The Art of Practice Management's Dental Pearls
The Art of Practice Management
A dental practice management consulting company that focuses on revenue and collection systems, front desk systems and forms, dental insurance processing, medical/dental cross-coding systems and employment-law compliance.
Making our insurance processing systems more efficient is key to the prompt receipt of insurance benefits, decreased costs related to that system, and speeding up the process of obtaining patient coinsurance payments. There is one very simple step that can boost insurance filing efficiency and that is to make sure that you
are filing dental claim forms on the correct form.

Although HIPPA has required a standardized format for electronic claims, there has not been any such requirement with paper claims. The ADA estimates that forty-nine percent of dental claims are still submitted on paper. When these paper claims are processed at the insurance companies, the claims are quite often converted to an electronic format. There are, at present, close to fifty different dental claim formats, so the problems develop when the format of the paper claim does not match the format of their electronic claim. Claim processors have to spend extra time searching for the required data with the many formats that they receive. The result is that extra time and costs are created for the insurance carrier with the resultant delays in the receipt of benefits by the dental practice.

There are several situations in dental practices that may be contributing to this problem and they are as follows:

  • When was the last time that your practice updated its practice management system?  If it has not been updated since the beginning of 2006, your insurance claim will not be the current ADA claim form.  If you are unsure if your practice management software is using the current ADA claim form, you should contact the software company to inquire.  If it is determined that you are not using the current claim form, they can lead you through the updating process.
  • Practices that still file on their own paper claim forms may have built up a stockpile of forms which may be outdated.  You will need to check the form type at the lower left corner of the claim form to make sure that it reads ©2006 American Dental Association.  Using those older forms may appear to be a cost saving idea but it actually is costing the practice due to the delays that it causes
  • Certain patients may provide employer specific claim forms.  You will need to explain to the patient that the insurance companies will accept the standard claim form and that submitting a non-standard form such as theirs will only delay payment.

The answer to these situations is easy. Converting your insurance processing system to electronic submission is the best method to seamlessly handle your claims filing. Yes, there is a cost to electronic claim filing but there are many hidden costs to paper filing in the form of paper, ink, postage, and extra staff time that are eliminated with electronic filing. In addition, electronic claim filing reduces the chance for errors which eliminates the additional delays caused by those errors. If your practice will continue to file on paper, simply make sure that you are using the correct claim form.

Time Line
Medical Claim Filers – The new year has arrived along with the required use of the 2010 updated CPT codes.  If you have purchased “CrossWalking – A Guide Through the CrossWalk of Dental to Medical Coding” and have not ordered your 2010 update, please contact me so that you can make sure that your manual is current.  Medical insurance carriers do not offer grace periods for the use of deleted or updated codes.

February 17, 2010 – This is the next effective date for HIPPA’s regulation changes regarding business associates becoming covered entities.  Business associates must be in compliance with the security rule and must have a written plan, must have trained their employees, and have the protections in place to protect the PHI from your practice that they can access or retain.

In addition, as of that same date, patients may restrict your use or disclosure of their PHI for any operational purpose or for filing insurance if they pay their fees in full from their own funds. There is no guidance available at present from HHS on how to handle this regulation. 

These regulations are very difficult to be in compliance with, so companies such as Total Medical Compliance are of tremendous help with keeping dental practices compliant with HIPPA and OSHA. 

My Favorite Quotes:
On a personal note, my mother passed away last week after a long struggle with medical problems associated with dementia.  I came across a quote that helped me deal with her death.  I would like to share that quote, as we all will deal with the loss of loved ones in our lives.

“I am standing at the seashore.  A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean.  I stand and watch her until at length, she hangs like a speck of white cloud, just where the sea and sky come to mingle with each other.  And just as that moment when someone at my side says: 'There, she is gone!' there are other eyes watching her coming, and other voices ready to take up the glad shout: 'Here she comes!'  And that is dying.”

Henry Van Dyke


For our patients – Let your patient know that flossing can help to prevent memory loss. West Virginia University has reported the results of a study show that “a clean mouth may also help preserve memory.”

For staff – Get a good night’s sleep. Winter has arrived along with the cold and flu season. According to USA Weekend June 5-7, 2009, a recent study found that those who were sleeping less were about three times as likely to develop a cold. In addition, those whose sleep quality was poor were five times as likely to develop a cold.

Dental Humor for the quarter:

Q: What's the difference between a dentist and a New York Yankee fan?
A: One yanks for the roots and the other roots for the Yanks.

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The Art of Practice Management
2217 Fox Horn Road  •  New Bern, NC 28562  •  Phone: 1-252-637-6259   •
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The contents of this publication reflect the opinion of the author only. This publication is for informational purposes only.
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