We are all pretty familiar with the mantra for dental billing. Bill for what you do and do what you bill for. Since an office is, hopefully, bursting at the seams with dental professionals it is fairly easy to stay within the lines on dental...
You’ve begun accepting medical insurances and submitting claims. Things are going well until you have a patient who has been referred to you. Their treatment is clearly medically necessary, their dentition was affected by recent oral cancer treatment and surgery. The pre-authorization for services has...
Licensed dentists commit fraud by “[billing] for services provided by unqualified or unlicensed clinical personnel” by putting their name on the claim to insurance companies and Medicaid, lying that he or she did the procedures for the patient (Cutler 2012; “Dental fraud scams”). By doing...
Dental hygienists perform many procedures to treat patients’ oral health, such as “removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth,” “applying preventive materials to the teeth (e.g. sealants and fluorides),” “teaching patients appropriate oral hygiene strategies to maintain oral...
Dental clinics provide a variety of treatments and services to patients. However, they are limited in what they provide, depending on their skillset. More dentists could assist them in taking on more patients, providing certain procedures that the practice cannot provide. Dentists could hire new...
In dentistry we are familiar with a cut and dry approach to coding. Generally there is only one or two, maybe three, procedure codes on the CDT listing that apply to any given treatment. So when a practice decides to begin submissions to medical carriers...
When a new yet difficult patient comes to a practice, seeking treatments with improbable expectations, dentists could deny them in order to avoid long term problems with them, regardless of “the potential income that could be derived from a case” (“Just say no: How to handle demanding patients”...
As any dental specialist knows any good practice can fail or thrive by the volume of referrals they receive. When you have a niche market you have to work a little harder to gain a following and dentistry is no exception. General dentists don’t experience...
Dentists can commit fraud in order to get more money by “[billing] for services not rendered,” intentionally sending wrong codes to insurance companies, upcoding, etc. (Lewis Jr. and Farragher 2013). When they get caught, dentists pay fines, serve prison time, and live with damaged reputations....
Some people cannot get dental care because they cannot afford it or do not have coverage (Melko 2017). Other people, such as students and the elderly, may have no time for it or lack transportation (Melko 2017; Reese III 2009). Instead of them going to...
