Dental - Medical Cross Coding

Duration: 90 Minutes
Instructor: Marianne H. Harper
Webinar Id: 800815


One Attendee
Unlimited Attendees ?


Medical Coding in dental practices is gradually becoming a necessity. Many dental practices have long been sheltered from having to explain to dental carriers why they performed the patients' procedures. They have simply submitted codes for the procedures that were performed.

It has been an entirely different case for medical practices. They have been required to submit the reasons for the completion of the different medical procedures along with submitting the procedures performed through the use of diagnosis codes and procedure codes. The diagnosis code set is used to identify diseases, disorders, symptoms, injuries, human response patterns, and medical signs. Dental practices need to learn how to use this code set so that they can accurately show the medical necessity of the applicable dental procedures. Diagnosis codes must be chosen that have a true relationship to the procedures performed. It can only be through the use of these diagnosis codes that dental procedures can be considered medically necessary and, therefore, covered by a patient's medical plan. The procedure code set was developed as a means for medical providers to report medical services with a uniform language that accurately describes medical, surgical, and diagnostic services. By making this code-set uniform, it becomes an effective means for reliable communication between medical providers and insurance companies. Dental practices will need to become familiar with this coding system so that they can accurately communicate the procedures that they performed to medical insurance carriers. Once accurate codes are chosen for procedures performed, they must be submitted on the most current medical claim form. This form is then submitted to medical insurance plans either electronically or on a paper form. Once received by the insurance carrier, claims will go through an adjudication process whereby they will be reviewed for eligibility of the patient and coverage of the procedures. Once a determination is made, the insurance carrier will make a determination of benefits and will then notify the patient and medical provider as to their decisions on coverage and benefits. This is why it is so important that dental practices understand this full process so that they can submit accurate claims for those dental services that the dentist believes to be medically necessary. Dental practices that implement dental-medical cross coding will be able to submit medical claims to a patient's medical plan and then follow that with submitting to a patient's dental plan if the patient has both types of coverage, thereby providing optimum benefits for the patients.

Why you should attend: Dentistry today is quickly becoming the field of dental medicine. As part of this paradigm shift, dental practices now have the opportunity to help their patients more easily afford those dental procedures that are medically necessary. In addition, more and more dental insurance carriers are suspending payment on dental claims until the procedures are first filed with the patients' medical plans. Most dental practices have no idea of how to submit a medical claim and, if the medical claim is not filed, how will the patient receive any benefits?

This webinar will provide the basics of medical coding and will take away the difficulty of implementing a cross coding system. By understanding the medical coding systems, dental practices will be able to submit these claims correctly and help to obtain plan benefits for their patients. Dental practices are familiar with working with one coding system, procedure codes, but after attending this webinar, dental practices will be familiar with the multiple coding systems of medical insurance. Attendees will learn that they probably already have the tools to begin cross coding right away and, if they don't have the software, suggestions will be made on how to obtain medical coding software at an inexpensive price. The webinar will also help dental practices understand what types of procedures are medically necessary and why implementing medical coding can both help the patient and also really help the practice with greater case acceptance and an increased bottom line.

Areas Covered in the Session:

  • Learn why it is so beneficial for a dental practice to implement medical coding
  • Identify what types of dental procedures can be submitted to medical insurance plans
  • Understand the importance of learning how to accurately use the medical code-sets
  • See how a medical claim form is completed
  • Discover that most dental practices already have the tools to complete medical claims
  • Find out about other medical coding software if your software won't cross code
  • Learn how to determine what medical necessity means
  • Discover sources of medical code sets including an actual cross coding manual
  • Evaluate your practice forms to determine if they are asking the correct questions
  • Learn the importance and best methods of documentation
  • See actual examples of cross coded medical claims
Who Will Benefit:
  • Dentists
  • Dental Office Managers
  • Dental Insurance Billing Personnel
  • Dental Hygienists
  • Dental Practice owners
  • Dental Business Office Staff
  • Dental Assistants

Speaker Profile
Marianne Harper's career in dentistry spans almost thirty years. Instrumental in her founding of "The Art of Practice Management", a dental practice management consultancy company, was the fact that Marianne was always considered "the problem solver" and, in her years in practice administration, she discovered the secrets to practice success.

Marianne now helps other dental practices achieve her levels of success by sharing her techniques. Marianne's consulting specialties are: dental business office systems, dental business forms, the implementation of systems to lower accounts receivable, and the implementation of a dental-medical cross coding system.

In addition, Marianne is the author of a dental-medical cross coding manual and eBook, is a published author of dental practice management articles that have appeared in dental journals and on dental websites, and is a well respected speaker and trainer.

Marianne is a member of the Speaking Consulting Network, The Academy of Dental Management Consultants, The Professional Management Consultants Association, and CareerFusion. In addition, Marianne has a Lioness Principle Certification.

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