Dental Medical Billing



The Process of Medical Billing Step 1. Update your Medical History (In Book)Step 2. Provide a comprehensive head and neck exam (In Book)Step 3. Understand the difference between medical billing and trauma billing (In Book)Step 4. If you believe a CBCT SCAN IS NEEDED BY CONVERSATION WITH PATIENT, YOU MUST GET THAT PRE-AUTHORIZED.Step 5. Documentation with SOAP NotesS SUBJECTIVE: What the patient tells you regarding their need for appointment “Pain and Swelling.”O OBJECTIVE: Medical diagnosed problems by doctors clinical radiographic, and tests. (results of pre-visorA ASSESSMENT: Detailed summary of patients’ condition after provider reviews all testsP PLAN: Treatment plan in phases with a one-year plan in place that includes periodontalStep 6. Verifying patients benefitsMake sure you have done your paperwork setting up your officeHave your electronic verification applications on the computerYou can use the phone. However, that is a long callHave the verification form filled out in front of youKnow the type of policy (PPO, HMO, and if so, can you bill with GAP)Give them the procedure codes to check on payable with or without a verificationAre there any written exclusions in the contract (have them email you)?What information do they need so this can be done within three-five business days?Make sure you get the name of the person you spoke with, and the reference # take the time and date down. (Get Weave) it will record your calls just like they do.Emergency Visits does not require a pre-authorization to see and treat patient (YOU MUST LET THEM KNOW WITHIN 49 HRS)Office visits have a necessary amount of documentation. Make sure you keep your provider writes the steps needed before you choose the procedure code.Understand the difference between diagnostic codes and the order to place them on the claim formProcedure codes are set by the dollar amount. Your letter of medical necessity comes from the notesSet up in your computer system SOAP with questions each person must answer.Train the team on their responsibility of the questions they need to fill out with SOAPAdministration: Fills out the SubjectiveAssistant: Starts the objective Vitals, review of Pre-Visor, Health History to be highlighted for doctor and hygienistDoctor: orders tests after his clinical (assistant is documenting for doctor why he wants and the outcome)Hygiene: completes her charting and diagnostic walk, oral cancer and any other job roles (all must be documented)Doctor: tests are read, and doctor and hygiene put treatment plan into the system ................
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