Medical Billing for Dentists: How to Get Paid on Time

medical billing for dentists

While 28% of Americans don’t have medical insurance, twice as many go without dental insurance. If you get patients who need a procedure but don’t have the insurance to pay for it, you might be surprised that medical billing for dentists exists. Rather than forgoing a payment or waiting forever for a low-income patient to fulfill their payment, you could seek out money from medical insurance.

Here are some of the five basic facts of billing medical insurance as a dentist.

1. Know That You Can Bill Medical Insurance

While dentists sometimes try to isolate their practices from the overall medical field, dentists are still licensed health care providers. They don’t exist outside of the realm of medicine.

That perception keeps dentists from billing medical insurance and keeps patients seeking help from the insurance they pay for.

The scope of a dental practice is actually laid out by the ADA and each state has statutes that regulate the dental practices. If you’re looking for codification, the state has all the answers. Since dentistry is not just limited to teeth, services can be reimbursed far beyond dental insurance.

In cases where surgery is necessary, the line becomes blurred and certainly begins to tip into the world of medical billing. If you can’t get services beyond teeth reimbursed by dental insurance, medical insurance might be the route.

Since so many medical conditions are connected to the kind of preventative care that dentists do, medical billing makes sense. If you can diagnose problems, treat them surgically or non-surgically, you’re performing the work of medicine and should be entitled to relative payment.

Given that you abide by the same standards, treat many of the same patients, and can be the first professional to notice issues, you’re as vital as a PCP.

2. Medical Billing Isn’t That Challenging

Learning how to do medical billing will take some new training for your billing and accounting staff. Your receptionists might even need to be informed as to what some standard procedures could be covered by medical insurance. Without the right amount of planning and training, your practice will struggle to succeed.

If your practice uses CEREC technology, implementing medical billing is nearly identical to the adoption of technology like that. Training will be required to get the hang of the process but will be worthwhile.

Once you’ve got a smooth workflow worked out, your whole staff will be able to manage medical billing and ensure you get paid as fast as possible.

3. Medical Billing Is For All Practices

While some myths persist that medical billing only applies to dentists who use CT, it’s not true. While any practice that uses CT should be using medical billing, it’s not a requirement. There are plenty of services that you could be billing medical insurance for.

Even exams and consultations could qualify you to implement medical billing. Since you’re diagnosing and treating during those appointments, medical billing is relevant to your practice. Even a normal 2D radiograph could be a qualifier for medical billing.

If you deal with any traumas to the maxillofacial region, including teeth or not, you could bill medical insurance. Any surgical or prosthetic procedures, whether you’re implementing or setting up a surgeon for installing prosthetics could be handled as a medical bill.

Many dentists help to identify the need for sleep apnea equipment for their patients. This could fall under the umbrella of things you could use medical billing for.

4. It’s Not That Time Consuming

While you might think it’ll be a pain in the neck to handle this kind of billing, it’s no more complicated than any other protocol.

If you don’t think you can handle CEREC in a practice as busy as yours, if you select the right cases and train properly, it should be a breeze. As long as you implement systems that make the process simple, you shouldn’t use any extra time at all.

Once you’ve set everyone up to succeed, medical billing will be as easy as any other system you use. If you’re servicing a rural area, the benefits could outnumber the costs.

5. Deductibles Won’t Be An Obstacle

Many dentists fear that high deductibles could be an obstacle to getting paid on time. Once you understand the actual function of a deductible, you won’t have this fear.

The government defines a deductible as the amount that is owed for health care or what the plan covers before health insurance starts kicking in. However, deductibles don’t apply to every single type of medical procedure. If you don’t know when a deductible would be applied, you might be surprised to find out what lies outside of the realm of deductible requirements.

Given that a deductible isn’t applied to every kind of procedure, that means it’s defined by each insurance agency. Application of deductible will vary between plans, so instead of wondering what the deductible is for a given procedure, look more closely. Understanding how the deductible is applied could be far more illuminating than the sticker price.

If you make a claim that’s half of the deductible, and the deductible is applied to all procedures on the claim, you won’t get a payment. However, if the deductible isn’t applied to the claim, the payment will get made to you. A deductible that doesn’t get applied to a claim becomes totally irrelevant for your purposes.

Medical Billing for Dentists is Often Untapped

If you’re a dentist who services a broad range of patients from different backgrounds, you might prefer to bill medical insurance rather than dental. While dental insurance billing is catered to the kinds of systems you already use, with some slight changes, you could get paid by medical insurance. Tapping into medical billing for dentists could change your practice in important ways.

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