Home Practice ManagementInsurance The Power of Dental-to-Medical Coding:

The Power of Dental-to-Medical Coding:

by Christine Taxin

New Credentialing Program Can Boost Your Practice

As our knowledge of the effects of oral cavity conditions on other parts of the body has steadily grown over the past few decades, more and more practices are learning to leverage the power of dental-to-medical billing. Among its many advantages, billing medical insurance in a dental practice can help you:

• Differentiate your practice

• Attain higher case acceptance

• Increase revenue

In fact, the demand for medical coders is at a historic high. Most healthcare providers in the medical arena will now only consider hiring candidates that possess knowledge and training in this highly specialized field. 

Yet although it’s not a formal educational requirement, the topic is highly complex and constantly evolving. Even after training thousands of dental teams over a period of decades, I find there are still new things to learn. A year of living with and adapting to pandemic conditions, for example, has linked the dental and medical health care fields more closely than ever, in new and unexpected ways.

But the importance of medical coding does not begin and end with the billing department. Since each member bears responsibility for the knowledge of why periodontal issues may be considered a medical necessity, the practice will benefit when the entire team receives training. Many teams have taken the first two days of our billing courses to learn about systemic links to the entire body and why there are numerous diagnostic codes that are part of the clinical examination. Some important course components include: documentation requirements; the digestive system connection; the many viral and bacterial issues within the oral cavity; and finally the diseases that can be helped with great oral care, including the COVID-19 virus and many other issues that we can see in the oral cavity. 

Team members also learn how the medical world does pre-authorization for CBCT or any other tests that your team may use in your office to start medical billing. I have seen an increase in hygienists and oral physicians wanting these courses since they are the providers who are responsible for the documentation that provides proof of a medical necessity. When everyone is trained, the office wins.

I have taught at many large universities, NYU Dental, Pacific Dental, Harvard Dental and Medical and many other organizations across the country helping everyone understand the role they play. Despite the technical nature of the subject matter, we do have a lot of fun, and hold a yearly meeting called the Insurance Extravaganza that provides specialists from a wide range of medical fields, as well as representatives of insurance plans that cover what you will be billing.

But given its central importance to a practice’s success and its highly specialized nature, it has always struck me that there have been no certified credentialing programs to recognize this important skill set in dental professionals. It is gratifying, therefore, to finally bring this type of program and standard to the dental industry through our newly established official credentialing courses. Dental Medical Billing has partnered with Find a Code and QPro who monitors the tests and credentials.

Learning how to get paid by medical insurance in a dental practice from start-to-finish is not easy. Our coaches at Dental Medical Billing have worked hard to make sure our billers in dental are able to earn the same credentials as a medical biller anywhere in the United States.

Here are the dental-medical cross-coding topics we cover:

• How to integrate medical billing into your dental office for sleep apnea, TMJ, implants, oral surgery, bone grafts, CT scans, and more.

• The importance of documentation and records, why they are vital for medical reimbursement for dentists.

• Verifying benefits, pre-authorizing patients’ medical insurance benefits.

• Searching for medical policies online.

• Using CPT, ICD-10 and HCPCS codes.

• How to complete the CMS-1500 medical claim form.

• The issues of billing both medical and dental for one service.

• Accurate & Ethical Billing – Learn what can be billed and how…and what NOT to do that will ensure you are receiving the best information for all billing questions.

Topics we teach:

• Dental Sleep Medicine (Sleep Apnea Appliances)

• Implants / Oral Surgery

• TMJ Disorder Treatment & Appliances

• Medicare for Dental Sleep Medicine

• Sinus Lifts / Maxillary & Mandibular Bone Grafts

• Mucositis

• Frenectomy for Infant Tongue Ties

• Oral Cancer Screening

• Guided Tissue Regeneration / Periodontal

• Oral Systemic Infection

• Botox Injections for Painful Bruxism

• Cone Beam CBCT/Panorex & Exams for These Procedures

Once you have gained the knowledge and credentials, new doors will open for different positions that require credentialing such as hospital, emergency room, offices, or third-party billing companies. We cover all applicable procedures.

It is an amazing time since more and more dental is considered a medical necessity. Think about how many changes the ADA has made in the past year alone. Their list of recognized dental specialties has now increased to eleven, including patients with systemic issues to be treated by providers who specialize in implants and bone grafts, oral cancer…and the list continues to grow. Each one of these topics has become a module as medical coders learn. The first step is taking a course that explains why any treatment is considered medical, learning how to read the medical plans, and understanding the terminology needed.  

Christine Taxin

Christine can’t wait to start helping dentists, office managers, and other team members learn everything they’ve been missing about navigating dental/medical insurance billing and maximizing their practice’s overall success. For more details on her exciting new credentialing program, visit the Medical Certifications section of QPro.com and find QMADC (Qualified Medical Advance Dental Coder). If you’re interested in scheduling a presentation or have any questions, don’t hesitate to contact her at ctaxin@links2success.biz, call 914-303-6464 or visit dentalmedicalbilling.com.

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