Resources

Breakdowns and Estimates: Are You Using the Correct Fee Schedule? (INN, UCR, MAC)

Insurance fee schedules can be confusing, even for seasoned dental coordinators. A common error? Using the wrong "fee schedule" when estimating costs, which can lead to unexpected bills and unhappy patients. Learn about the four main types—Full Fee, UCR, INN, and MAC—and the key differences and potential pitfalls for each.

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Navigating Year End Considerations in Dental Offices

As the year draws to a close, dental offices must consider a range of factors to ensure their practice operates efficiently and effectively. This article delves into key aspects, including insurance, patient scheduling, equipment management, and the use of marketing letters, offering valuable insights and guidance. 

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Top 10 Ways to Improve Savings and Profitability in Your Dental Office

With the current economic market, it has never been more imperative to assess our business practices and find ways to counter the rising costs of overhead expenses as well as stagnant insurance fees.  A review of your expenses should be done more than once a year to make sure you aren’t overspending.

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Handling Insurance Audits

Facing an audit is one of the most frustrating challenges for any practice, but it doesn’t have to be. With the right knowledge, preparation, and prevention, you can avoid major headaches. In this article, we break down two different types of audits—each with unique processes and outcomes—and how both in-network and out-of-network offices can be impacted. 

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How Does Insurance Affect Your Marketing Success?

Explore the intricate and powerful interplay between your marketing campaigns, your insurance claims processing, the satisfaction of your patients, and your practice’s ultimate profitability. Discover actionable insights to elevate the results you can achieve.

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12 Tips to Maximize Reimbursement from Dental Claims

Discover ways to navigate your dental insurance challenges more effectively.  This article contains 12 actionable solutions to streamline office operations, enhance the satisfaction of your patients while also boosting the profitability of your practice.

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Periodontal Maintenance vs Prophylaxis - Can You Alternate These Codes?

This debate has persisted for decades within the dental community and its teams. On one side, there are those who firmly assert, "once perio, always perio." Conversely, there are those who argue, "it depends on the current health of the tissue."

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Responding to Insurance Requests that Do Not Make Sense

Sometimes the questions requested by an insurance company are system-generated and as a result are very generic. The way to think about a relatively vague question is not to focus on the exact words they use (which could be incorrect), but instead focus on the type of information they are looking to receive. 

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Part 2 - The Inlay/Onlay Dilemma - How to Get Insurance Coverage

The initial segment (Part 1) of this series explores the complexities surrounding inlays and onlays when seeking reimbursement through dental insurance. To summarize, both procedures often get "downgraded" by insurance providers to the level of fillings, leading to increased costs for your patients. The subsequent sections of this article are dedicated to exploring potential remedies for this issue.

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Part 1 - The Inlay/Onlay Dilemma - Challenges

Some dentists will recommend or offer the option of either an inlay or onlay for patients in an effort to stay more conservative when treating teeth. This approach effectively aims to preserve teeth that have incurred partial damage. However, a common hurdle arises when submitting an insurance claim, only to encounter denials or service downgrades from the insurance company.

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Should You Outsource Your Dental Insurance Billing?

Outsourcing aspects of your business to an outside provider has been a common tactic of many businesses for years. It’s becoming much more prevalent in dentistry post-covid, due to challenges many offices are experiencing challenges finding and retaining enough team members to stay functional.

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Why You Should Think Twice Before Criticizing Fellow Dentists

The majority of dentists are compassionate individuals who have chosen their profession with the genuine intention of aiding others. Nevertheless, perhaps due to our extensive educational backgrounds and inherent attention to detail, we may occasionally find ourselves excessively critical of our peers.

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Insurance Forms

Denture Timelines - Levels 1-3

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Treatment Plan Template

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ADA Non-Covered Services Form

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Crown Narrative Form

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Insurance Overpayment Letter

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Insurance Letter Deny Refund

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Patient Forms

Do Not Bill to Insurance - Patient HIPPA Restriction Request Form

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1) Patient Form - Getting To Know You As Our Patient

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2) Patient Form - Financial and Insurance Form

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3) Patient Form - Medical History

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4) Patient Form - Dental History

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5) Patient Form - Informed Consent for Services

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Consent for Use and Disclosure of Health Information

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Dental History Form

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Secondary Insurance

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Update Medical History

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Sample Hygiene Clinical Note for SRP

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Consent Forms

Consent for Use and Disclosure of Health Information

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In Office Bleaching Consent Form

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Informational Informed Consent: Oral Sedation

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Oral Sedation Informed Consent

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Perio Informed Refusal

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Employment Forms

I-9 Form

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W-4 Form

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Employee Key Agreement Form

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General Team Expectations

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Reference Letter Sample

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Team Dental Benefits Option 2

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Practice Management

End of Year Letters

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Bleaching Syringe Log

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Bleaching Trays Tracking Sheet

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Lab Case Tracking

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Lab Cases

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Limited Exam Checklist

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Limited Warranty

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Medical Consult Request

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Refund - Liability Release

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School/Work Excuse

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X-Ray Protocol

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XRay Training- Anterior PAs

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Non-Covered Services by State

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Interpreting Non-Covered Services Laws - Cheat Sheets

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Assignment of Benefit Laws

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Insurance Recoupment Laws

Insurance recoupment laws encompass several key concepts. It is essential for stakeholders to be aware of these nuances to ensure compliance within the complex landscape of insurance recoupment.

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Insurance Commissioner Contacts by State

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Internal Coding Examples

Many procedures and visits are not covered by ADA codes, hence the need for offices to create a good set of internal codes for both tracking and patient billing purposes. Here is a basic list to help you think about what codes you may need to create for your office's function.

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How to Handle an Appeal Chart

Let´s face it, insurance claims get denied. When it happens, it´s important to understand what recourse you have. This chart lists the most common EOB denial language, whether an appeal can potentially change the outcome, and what specific action is recommended.

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Secondary Insurance Calculator

This calculator is designed to assist teams with correctly inputting reimbursements from multiple insurance companies. It will help you determine the correct input and write offs for accounts and claims that involve secondary insurance.

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Buy the Book! Understanding Dental Insurance: A Guide For Dentists and Their Teams

This book, written by Dr. Travis Campbell, serves as an additional training tool offering in-depth information for the more experienced, as well as a quick “look up” to have in your office for anyone with questions about dental insurance. Packed with information, illustrations, examples, tips and case studies, this guide covers every aspect of dental insurance from claims for simple fillings to complex hybrid denture and implant cases in real life situations.

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Old habits die hard. If your current dental insurance claims process hasn’t been updated, it’s likely outdated.

Up-to-date, ongoing billing education isn’t just helpful, it’s essential for your practice to thrive.

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