There may be several reasons a practice would rather not submit a claim to the dental insurance carrier for services provided to a patient: the service is not a covered service, the patient has reached their maximum, the office is in-network and the network fee...
With nearly 65% of dental practices participating with dental insurance, dental insurance billing is a crucial element of revenue cycle management. Let’s explore the 7 most common claim issues that lead to denials and delays, and how to avoid them to have steadier cash flow. 1....
Let’s face it, denied claims are a pain for everybody: the practice, the biller, and the patient. It takes so much time and effort to appeal the denial, and in some cases the denial is upheld, even when all evidence provided by the practice supports...
In the not-so-distant past, implants were not very predictable. Technology has advanced significantly, and today’s implants are much more predictable and reliable for patients. Implants are a new adjunct to dentistry, providing patients the option for the highest standard of tooth replacement. The CDT codes have...
When speaking at various dental meetings, and when responding to email questions about extractions, I have encountered some confusion about the difference between simple extractions (code D7140) and surgical extractions (code D7210). Understanding the differences requires understanding the nomenclature, so let’s dive into each so...
What is the code maintenance committee? The Code Maintenance Committee (CMC) is a committee charged with evaluating and voting on CDT changes while maintaining the best interests of the dental profession, patients, and third party payers and administrators. The CMC consists of 24 voting members and...
CDT code changes adopted by the American Dental Association’s Code Maintenance Committee become effective on January 1st each year. Dental teams are made aware of the changes when the new reference materials become available, usually around the end of July or the first of August. ...
The American Dental Association (ADA) has released its Code on Dental Procedures and Nomenclature for 2021 (CDT 2021) Please use CDT 2021 codes when submitting claims to any dental/medical insurance for services you perform on or after January 1, 2021. If you are resubmitting claims where your...
The patient owns their records and therefore is entitled to a copy (not original) whether they have a balance on their account or not. Most practices have digital radiographs, photos, and notes, so it isn't an access issue. Providing a copy to the patient or...
*From the American Dental Association: The committee added the following procedure codes to CDT 2021: *• D0604 — antigen testing for a public health-related pathogen, including coronavirus. Definition from the Merriam Webster dictionary: Antigen is any substance (such as an immunogen or a hapten) foreign to the body that...
