“Dental carriers are now requiring that any service that could be payable by any medical carrier, including Medicare; be submitted to medical first.”

National Provider Compliance Corporation (NPCC),

Medical billing for dentistry in 2019

Change is coming for dentistry! If you think it isn’t, you are in for a rude awakening. According to the National Provider Compliance Corporation (NPCC), “Dental carriers are now requiring that any service that could be payable by any medical carrier, including Medicare; be submitted to medical first.”

Delta Dental is already providing education that medical diagnosing will be part of your dental claim form. Also, the CDT Companion Guide highly references diagnosis codes for dentistry.

With that in mind, would you want to access larger reimbursements for services you perform? That’s the upside of medical billing in dentistry, there are no frequency limitations or maximums in medical insurance. Statistics say that only two to four percent of Americans actually use their maximum medical benefits on a yearly basis. Mainly in part because there are substantial procedures in dentistry (CDT codes) that are non-covered services:

•   Bone Grafts
  
  
•   Block Grafts
  
  
•   Nasopalatine Procedures
  
  
•   Resorbable Membranes
  
  
•   CBCT’s
  
  
•   Sinus Augmentations
  
  
•   And, other oral surgery and periodontal treatments.

There is a reason they are non-covered services in dentistry, these are all considered medical procedures. Just taking bone grafts as an example, a bone graft is needed due to atrophy, even if it is because of tooth extraction. That bone graft would be covered by medical insurance not dental.

All signs are pointing to big changes for dentistry involving medical billing. Will you adapt or be left behind?

It may not feel like the easiest choice, but adapting and growing with the changes will produce a better long-term outcome. While also improving your practice and increasing your case acceptance. 

At Devdent we are here to empower and educate dental providers and their teams. We give you all the tools and training so that you can adapt to the future of insurance billing. Will you accept the change and take your practice to the next level, or will you bury your head in the sand hoping it will go away? Remember, how you react to change is what creates your outcome!