If beneficiaries do not succeed with their internal appeals for their medical claims, they could go through an external review process in which another company reviews their denied claims (Berger 2017). They can go through the external review process for cases related to disagreements on...
In the United States we are on the cusp of a major healthcare debate. Politicians have begun to advocate for “Medicare for All” as a very loosely interpreted form of single-payer insurance. Let’s take a look at what Medicare currently covers in terms of dental...
Depending on their patient’s condition, dentists and medical doctors can work together on their patient’s treatment plan. By doing so, they can greatly improve the patient’s condition. Dentists should indicate that this collaboration occurred for medical insurance. Furthermore, they have to show the doctor, with...
Dental insurance companies require CDT (Current Dental Terminology) codes on claims, while medical insurance companies require CPT (Current Procedural Terminology) codes, which “[describes] medical treatment,” on their claims (“Billing medical plans for dental treatment” 2016). Medical insurance companies also need an additional code: the ICD...
As dental offices bill higher levels of restorative treatment it is becoming increasingly necessary to utilize appeals opportunities and peer to peer options to overturn unfavorable coverage decisions by medical carriers. A popular recommendation from consultants is to use Wilson & Wickline letters when appealing...
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...