Product Detail

• Identify the biggest loss of income for your office and list coding strategies to correct it
• Examine the intricacies of the dental insurance world
• List the proper documents that should be included with insurance claim submissions
• Discuss the impact of HIPPA laws on coding best practices
• Articulate the proper steps to take to bill periodontal services correctly
• Discuss how your office is being watched and how to avoid billing fraud

THE DENTAL CONTRACT

• Insurance carrier rights
• Trends in today's contracts
  • changes in benefit frequency
  • oral-systemic disease link
  • avoiding dental fraud
  • PPO participation

PRACTICE MANAGEMENT

• Fees
• Patient communication and managing the patient
• What consultants look for—common practice mistakes
• The importance of self-auditing records
• Risk management tips

AVOIDING DENTAL FRAUD

• Avoiding "red flags"
• Bundling and unbundling
• Suspicious claims
• Fee discounts
• Over-utilization
• Accepting Medicaid: Should you/shouldn't you?
• Examples of legal action

THE COMPLETE CLAIM FORM

• How to look at claims like a claims reviewer
• Correct x-ray, photograph, and narrative submission

INSURANCE STRATEGIES

• Learn how the insurance company thinks
• Learn to prevent denials
• Learn to correctly resubmit claims for appeal
• The truth about insurance company stall tactics—Are they real?
• Effect of the HIPAA laws on coding
• Effective communication skills
• Discover how to use the EOB to your advantage

EFFECTIVE CODING AND BILLING

• Tips you can use to keep your practice afloat in a down economy
• Identify the biggest loss of income for your office and how to correct it
• CDT—the latest additions and revisions
• Documentation needed to support claims
• Correct use and maximization of codes
• Electronic claim filing
• Outside financing—Which lender should your practice recommend?
• The correct claim attachments and narratives—What needs to be included?
• Important tips to ensure a complete claim—the first time you submit it

SPECIAL AREAS OF ATTENTION

• Learn to bill periodontal services correctly
• Fraud: Prevent fraud from occurring in your billing

Save time and $10 off the price of other submission methods – purchase & take the CE test online for $9.99 USD per participant. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). Please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion are available for email, download and/or printing from your online account immediately following the successful completion of the post-test/evaluation.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

• Dentists
• Office Managers
• Dental Hygienists