Product Detail

• Identify what you need to be aware of to maximize billing
• Examine the intricacies of the dental insurance world
• 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

Avoid Dental Fraud

• Avoiding “red flags”
• 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 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
• WILL YOUR RECORDS SURVIVE AN AUDIT?
• 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 including the new D4346
• Fraud: Prevent fraud from occurring in your billing

Paul Bornstein, DMD, has reviewed thousands of claims, helped draft contracts, and developed fraud detection guidelines as chief dental consultant for a national insurance company. In addition, Dr. Bornstein has over 30 years of dental practice experience. He served as an instructor and assistant professor for Tufts School of Dental Medicine and as a member of the diagnostic department for the Harvard School of Dental Medicine. Dr. Bornstein has acted as an expert for the defense in multiple fraud cases at both the state and federal levels. He has lectured in 47 states including the Yankee Dental Conference, the Greater New York Meeting, and the Big Apple Dental meeting on dental insurance, fraud, and HIPAA. Dr. Bornstein is a published author with articles in Dental Economics and Dental Practice Report and in recent years he has been a contributor for the ADA publication Coding Companion. He is a member of the American Dental Association and the American Association of Dental Consultants. Dr. Bornstein’s seminar is based on his unique experience of being on both sides of the claim form. Participants can expect to receive the most current and accurate information on optimizing insurance reimbursement.

Speaker Disclosures:

Financial: Paul Bornstein is the owner of Dental Office Consultants. He receives a speaking honorarium from PESI, Inc.

Non-financial: Paul Bornstein is a member of the American Dental Association; and the American Association of Dental Consultants.

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.

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Dental Hygienists
PESI, Inc. is designated as a nationally approved sponsor by the Academy of General Dentistry, which is recognized by many state dental or hygienist boards. Please check your state rules and regulations to determine if this self-study course meets your state criteria. This activity consists of 6.0 clock hours of continuing education instruction.

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Other Professions
This self-study activity qualifies for 6.25 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

• Dentists
• Office Managers
• Dental Hygienists