Streamline Your Processes with a Dental Invoice PDF for Operations

Dental invoice pdf for Operations

all right hello and welcome everyone to today's what's new in Dental billing and coding webinar my name is Jacob bover here on the webinar team at rectangle health and want to thank everyone for taking time out of their days to join us here today so before we hop into our presentation just a few quick housekeeping notes um this is a onehour onece credit course we are Pace accredited through AGD to provide CE so in order to get that CE please make sure you are on for the duration of the presentation and we're also going to have a few polling questions throughout the way to make sure you're engaged in paying attention so when those pop up make sure to answer them so that we can uh send you the C credits in regards to C credits you are going to be getting those credits within the next two weeks be on the lookout for an email from Nora from our webinar team those C credits will be coming to your inbox from the email you registered um sometime within the new next two weeks so be on the lookout for that if you don't see it make sure to check spam or junk um because it'll be coming your way um if you are joining us today from mobile and you can get to a computer we do recommend that for a better viewing experience so easier to answer polling questions and participate throughout the webinar if you have any questions at all throughout today's presentation feel free to place them um in the question Tab and we'll be sure to answer them as soon as we can and if you're having any issues or have any additional questions um just email us webinar rectangle health.com and we'll be sure to help you um you're going to be um hearing from Stephen Pam today on a lot of great things we're going to be putting different resources um for you in the chat so be on the lookout for that and then we always get the question um about follow-up materials so everything's going to be coming your way including the recording um within the next 24 hours so be on the lookout for our follow-up email from us so with that I am very excited to introduce our speakers today today um first off we have Pam Peterson as the CEO and president of total Patient Service Pam Peterson is responsible for directing the activities of a large group of professional consultants and a client support team that advises and coaches Dental practices from all over the country she has over 25 years of experience and she's got a great presentation for us in store today and also we have Stephen J Anderson Steve has been named Dental businessman of the Year by excellence in dentistry and he and his team coach top practices in Dentistry to reach the highest levels of C case acceptance and patient service so with that I'm excited to send it into our speaker Steve take it away good thank you Jacob great to be back with the uh rectangle family as well as with those that are participating from Adam I love Adam and uh we've got a packed hour ahead with essential information you need to know right now of what's new in billing and coding uh I'll just give you a quick backstory so uh Pam and I have worked together for over 20 years at total Patient Service uh so we've got an entire team of what we call coaches practice advisers that are in practices every day working side by side with dental teams to implement the highest level of Patient Service uh and systems in practices so we get a a pretty good view of everything that's going on in Dentistry on an ongoing basis and we're going to share some of that with you today uh I will mention that we'll provide some resources as we go along so would be good to have your phone handy we'll have a few QR code uh download materials that'll help as you implement the changes that we'll talk about uh today this will be laid out what we're going to talk about moving forward is we're going to talk about uh changes that have been made in the insurance filing world one major one that we'll talk about first off we'll talk about new codes revised codes and codes that are no longer codes that have been discontinued and then maybe the most important part of what we'll talk about today is miscoding so codes that get misused or miscoded where you're not getting uh the most from what you could be for your practice so that's a big a big bonus today is proper use of some of the most misused codes so with that uh we're going to jump into the biggest change that we haven't seen since 2018 which is a a updated new Ada Insurance claim filing form you'll want to make sure that you pay very close attention to this because this doesn't happen very often and there are some significant changes that have been made so that you make sure you're using the right form so with that and Peterson tell us about the new Ada claim form perfect thank thank you Steve I am thrilled to be here all right so with the the new Ada claim form so just hold on to your seats it's been over 10 years since this form has been updated and um there's been some significant changes and uh I was asked and I did some research on behalf of all of us here today is why did they update it well the insurance um agents uh they're they're really um measured by the volume of claims that they um that they process not by how many that they reject or how many um that they approve it's by process and so they've updated the claims so that it really streamlines um the process for the agent to really support you at the practice so let's talk about the updates in the 2024 claim so first um the first update is in box 3A there's a standalone box for the payer ID and so when you enter all the information that you normally do the payer ID has its own box so that when the um agent is looking they can easily pick up the payer ID the next box that was updated is box 11a this is for payer ID as well um this is for secondary insurance so if you file secondary insurance on behalf of your patient this is where you would add the pair ID for secondary insurance if you don't file secondary insurance it's not applicable to you just leave it blank the next update is box 28a I'm sorry just 28 you see that it's highlighted in yellow this is where you um add clarifying notes to address the surfaces to indicate that if the restoration involves the anterior incisal Edge so you would place it there so that it's really clear for the agent who's processing your claim the next box that was added is box 39a this this is where you would enter the date for the patient's last SRP now this is a patient that um has has a history outside of your office and so what we recommend is you talk to your patient and get the closest to the date as you possibly can now there are some guidelines with this date that was in all caps and I feel like it's important that I share this with you you must enter the month the day and the year in that format they really want that format so if you do it in any other way and uh someone wakes up on the wrong side of the bed you could run the risk of your claim being rejected I feel like I'm back in my college classes if you do not put the name and date correctly you will fail the gotta do it right yes absolutely the next box is 53a through 58 so this is the box that uh has been amended and this is for locom tenants and in layman's term terms this is a treating dentist um that is a substitute or filling in for a doctor that's on leave or medical leave or vacation but this is where you would add the information so locom tenants um that the definition of that is a substitute or to fill a spot now it's important that the treating dentist goes in this box if there's a dentist that is in this box that did not treat the patient that's deemed fraudulent so please make sure that the dentist that is treating the patient if they are a substitute and they are filling in this is where you enter their information hey so Pam Qui quick question on that one do we know the the time duration and I'm sure it's different for every insurance company if if somebody's filling in how much time do you have to get them credentialed versus just using this do we have any and is that I mean Company by company yes every every Insurance um company is different and some of them have made some updates um in in the beginning it was really difficult because everything was by mail and there's some that you can get that process done really seamlessly um like online especially if they've been credentialed in another office so it's it's by diff insurance by Insurance all right so that' be a check your contract or call call the insurance company yes yes so box 56a um this is where you add the specialty code and every doctor has an assigned every position whether it's a general dentist an oral surgeon or any other specialist they have a specialty Cod so that when you have a treating dentist that is a specialist that comes in and they treat your patient this is where you would enter their their uh identification code this is different than a national provider identification number and um many of you I know I'm preaching to the choir that you are familiar with this if you're not we do have a list so please don't hesitate we'll make sure that you have our information we'll be happy to provide that list to you as well all right okay so Jacob this is the first poll question so um one of the things I love about how Jacob runs his webinars is you have to pay attention and he makes sure that you pay attention because you have to respond to the poll if you want C credits so uh the question is the current Ada claim form is effective as of and you get to choose the date so it's effective as of what date January 1st 2018 January 1st 2024 January 21st 2025 or none of the above so you get to choose the date if you are listening to Pam you will know the right answer all right looks like they are listening we had 8% say January 1st 2018 86 6% say January 1st 24 3% said 25 and 3% said none of the above okay so the correct answer is yes January 1st 2024 so this just went into effect so moving forward you need to use the new Ada claim form yes yes um and um a sideline on that there are there is a a a time frame where they'll become real sticklers and we recommend that you start now because this was effective uh January 1st 2024 okay all right this what's new okay yes all right so before we jump into the new codes I I want to talk to you about the resources in the event that you're questioning okay who's doing all this for us so Ada has a committee that's within uh Ada and their sole responsibility is to support you and so this commit committee is also known as CMC C which is the code maintenance committee and their role is to ensure that all stakeholders have a role in evaluating voting on uh new updated CDT uh code changes now the the stakeholders are the profession which is all of you and your patients and payers so they're taking care of you the practice the patients and the payers to ensure that we are current um with our codes based on all the things that are going on as far as how you treat patients and things that are new updated and improved and so let's talk about the codes that are new in 2024 the first is d396 this is a 3D printing scan that you can obtain a diagnostic cast also known as a study model so back in the day there was only one way in my how I was raised which is an alginate now you have the ability to use your scanner to produce diagnostic cast also known as a study model so the new code is 0396 the next code that's new and it's it's found in the preventive is d301 it's immunization counseling so if a clinician sits down with the patient reviews the benefits risk consequences of not obtaining the covid-19 vaccine um there's a a code that the doctor can use with counseling and guiding the patient back to their Prim caregiver this is the code that you would use for the time that the P that the doctor uses when having the conversation the counseling session with the patient and please note um in the summary on the claim where you would put a narrative that we recommend it for the patient to go to their primary care physician and also update your Note quick question on that one Pam uh so as we go along if you have questions as Jacob mentioned you can enter them in the question box and your control panel on your screen so here's the first one so with that new code does that mean insurance companies will pay for immunization counseling that is a great question and um we always trust but verify there are some insurance payers yes many of the codes that I'm going over that are are uh existing and the ones that are new um there are still some payers that will not will decline payment we also want to make sure that we uh get a breakdown of your patients Insurance savings on all of the codes that I'm going over today to see what coverage that is available for your patients so there are some that are yes and some that are no so thank you for asking that a lot of the um yeah what we found is as I'm sure everybody knows is sometimes when a new code is released doesn't mean necessarily mean insurance is going to reimburse for it what it does mean is it's on the radar and eventually down the line it may get reimbursed so it's a start it's a starting point yes and absolutely and for that question it it um made me think of of something that I would recommend so thank you for the question is as we go along if there are key codes that you you um get a breakdown of uh Insurance savings identify the ones that we're going over today that you'll add to your insurance verification form so that you'll know exactly what the payers are saying the next new codes these are um located in the restorative um the first is the d2972 this is a band stabilization and it's per tooth and it's typically cemented around the Moler of the tooth and this procedure is done mainly for pre-orthodontic patients or patients that are medically compromised now this is an interim procedure which means it's not a final restoration but it's a interim procedure and so this is the code that you can use um when uh you are using a band stabilization per per tooth if it's a medically compromised patient or orthodontic the next code is 2989 this is an excavation of the tooth result to determine if the tooth is restorable and um how I like to go off grid with this whenever I was reading this code what I thought about is um I know it's lunchtime and you're dental people so you won't be grossed out by this if I gave you a crisp Red Apple and it looked delicious you bit into it and it was rotten uh it looked good on the outside but it wasn't good on the inside that's what happened to some teeth um when doctors look at it it looks okay and then when they open it and I know clinical assistants can attest to this that the Decay is endless and so now when a doctor excavates a tooth to determine if it's restorable or not um and if they refer them to have it removed or if they remove it you can use this code 20 989 for the procedure that you did prior to the next step of the non-restorable tooth and like we stated it before add this to um your breakdown of insurance savings to find out what your payers are paying towards this uh new code which is 2989 and I know Steve loves uh the the word excavation yes I do all right um the next code that's new is the d299 1 this is an application of hydroxy appetite um this is a medicament that's used um to support bone regeneration prior to this code this was this medicament was used with bone regeneration and wasn't charged out and now there is a code for it we have one new implant code which is the d689 this is accessing and retorquing a looed implant screen through now occasionally a good standing implant um that is still functioning well it gets loose and so patients will come in the doctor will spend time tightening it and then we would charge it out as a no charge visit there is a code for it so I would get a breakdown to see what the coverage is it's d689 which is a new code and this is a code that you use when you are tightening an implant and this is per screw by the way Pam I glad to know that there's finally a code that can be used when I have a screw loose I like your code commentary by the way all right next next new code this is Earl surgery and U the new code is d72 84 this is a biopsy of a minor salivary gland what was before which has always been which is soft tissue the salivary GL you would use this code if a patient presents signs or symptoms of shrin syndrome that's the drying of the eyes in the mouth so if a doctor does a workup this is the code that you would use for the biopsy which is the 7284 the next code that's new is the D 7939 this is an osteotomy using a dynamic robot many um many oril surgeons and peronists already have this in place which is it's a guided uh virtual guidance and they actually refer to it as a robot and so now there is a code that you can use when um utilizing this uh with uh taking care of the patient which is the d79 39 all right all right this is a big one this is a big deal this big big deal so I don't do you ever remember this happening I'm sure it's happened in the the past but it doesn't happen very often you know I I just I don't recall when the last time a new category of services was added and yeah so this is like a big big deal so it's a whole new category of codes for a new service maybe not new but at least it's now going to be recognized with specific codes so pay attention very important here I know they're like reveal it Pam there you have it it is it is sleep s apnea services this has been like on the sideline and I'm not sure why so sleep apnea Services were um found with in adjunctive Services um or miscellaneous and um there are a lot of practices that serve patients with sleep apnea and uh when St and I were talking about this he got really excited about um having something in place in dentistry uh did they have do they have it in medical yes and it's long overdue uh for Dentistry to make sure that we have our own codes um there are a couple of codes that aren't new they're still in place but now they can be found in this category which is the 99 47 the 9948 the 9949 and the 9953 let's talk about the new codes that were added the first is the D 9938 this is a fabrication of a custom removable clear plastic temporary aesthetic Appliance what we refer to this in the practice is an Essex retainer the D 9939 is the placement of the removable clear plastic so deliver it of deliver the Essex retainer so one is to fabricate and the other is to deliver and so these codes were added the 9954 is the fabrication and delivery of an oral Appliance therapy and what we refer to this in the practice we just call it o oat we have a lot of acronyms I know and uh this device is used immediately after removing the overnight Appliance and so this this uh Appliance is used to make sure that everything is uh that you relieve uh muscle jaw pain and in the past there was an code for fabricating the uh appliance that you would wear in the morning you just only had the overnight um so I'm glad that the uh code maintenance committee they listened so the new code is D 9954 the next next um sleep apnea coat that was updated is the 9955 this is an oral Appliance therapy this is still the oat but this is the titration and what that means is when a patient comes back this is Post delivery of of an appliance that's in office so when the patient comes back the doctor checks and evaluat the patient's response to treatment to ensure that everything's in good standing um make sure that there's no side effects and that the device is operating properly the 99 956 are for patients who are doing an at home sleep study so when they come in for a Post delivery for the same thing which is the titration the 9956 is what you would use so you have one that's for related to breathing disorder uh breathing disorders that is at at home that's the 9956 the one in office is the 9955 the last but not least is the 9957 so when the doctors doing an oral exam or a questionnaire whatever method and system that that the practice has in place as far as screening if this is a candidate for sleep apnea this is the code that you would use which is the 9957 and I'll say it again always trust but verify get a breakdown of your patients Insurance savings and it's important to make sure that um there's always a narrative followed with with the um utilizing this code especially on the findings of 9957 okay so we have the new we have had the new category and now there's a couple that are revised so when you're looking at my screen when you look at the screen you see all the red it's like no wonder well the d2335 was very confusing and um the code committee made it they simplified everything um they so now the d2335 is a resin based composite for more surfaces and it's the anterior so no more of all of the jargon like should I use this code or not so I'm happy that they simplified it the next code that they revised is the um D 5876 this is adding metal substructure to an acrylic full denture now this is not an implant denture this is a removable complete denture without fr framework all right I think we have another another poll Jacob all right let's do it all right so the new CD code category of service so the new category of service is for sleep apnea Services oral cancer diagnosis implant restoration or all of the above everybody said yes all right they're paying attention we had 96% say sleep apnea services and uh 4% went for the all the above which happens ah you're sleeping you're sleeping on in the webinar sleep apnea it is Big breakthrough there so um it's that that whole sleep apnea piece is going to be one of the biggest uh I think it's going to be one of the biggest areas in dentistry in the future huge it is epidemic and uh Dentistry is perfectly positioned to treat it so so excited they got codes for it now it's not miscellaneous anymore all right so here's a couple of suggestions uh as we've gone through new Revis uh new Services a new area of service uh so grab your phone uh this is one of the resources that I promised you if you want to scan the QR code that's coming up here what we've done is created a checklist that you can download that'll help you implement everything that we've talked about today so this checklist includes all the new codes revised codes all the things so you can track what we've talked about today I'm sure you've been keeping copious notes uh but there's a checklist that includes all those one of the recommendations by the way uh that you'll see on this checklist is the very first thing add you're updating uh the codes is to also update your fee schedule and so what we recommend is that at least once a year you update your usual and customary fees so that they're keeping Pace with inflation with what's going on in your Market Etc so there is a link on this checklist uh fact it's the very first uh item that you can um or actually when you download when you actually download the uh the checklist there's a box that you can check for your fee analysis so as a part of this webinar today as a extra added bonus you can request the fee analysis by checking the Box uh when you fill out the form to get this uh coding checklist so if you check that uh you can provide your zip code and the team at total Patient Service will send you uh the report for your ZIP code uh of the fees in your area based on percentile so uh and where you're you then you can compare your usual and customary fees to your market and Pam your recommendation is that usual and customary fees should be set in which percentile um 80th 80th percentile is what we prefer is what we recommend so this report will show you what the 80th percentile fees are for your area you can compare your your current fee and then adjust ingly up totally up to you but you can adjust ingly it just gives you some idea of what's going on in your Marketplace so um highly recommend that there's uh Jacob also put in the chat box a link if you want to just click on the link and um that uh that that'll help you there as well so um coding checklist and a lot more to come here and uh as well as your fee report you can request and we'll put this up here at the end of the webinar as well Perfect all right Pam I think we're on to miscoded so yeah this may be the most valuable part of the webinar uh these are what we find the most common mistakes that are made in Insurance coding uh you pay attention this you'll get better reimbursement because you'll be coding correctly yes thank you Steve all right so um what I would like for you to do as we go through miscoded um I want you to think about start stop continue because I know many of you this will be a refresher and these are things that you are doing and you're doing really well and so as we go through them I'm going to continue to do that if there's some things that you need to add and start I'm GNA start if there's some habits that we need to stop then actually write your notes and think about the things that you will stop so let's talk about the first codes that are common habits that sometimes don't get us in some trouble the first is why alternating a d4910 which is aaral maintenance and a d1110 which is a healthy mouth cleaning is never a good idea I know that many insurances will reject 4910 and so what happens is practices will abandon their standard of care they'll start alternating and what that means is not only did they abandon their standard of care is they didn't charge what they did and they didn't do what they charg we recommend that you code what you do and do what you code so it's never a good idea to alternate these two what I U say that again that's that's a good reminder what is it to code what you do and do what you code ah very good I like that um and one of the pearls that I took away from the late Charles Blair Dr Charles Blair is um he shared this years ago is in the notes section where you would write your narrative just place down there write clearly type it in there clearly please pay the allowable amount towards the procedure that way you are an advocate for your patient of of getting it whatever they can from their insurance savings and you're you are not abandoning your standard of care you are coding what you do and you're doing what you code and one last example on this is um many times when you um submit for a composite restoration and the insurance will send it back and say we're going to downgrade to amalgam the doctor never goes out and buys an amalgamator and starts doing amalgams he or she still they um code what they do and they do what Their code so let's make sure that we don't alternate 4910 with a d11 1110 I know you're probably we got yeah I think the key to that Pam is the narrative to Yes um if it's not allowed then pay the alternative amount absolutely and that way they're not abandoning their standard of care okay all right so here's the next poll here we go read this very carefully here we go Jacob all right you should always alternate 4 910 and 1110 to maximize insurance reimbursement yes or no yes or no true or false all right with h 83% of the votes in 1% said yes and everyone else said no that is correct so you don't alternate them you code what you do and you do what you code and then add the narrative let the insurance come down downgrade it is that what you called it Pam well we call it downgraded um downgrading and uh insance wants to be fancy they call it remapping which is REM yes all right let's talk about some exam there are three common exam codes that you use every single day which is the d0120 the d0140 and the d0150 which is your periodic exam um your uh limited exam and your comprehensive exam there are three codes that are exam codes that aren't used as often and I'd like to talk about that the first one is the d0160 um this is not a standalone exam code it must be followed with a complete exam code or a pardonal comprehensive exam code now utilizing this code there there are some frequency limitations most payers will um allow you to use this up to twice a year always trust but verify and get a breakdown of your insurance savings now with this particular um code the d0160 this is when um an example would be um if it's problem focus a patient the clinician wants to see the patient back for another appointment and example would be for TMJ you would use the d016 so it's when a second evaluation appointment is needed the next that is not a standalone code um as well this must be um followed by uh an exam as well this is for an established patient not a new patient and this patient uh these are uh problem focused as well and it's normally is soft tissue or trauma and so whenever um a patient when definitive treatment has not been rendered this is the code that you would use and so the example that you see on the screen which is um ulcer ulcer on the tongue or any lacerations in the mouth where the doctor takes a look at it and wants to see them in a couple of weeks for re-evaluation this is a code that you use is the d0170 where you see the word um above miscoded this code is often confused with a d171 171 is a post-operative code that's the code that you use um after surgery or after a tooth has been removed when you bring a patient back to check the socket or to REM suture removal the d07 is not the correct code so make sure you know the difference between the two codes we often uh when working with the coaches um we often see that with the pract in the practices that we're working with all over the country where you we see a lot of rejections uh and denials and it's because they were misused it's easy to confuse use those to the next code is the d0180 uh this is a standalone code and cannot be used in conjunction with a d150 this is a comprehensive perodontal evaluation code and I know many of you are using this code so you use this code with um new or established patients and these are for patients who present symptoms or signs or have high risk factors for Donal disease and uh so example for highrisk factors do they smoke do they have some inflammatory diseases like diabetes hypertension high cholesterol these are patients that you could actually use this code with now there are some frequency limitations and it's not as strict as the d150 there are a lot of payers that will pay twice a year always trust but verify and when using this code there are some guidelines when you are filing on behalf of your patient you must submit Sixpoint measurement around every tooth so if you have a hygienist that will do wnl like within normal limits and then put a line you're you run the risk of your claim getting rejected you also want to make sure that you chart bleeding points bone loss forcation gingle attachment all of that documentation must follow when submitting um the d180 along with legible clear x-rays full mouth series so that's the d180 we have a poll Stephen all right here we go so which of the following is Jacob you can pop this up which of the following is not an exam code so 0180 0140 0120 or o10 which one is not an exam code all right are you they were paying attention we have 80% of the votes in and 97% said d010 so uh looking good nice these are easy questions if you're paying attention all right let's talk about some under utilize codes and how to use them correctly um the the first one is the d0220 you use this a lot it's for a PA what's misused and not used is the d0230 this is for an additional PA what we find when we're working with practices and we see a lot of denials um and just a stack of eobs it's when the d0220 is used for the first PA second PA and so on well Insurance a summary and then just deny it so you want to make make sure that for the first PA the code is d0220 the additional p pa is the 023 Z next are buildups um buildups we we say the same thing as we did with um the 4910 and 1110 code what you do and do what you code I know that there are some payers that got really um adamant of telling us that the buildups are inclusive with um the crown we still recommend that you Bill out what you do so the first build uh buildup which is frequently used it's the d2950 um it's for retention the d249 is for restoring so restoring an example would be an endodontic tooth now I know a clinician would argue and say all of my buildups are for retention when submitting to Insurance the 2950 retention the 2949 to restore if it's an idic tooth and always always it helps with a narrative the next that's miscoded if you're practice use silver diamine uh this is the fluorite the 38% what's used often is the d1354 and it's per tooth and it's to use when there's active carries the the d355 isn't used as often and it can be this is per tooth as well and this is used when you are applying it in high-risk sites now uh you can use both of these either of these codes in conjunction with the 126 if your your patients insurance covers the 126 if it doesn't uh you can't use it in conjunction with for payment all right we're going to do a little traveling but we're not going to go to the actual state of Ohio um only only handle it once and I am reciting what um our tops coaches say often uh when working with practices all over the country one of the things that we really pride ourselves on is identifying the things that we can do right the first time so that it will afford you to really have time available to do what you do best which is patient care and not so much as the technical part of Dentistry so Ohio only handle it once do right the first time all right there's a poll Steve all right so we did this quick the acronym Ohio stands for only handle intelligent organizers on hand in office only handle it once or open house in office what does it mean what do I think you'd really have to not be paying attention to miss this one this like 30 seconds later um I I only see two people out of the hundreds that are in here that missed it so we're we're doing good but uh 99% said uh only handle it once perfect thank you leaders I the last thing I want to do is is is put you to bed all right let's do a recap on some or put you to sleep there is a difference well let's talk do a recap on only handle it once number one is um to reiterate we have a new claim and I would hate for you to do all of the work and have everything um completed properly on the claim and it gets rejected because uh a processor says this is the wrong claim so make sure you're using the right claim which is 2024 from Ada there are um um I know that many of you are familiar with this so if you had a claim in front of you you would know exactly what I'm talking about these aren't updated boxes these are boxes that are important that you complete when filing on behalf of your patient you want to make sure in box 33 if there's missing teeth that you need to make iter it there especially if you are doing a procedure where you are replacing those missing teeth box 35 any additional information um as far as your narrative or remarks what I shared earlier that the the urance agents they are trained to process claims timely to be really efficient and so in order to be efficient they're just looking at the Box first and they're looking at your information second so make sure you place it in the correct box box number 36 is where you have the signed treatment plans and fees 37 authorization of benefits we highly recommend that you do not leave these boxes uh uh vacant so that you can Ohio only handle it once there's a few things that will um allow you to get paid timely let's talk about those things number one make sure that the insurance claim is filled out properly Ohio correct procedures listed on the claim trust but verify the claim files submitted within 24 hours not 48 not 72 not 36 like in Texas we call it get or done um documentation sent with the claim um when I share with you the d180 there's quite a bit of of documentation that goes with that claim so make sure that we Ohio we only handle it once review claim submission status I'll unpack that one in just a second so when we're working with practices this is how we um check in to make sure that you are have a healthy um healthy Insurance reporting and that you're getting paid timely here are the three reports that we check and the buzzword is daily the first insurance claims not sent the second procedure is not attached to insurance and the third secondary insurance claims not sent so whether you file secondary or not we still recommend that these are the reports that you look for which is insurance claims not sent procedes not attached and secondary now it doesn't matter what practice management system that you have if you have the ability to um file electronic claims you will have these reports in your software and I know many of you are familiar with it the goal is to pull up these reports and it's a blank page on all three um the only time that I would print it is if you are cleaning up your system and you have some work to be done which is uh the insurance that are not have not been sent so those have to be cleaned up procedures or secondary when I said that I'll unpack it a little bit later about claim submission this is what I was talking about now when um because you have the ability to file electronically everyone will have this system and sometimes technology fails so these are the three steps you want to make sure that you get a check mark number one is your claim has been validated if not you'll get a warning and it'll tell you your software is pretty Savvy it'll tell you what needs to be corrected and it'll give you a timeline before it goes to rejection if it goes to rejection that's not good that means it's sitting in your third party software The Next Step would be a confirmation it's on its way and then third Clearing House it's on the desk of the insurance so the goal is to make sure that your submission status is always clean and I would just check in and and take a look at this at the end of every day so that you can start the next day fresh and not have to worry about cleaning up things um the day prior let's do a recap and these are you gonna say Pam we know but let's talk about it anyway all right so number One never include anything that's not documented in your clinical chart um if you didn't document it it didn't happen you want to make sure that you use proper spelling punctuation and grammar avoid handwritten narratives to ensure legibility um if an agent um if an agent doesn't understand it they're not going to take time to call you and say hey what did you mean by this what will happen is your claim will go in the lost and never found so it's a stack you'll have to call about it the last one is you want to Omit irrelevant or unnecessary comments coming in for a landing never use aggressive language or statements to check challenge the expertise of a consultant or the components of their dental insurance plan so if you feel like this just take a breather or walk a glass of water and then hop on the phone with them never um never uh make sure that you incl you include clear diagnostic quality uh radioraps and never send your Originals because you may not get them back and it helps if you would just help the agent work really quickly label your radioraps left to right and last but not least always have an easy proven process for collecting the patients portion yeah this is a big this is important piece of this because you know we spent all of our time talking about insurance claims today the patient always there's always a patient portion and one point since we're talking about insurance by contract if you're contracted with insurance you have to collect the patient portion if you don't that's insurance fraud let me say that again because we used to see practice to do this all the time and it is fraud so if you're billing insurance and writing off the patient portion without disclosing that to Insurance you are committing insurance fraud yes for which there is a very severe penalty so I don't care whether you've done it in a previous office it doesn't matter whether you think everybody else does it if you don't collect the patient portion and you do not disclose it on the claim form that is insurance fraud so important point so um regardless of what you've done in the past regardless of what you're asked to do just know that is a that is a fact all right so collecting from the patient's an important piece of it so making sure that that that's easy uh that it's not you know whatever uh payment solution that you have there's a lot of components to this so let me just run through real quickly some things that you should look for in a good payment solution uh for your practice so uh it should enable you to do what you do best which is interact with patients so it shouldn't take a whole lot of of administrative time um it should decrease your accounts receivables so there's never a receivables problem there's a receivables are a symptom of the problem which is a financial Arrangements problem so if your receivables are out of control it's because there's a financial Arrangements issue that you need to address uh it should be able to eliminate paper so if you're still sending out if you're still mailing statements it's time to relook at your payment solution and how you're collecting uh very few people look at their mail anymore so if you're you're spending a lot of time and a lot of money if you're mailing out paper statements for something that's not going to get good results ought to be easy for your patients create a great patient experience and keep them loyal to your practice and let's go on to the next slide Pam so those are just some some ingredients of a good a good payment solution um of course digital uh if you have uh by now uh you should have a text to pay option so this is where you can text your patients and there is a link that they can click on within the text message where they're able to pay their balance or pay whatever is due so uh we're having huge success with text to pay especially in even in AR uh but it's a again it's a it's a solution that's out there and works a lot better than sending out statements um the other one that I'll mention on here is having a card on file uh that has to be P what's called PCI Compliant so if you're writing down credit card numbers or if you have credit card numers stored in your practice management system you are in violation of the law so that is not um by law you have to securely uh store credit card information it has to be in an online system that's PCI Compliant you can't store it in your own system you can't do it in writing can't do it in your computer system has to be a special system so it makes it easy to to run balances with patients's permission if you have that system set up so just a couple of couple of points so Jacob will put has already put in the chat box um if a more convenient payment solution uh is in the works for you uh Jacob put in the in the chat box a link where you can get a free demo on how to do a payment solution that has all of these criteria so uh make it easy for your patients to pay that's a whole part of this whole solution um Pam if you'll go to the next slide and the one after that I believe next one and as we mentioned again this is the same QR code that we put up earlier in the webinar so if you didn't have a chance to scan that QR code uh go ahead and scan it you'll when you go to the the landing page there uh make sure to check the box uh that says yes yes I'm interested in a fee analysis by ZIP code and then enter your zip code and you'll get a free uh fee analysis on your UCR codes uh that then you can update your UCR codes in your practice for your Market uh wherever you are so that's a a nice little added bonus for the webinar today for those of you that participated uh you get the checklist and if you check the box the fee analysis by by your ZIP code update your your fees so that you're current and you're getting paid what you're worth important deal Pam thanks for sharing your coding expertise with us and all the new and updates and new category of service and new codes and Mis codes ton of information there and uh again you're welcome to download the checklist so you implement what we've talked about today That's essential for if you're going to be here make sure you implement what we've talked about and then uh the total Patient Service all the contact information is on the coding checklist as well as you move forward to implement this uh feel free to reach out we've got a coaching team virtual coaching team as well that can help with all things coding all things case acceptance all things get paid thanks for joining Jacob thanks again for the invitation to participate with you and it's great to be with everybody today good luck have a awesome successful uh 2024 implementing the new changes that we've talked about today yeah and uh before everyone pops off here just want to thank uh you Stephen Pam great presentation my H question tab here is buzzing with thank yous and this was awesome so um really fantastic job um I have I do have a few questions of people asking about followup so basically we will be sending out the link that's shown right right here from the QR code so if you need that checklist you want to share it with your team we also will be sending out a link to that recording so be on the lookout for an email in the next 24 hours that's going to have everything you need so for everyone asking about that you are going to have the resources here that you can share with your teams um I saw a large large majority of the people in this webinar um answering our polling questions so that means you'll be getting CE credits be on the lookout in the next two weeks those C credits are going to come from Nora on our webinar team so if you don't see that email in the next two weeks check your spammer junk and if not um reach out to us and we'll be sure to get you taken care of um really thankful for everyone joining us here today as Stephen Pam mentioned um if you are interested in improving the way you're practiced as payments I put a link in the chat um our credit card processing rate start at 1.8% so um some really great stuff available there so if you're interested in that um feel free to take advantage and with that we are three minutes early which is wonderful love ending um before the top of the hour so uh thanks again Stephen Pam and um everyone have a great rest of your day okay thank you job bye bye take care