Paul Bornstein – CDT Dental Coding & Reimbursement Update: Identifying Common Practice Mistakes

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Paul Bornstein – CDT Dental Coding & Reimbursement Update: Identifying Common Practice Mistakes
Without a thorough understanding of insurance reimbursement, today’s dental office is at a serious disadvantage. In this economy, dental professionals need to ensure that they are getting reimbursed as adequately as they can. Insurance companies use various tactics and strategies that, unless understood, will cause unnecessary delays and rejections during claims processing. Each office has unique insurance problems. All offices have common insurance problems. We will teach you how to be aware of the potential problems and offer possible solutions!
Why this Program is Unique:

Get your practice up to speed with an experienced dentist who ran a dental insurance company and practiced for 30 years.
You will be given a consultant’s perspective on records and billing, so you can do your own audits, increase your income, and decrease your risk.
You will obtain helpful, realistic, and practical risk management and practice management tips.
You will be given the information you need to file claims correctly and challenge denials with appropriate documentation and narrative.
You will understand how insurance companies evaluate your claims.

Most Offices Can Immediately Increase Income with the Information in this Recording:

Overcome a down economy with LEGAL ways to maximize billing.
Implement proven strategies to improve patient collections.
Bill properly for general practice, periodontal, and oral surgery services.
Help prevent rejections.
Identify what insurance companies look for other than fraud.
Assess the claims process from the insurance company’s perspective.
Examine the pros and cons of accepting Medicaid.
Analyze dental contract language and determine how to best educate the entire dental practice, including the staff, doctor, and patients.
Formulate the best narratives and documentation.

Identify what you need to be aware of to maximize billing.
Examine the intricacies of the dental insurance world.
Discuss how your office is being watched and how to avoid billing fraud.

The Dental Contract

Insurance carrier rights
Trends in today’s contracts

Changes in benefit frequency
Oral-systemic disease link
Avoiding dental fraud
PPO participation

Practice Management

Fees
Patient communication and managing the patient
What consultants look for – common practice mistakes
The importance of self-auditing records
Risk management tips

Avoid Dental Fraud

Avoiding “red flags”
Suspicious claims
Fee discounts
Over-utilization
Accepting Medicaid: Should you/shouldn’t you?
Examples of legal action

The Complete Claim Form

How to look at claims like a claims reviewer
Correct X-ray, photograph, and narrative submission

Insurance Strategies

Learn how the insurance company thinks
Learn to correctly resubmit claims for appeal
The truth about insurance company stall tactics – Are they real?
Effect of the HIPAA laws on coding
Effective communication skills
Discover how to use the EOB to your advantage

Effective Coding and Billing

Tips you can use to keep your practice afloat in a down economy
Identify the biggest loss of income for your office and how to correct it
CDT – the latest additions and revisions
Documentation needed to support claims
WILL YOUR RECORDS SURVIVE AN AUDIT?
Correct use and maximization of codes
Electronic claim filing
Outside financing – Which lender should your practice recommend?
The correct claim attachments and narratives – What needs to be included?
Important tips to ensure a complete claim – the first time you submit it

Special Areas of Attention

Learn to bill periodontal services correctly including the new D4346
Fraud: Prevent fraud from occurring in your billing