Both dental billing and medical billing are alike. They both depend on a detailed understanding of the principles of coding and billing and an understanding of how insurance companies to process, receive, and pay claims. This comprises information on how to:
There are a few similarities between formulating medical claims and dental claims. For instance, insurance and patient demographics and insurance information given to medical carriers are alike. Yet, there are some significant differences between the two. Let’s take a rundown on each one of them.
Dental coding uses a diverse set of data to send claims and code, unlike medical billing and coding. Medical coding depends on three primary texts: ICD-9, HCPCS, and CPT. Dental coding, instead, uses a text named Current Dental Terminology (CDT) maintained and published by the American Dental Association. This article is drafted explicitly for dental insurance coding and billing. It consists of all codes you require to bill dental claims and code because each dental process code links to a dental diagnosis.
Just like hospital and medical claims use their claim forms, so does dental insurance billing and coding. The dental claim form is called J400. This comprises a space for patient identifying information and demographics, dates of service, patient dental insurance information, and dental procedure codes. They also contain spaces for info regarding provider identification, treatment location, and charges. This is also like medical claims forms. However, there is a large amount of extra information required on dental claims forms. For instance:
All of this data is counted in when the dentist does the essential procedures, as specified on the claim.
Another significant difference between medical coding systems and dental is the frequency of revisions and deletions between updates and periods.
There usually are 3 different kinds of insurance coverage for provider services:
If the patient doesn’t have the correct type of insurance, the insurance won’t pay for any of the procedures performed, and the patient will have to pay for everything. In short, you have to pay exceptional attention to the kind of insurance coverage that the patient has. Many patients may erroneously believe that their medical insurance also covers dental procedures.
Alternatively, if the patient receives dental care connected to a medical condition, the medical insurance can accept the bills. This is to say that the patient can go to either their medical or dental office to get the same treatment with different insurance companies billed.
Dental care specialists are unwilling to outsource their coding and billing. This is generally due to the massive amount of first-hand knowledge required to bill dental claims and large amounts of medical records attached. Eventually, dental billing and coding are very similar to medical billing and coding. You have to use a changed coding text and put the codes in a different form. However, the basics are alike. Take note of precise practice compliant billing, coding techniques, and stay detail-oriented!
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We are a one-stop-shop dental billing company for all your dental needs and encourage you to focus on patient care while we diligently work to enhance your practice overall management. Contact us today.
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