What Do You Fear in Medical Billing?

What Do You Fear In Medical Billing?

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Written by Laurie Owens, CPB, CPC, COC
Devdent Director of Medical Billing Education
Edited by Jo Gardner, B.S. Merchandising

Fear of the unknown can be much stronger than fear of known terrors.  I used to watch the old suspense movies with my hands over my eyes.  Why?  I was afraid of the unfamiliar, of the unknown.

As I think about the many doctors and administrative teams about medical billing in dentistry, the theme is the same…they fear the unknown. Being afraid and overcoming that fear is the difference between talking and doing.

Here are the top 5 common fears of starting medical billing in your dental practice:

What Do You Fear in Medical Billing?

5) Fear of not knowing what services can be billed to medical insurance.

One of the key points when I speak is that services you provide can potentially be covered benefits because it is not the what, it is ALL about the WHY. Why are these services medically necessary?  How will they help the patient and what caused the breakdown?  You can bill for veneers if your patient had an adverse effect of tetracycline, making it a medical necessity.  So ask yourself:  How will the procedure help my patient’s health or correct a problem/defect created by the patient’s health?  If you cannot answer that question, then do not move forward with medical billing.

4) Fear of patient perception.

Money is an important and mitigating factor for many patients. We have to remember that medical billing for dentistry is a courtesy…DO NOT EVER  PROMISE medical insurance will pay one penny.  Even with a preauthorization of services, you do not know what amount will be allowed or if they pay those services at a lower percentage.

Help your patient to understand that this is the policy they chose or were able to obtain and that because you will advocate on their behalf, the worst thing they can say is, no. Even if you were able to help your patients reach or apply something towards their deductible, you have helped. You may be surprised to discover that patient ratings are usually higher than expected by treating physicians.

3) Fear of documentation errors.

This fear is very prevalent not only on the dental side but the medical side as well. All the way around, we need to write more descriptive notes that accurately describe what occurred during an exam and what services have been completed on the surgery side.

Remember the old saying, “Write your notes as if you are reading them in court.”  Dr. Roy Shelburne can help your team to get the documentation to show medical necessity which is a complete requirement in dental and medical billing.

2) Fear of being audited.

This fear is actually something we should all be preparing for. I know it is not fun but there are some ways to have the “surprise” audit is not so difficult.

Completing internal retrospective and prospective audits is the answer.  In laymen’s terms, you audit services you are going to do and those that have already been completed.  This audit reviews documentation, ledger postings, and any “deletions” in your practice management software.

1)Fear of failure. 

Well let me tell you something, you will fail!  Now do not get mad at me, that is the learning aspect. Devdent is here to help train you and our Imagn Billing software was built for dentistry only! The education aspect of medical billing for dentistry is a hurdle that you must conquer for better patient care. Our goal is for you to learn from failure and reach heights for your patients that will market itself.

Don’t let fear of the unknown stop you from helping your patient’s obtain the medical coverage they truly need.

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Laurie Owens

Director of Medical Billing Education
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