TMJ benefits are notoriously difficult to “crack” in the medical insurance industry. Today we will explore the different diagnosis code sections available for TMJ disorders. Use these codes to implement questionnaires in your practice so that you don’t miss vital symptoms. The...
Dentists can bill medical insurance companies so that patients could receive coverage for procedures treating injuries caused by traumatic events (“Most Medical Insurances Cover Dental Work as a Result of Trauma”). Dental trauma, usually classified “as a ‘non-biting injury to a sound natural tooth’” by...
For several years I had the great pleasure of working for a dentist who saw only sleep apnea patients. That’s right – ONLY patients who were having sleep apnea appliances done. We were a small office in coastal Georgia and we were open five days...
One of the most common things dentists struggle with when prepping to send medical claims is providing the right documentation. Among those are letters of medical necessity. Not something we ever get requests for from dental carriers and much more involved than the standard narrative....
Terminology for medical insurances can seem confusing compared to dental care. While there are generally less moving parts to keep track of (services generally are covered at a standard percentage before the deductible and OOP) if you aren’t familiar with the lingo you can easily...
Dental insurance can limit coverage with annual maximums and usually provides full coverage for cleanings, “but only pays a small fraction of the cost of other treatments” (Taxin 2016). Although some patients cannot afford certain treatments or decide to deny them due to little to...
It may seem like a fairly obvious description however many patients and doctors don’t know what this phrase means. Simply put it is a procedure that is not covered by the patient’s insurance plan. Most providers are confused because it is assumed that if a...
By Stefanie Fario Of all the congenital medical conditions that can occur in children and newborns cleft lip and palate is one that involves years of dental treatment. While tissue release and palate grafting often take one or two surgeries immediately after birth the child is...
This is a common problem for our medical billing clients. As a dentist you are in a unique position to talk with and counsel patients who suffer from sleep apnea and may or may not be currently treating it. Dental providers are the only providers...
People in PPO plans can receive more coverage and benefits at in-network dentists. Though, some people may go out-of-network in order to visit their preferred dentists. Others may visit out-of-network dentists because they may live “in rural areas or in areas where providers seldom participate...
It is something every dentist dreads hearing – the word fraud linked with their practice or staff. While you can never absolutely be 100% sure that you will avoid making any mistakes in your billing practices being extra vigilant in certain areas can certainly reduce...
Many appointments seem to indicate the profitability of the practice (Jameson 2001). However, too many appointments can stress out dentists and hygienists and the practice cannot schedule new patients or have enough time to address dental emergencies (Jameson 2001; Tekavec). Dentists may even spend less...
