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Changing Trends and Billing Practices in Dental Medicine

October 17, 2013



Dental medicine has been suffering from the far reaching effects of the economic meltdown. Dental benefits are the first ones to be revoked by employers and people refrain from buying dental insurance at the time of financial crisis. Even though more than 55% of the U.S. population is enrolled for some kind of dental benefit plan, dentists are still finding it hard to maintain the financial viability of their practices. There are a plethora of reasons affecting the overall profitability of dental clinics, such as –

  • Limited number of insurance carriers
  • Low reimbursement rates
  • Aversion of dental medicine practitioners towards cross billing
  • Lack of awareness about coverage for various dental procedures

Since the field of dental medicines has remained largely neglected by healthcare policy designers as well as insurance providers, dental medicine has rarely ever experienced any groundbreaking changes. But off late, billing practices in dental medicine has witnessed a major turnaround. Some obvious changes in billing practices have started appearing as a result of cross billing. While it wasn’t a favored practice by dentists, unquestionable financial benefits of cross billing have changed the outlook of practitioners towards it. Cross billing in effect garners the following changes in billing practices of dental medicine –

  • Revised coding of dental procedures – To avail the full benefit of higher reimbursement rates being offered by medical insurance carriers, it is essential for any dental practice to introduce proper coding changes into their billing procedures. Oral health and hygiene is now being consciously recognized as an important integral of overall body health. Therefore, as per the latest healthcare reforms, dentists can medically bill an array of procedures such as diagnosis, therapy, surgery and oral applications by correctly identifying and billing these procedures under medical procedures instead of dental procedures.
  • Adopting e-documentation and billing – While healthcare reforms are necessitating use of EMR practices for all care providers, dentists are yet to understand the full significance of electronic medical records in patient database management as well as information transfer. EMR also facilitates adoption of regular coding changes in billing procedures and avoids any unwarranted coding errors at the time of claim settlement.
  • Medical insurance carriers over dental carriers – Dental carriers are consistently offering poor rates of reimbursement, even to the most established and financially influential dental practices. Patients, at the same time, suffer the inconvenience of paying for specific dental procedures which are not covered by any carrier. This increase in the no. of individual payers in payer’s mix of a dental practice drastically depreciates the cash flow of the practice. Also with changing healthcare reforms providing medical coverage to millions more by 2015, it is a prudent move to adopt medical insurance carriers for claim settlements and reimbursements over dental carriers.
  • Negotiating reimbursement rates – Dentists are also likely to negotiate better reimbursement rates with dental carriers and employers offering dental benefits to employees in the years to come. Cross billing, EMR and revised coding practices are likely to give new leverage to dentists in the U.S. healthcare market.

Medicalbillersandcoders.com is a billing solution provider that can not only prepare your dental practice for cross billing and other changing billing practices, but also introduce more profitable and effective billing solutions in your dental practice at regular interval.

 

Category : Dental Billing