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Did You Miss Your Chance To Bill Medical Insurance??
Just starting out in Dental Sleep Medicine (DSM) can be overwhelming. One of the first questions we are frequently asked by our providers is, “How soon can you start?” A patient has been seen, treated, and now the billing needs to begin…quickly.
There are many bases to cover when starting the DSM portion of your practice. Marketing, adding team members, purchasing equipment, selecting appliances, deciding a fee schedule, billing for visits, selecting practice software, and so much more!
The most common progression for providers to follow would be to start at the top, with practice preparations and marketing, and work their way down to creating an appliance for a patient leaving the billing part at the very end. This process would work if there were no such thing as benefits, authorizations, and claims payments. This progression might work if patients are cash pay, or have extremely simplified insurance without authorization requirements, limitations, a DME maximum, labor groups, employer restrictions, or other potential complications.
To best prevent, or at least be ahead of any issues that may arise; we recommend finding a billing company or professional biller/coder to be a priority. Either resource will become a part of your team; assisting if not completely managing the DSM billing operations.
A professional billing company will manage authorizations, benefits, claims filings, appeals, documentation management, and portals for your practice.
They will handle all issues including phone calls, emails, faxes, and messaging with Insurance companies. Some billing companies may have even built up relationships with insurance representatives, making the process smoother and issues easier to tackle when they arise.
Medical and/or Dental software products these days tend to come with a billing service. These representatives/account managers can provide basic support, but the depth or limitations of their support isn’t always clear up front. We recommend you call your software maintenance/support team and get a clear understanding of all provided claims services, and, any fees in addition to your monthly maintenance fee.
We cannot stress enough the importance of establishing a solid DSM billing department (in house/outsourced), prior to seeing your first DSM patient. A smoother process aims to reduce claim issues and maintain revenue flow.
A hold in billing is a hold in revenue.
For more information on what to look for when picking a billing company or professional biller/coder, please refer to our article “Dental Sleep Medicine and the Challenge of Medical Claims Processing”. In this article you can find some questions to ask the billing service, prior to adding them to your team.
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