.
There are no "routine" audits or reviews, so why were these practices audited and what should a practice do when audited?
Reporting the correct fee on a dental claim form is key to receiving proper reimbursement and reducing risk.
Providing a gift in exchange for a referral may not be legal. Furthermore, offering discounts on your services through advertising websites may also be prohibited.
It is important to understand the two types of NPI numbers so that they can be properly reported on the claim form.
Coordination of benefits occurs when a patient is covered by more than one dental benefit plan.
A supernumerary tooth is an extra tooth beyond the 32 teeth in the permanent dentition or 20 teeth in the primary dentition.
A non-covered service is a dental treatment or service that is not covered or reimbursed by the patient's dental benefit plan.
Prompt Payment Laws By State.
New study shows significant reduction in medical cost for diabetic patients with periodontal disease who receive periodontal therapy.
Call centers are not always aware of their own revised policies - here is one practice's experience with this frustrating issue