July 29, 2020 • 5 min read

Are You Getting Your Toes Wet or Are you All In? 3 Steps for Successful Medical Billing in Dentistry

The author grew up on a tropical island and learned to swim as a child. They recall being thrown in the water from a boat and their granddaughter being uncomfortable with the cold water at her first swimming lesson.



Laurie Owens

CPC | CPB | COC | Director Of Medical Billing Education for Devdent

3 Steps for Successful Medical Billing

Growing up on a tropical island was amazing…the sun, sand (not particularly my favorite as an adult), and the pièce de résistance, water.  As a young child, we were always near or in the water.  It was not an option to not know how to swim.  I did not get there without being thrown in the water from my uncle’s boat as they puttered to shore (with a life vest so don’t panic).  Picture in your mind, a two-year-old me in the ocean having to make my way back to the beach.  Can you imagine doing that to a child in this day and age?  Most parents now days send kids to swimming lessons.  When my granddaughter went to her first swimming lesson at the age of two, she dipped her toes in and wiggled them around.  Right away she said, “Too cold, Gwamma!” and immediately made her way towards the changing room with me close behind.  She didn’t want to get in because she was uncomfortable with that nasty cold water.

Many, many, many people have told me, “Oh, we tried medical billing”.  When I pressed for details to see what may have happened, I noticed that they were acting like my granddaughter.  They were sticking their toes in and not liking the feeling.  Most have stated they filed one or two claims and did not get paid, so they stopped because it was a lot of effort and no reimbursement.  Getting into the nitty-gritty of the matter, I found out that one of problems was that they did not get preauthorization (which could be fought I might add) and the other was that there was a contract exclusion (which cannot be fought).  

Here are 3 steps to go from sticking your toes in the water to being “all in!”

  1. Get Educated – We have a medical billing software designed for dentistry, but that cannot “educate” you about what things qualify for medical necessity.  Without education, you will be jumping out of the water faster than you can say “Jack Robinson.”  

Our two-day live course can answer many of your questions and you will have overnight to think of more.  If you are unable to take a course with us, please make sure that whomever you learn from is an active (not past tense) medical biller for dentistry.

In our two-day course, whether live or online, you will get an understanding of:

□  What qualifies for medical necessity

□  SOAP (subjective, objective, assessment, plan) notes that will support and compliment your coding

□  Understanding medical insurance

□  How to tell your patient’s story with diagnosis coding sequencing

□  3 ways to submit medical claims

□  How to implement medical billing at your practice

□  What the law is about medical billing

Let me say with all confidence, you cannot and will not be successful in medical billing if you and your team are not on the same page.  If they do not know what you know, how do you expect them to be proficient in the execution?  

2. Be Coachable – You are entering a realm where others have not made it through.  Not because they couldn’t, but because they did not want to go further.  When a practice I did billing for started medical billing for dentistry (periodontics), it was tough.  The clinical and admin team members thought I was speaking Greek when I discussed what was needed in our notes.  The notes improved for about three days and then they were back to being as ambiguous as ever.  About 17 years ago, Dr. Robert Gottlieb taught me something he probably doesn’t even remember, “if it is not their idea or thought, why would it last?”  It was as if a lightbulb went off in my head: instead of telling them, I need to ask them how to do it.  Our team was so amazing with their notes once I changed MY thinking.  We did not have to write letters of medical necessity for the last 5 years that I was there!

Are you working to coach your team to medical billing or are you being tyrannical and only telling them what you want?  As much as I had to be coachable, so do you.  Your office should have a coach, they see beyond what you or your doctor sees.

3. Don’t Quit – When you begin medical billing for dentistry, I guarantee you that discouragement will come.  Why do you ask?  Well, it is because not all insurance plans are the same.  In dentistry, we have a lot of feelings.  Like when their medical deductible is high, or the plan has a contract exclusion we feel bad.  Did you pick the insurance policy with the high deductible and contract exclusion?  No, that is your patient’s contract that you, by law, must uphold.  My question is, why do we feel bad about something they chose and we don’t control?

There is an old adage that I think applies, “reach the reachable and teach the teachable”.   What that means to me is that you help everyone that you can help, but there will be people that you cannot help.  Please always remember that is not your fault.  If you quit, you will never be able to help the ones that have benefits.

Back to my story, my granddaughter did not go and change because dipping her toes in felt funny, cold, and not inviting.  After we talked about beating up her fear, I got into the water and she jumped…all in!  

Dipping your toes in the water will only bring frustration and you will end up not submitting anything else.  If you are determined to help your patients by accessing medical benefits for medically necessary procedures…go all in!  Reach out to those of us that have been doing this for years all over the United States.  No one at Devdent will ever tell you it is easy peasy lemon squeezy.  Are you determined to do right by your patient or is it too hard?  Attitude depends on your perception.

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