As a dentist or administrator, you know that your billing and coding are important. For both the sake of patient satisfaction and for staying in business, it’s critical to get it right every time. But what do we mean by “right”? Unfortunately, there’s no such thing as perfection in healthcare (or anywhere else), and even the best and most experienced providers make mistakes from time to time.
But what we can do is avoid common mistakes due to personnel’s lack of knowledge or experience. In this article, we’ll discuss seven dental billing mistakes that your practice is likely making right now. We’ll also offer some tips on how to avoid them.
Dental Billing Mistakes to Avoid:
Outdated Information
One of the most common dental billing mistakes is using outdated information. This can include anything from the incorrect address to the date of birth. Make sure you’re always using the most up-to-date information available, and double-check everything before submitting a claim. Otherwise, insurance will deny the claim, and you’ll be left chasing payment for the bill.
Incorrect Coding
Another common mistake is noting incorrect procedure codes on claims. When insurance companies receive claims with wrong codes, they often deny it, leading to lost time and money for the practice. To avoid this mistake, make sure you’re always coding correctly and giving administrators valid codes for the day’s procedures.
Unbundling
This dental error includes deconstructing codes for a dental procedure, meaning that rather than report a procedure as one code, you include the codes for every aspect of the visit. For example, if you bill a crown with numerous codes for each step, like anesthesia, this would be considered unbundling.
Whether your administrator made an accidental error or purposefully unbundled for more compensation to the practice, it could cause a serious issue. To avoid this mistake, be sure to bill procedures as a single code when applicable.
Changing dates of service
While it might sound ridiculous, many dental practices accidentally put incorrect dates of services on claims. If a patient came into the office over the course of a few days to complete a procedure, each date must be reported. Each visit to the office is billable to insurance, and the dates on dental documentation and the claim must match exactly.
Waiving co-payment
It might sound charitable, but waiving a co-payment is not a smart move for your dental practice. Dental offices often waive co-pays to demonstrate they care for their patients. But in doing so, you’re committing fraud in the eyes of insurance companies. It’s critical to bill the patient thoroughly and never waive a co-payment at any time.
Not billing for a provided service
This dental billing mistake is probably the most straightforward. If you provide a service not billed to the insurance company, you are essentially stealing from the insurance company.
Unfortunately, administrative staff can innocently commit this error due to a lack of communication or convoluted software. If it’s unclear what procedure was completed, it may be reported as the wrong service or wrong type of procedure. For example, a visit could be billed as surgical when only the preparation tasks were completed that day.
Not verifying insurance
Front office staff must ask if a patient’s insurance has changed at every visit. Insurance companies often change co-payments, benefits, and coverage based on several factors. And this is why it’s essential to keep track of these changes to avoid mistakes in dental billing, as the practice could be blamed for the incorrect claim.
Final Tip
Dental offices make mistakes with dental billing all the time. Having the right dental billing tool in place can save a practice many headaches and issues. Using effective dental billing tools will help ensure that you bill all procedures correctly, saving you everything from a paperwork headache to allegations of fraud.