Billing
Resources and information on laws related to dental benefits; eligibility verification; proper coding; understanding how to properly bill for treating providers; and navigating the payment dispute process.
Benefit Breakdown Form
The quickest and easiest way to verify dental benefits for your patients is through the dental plans’ convenient online portal access where you can view, download, and print a patient’s benefit breakdown. This form may be used when verifying patients' dental benefits via telephone or to supplement the information provided on the dental plan’s online portal.
Billing Medical Plans
Learn cross-coding: billing medical insurance in a dental office; how to select the correct CPT code and ICD-10 codes when billing medical plans.
Completing and Filing the Claim Form
Common reasons for claim delays and denials; correct use of procedure codes, Tax Identification (TIN) and National Provider Identification (NPI); practice’s fee schedule and radiographic image attachments; electronic claim (E-Claim) filing.
Considerations When Billing for an Associate
Overview of the payment arrangements to consider once an Associate begins providing treatment in a dental practice.
Current CDT Code Books
Dentistry is an ever-evolving field, and CDT codes are critical to the everyday workings of dental practices.
Explanation of Benefits
Understand the elements of the Explanation of Benefits and what to look for.
Financial Agreement and Consent Form
Tool to utilize during the patient financial discussion to document financial options presented, patient obligation and financial consent.
Is it a covered benefit? Understanding the noncovered services law
Understand the CA law that regulates what dentists can charge patients for procedures that the policy does not cover AB 2275.
Managing Payment Problems
Learn about your rights and actions you must take when dealing with refund demands made by dental benefit plans.
Patient Request to Restrict Disclosure of Patient Health Information to a Dental Benefit or Health Care Plan
Includes information on this patient right to restrict disclosure of patient health information to a dental benefit or health care plan and a sample form to use for a patient who requests such a restriction.
Steps to Comply with the No Surprises Act
Information regarding the requirements to comply with the No Surprises Act which became effective January 1st, 2022. The No Surprises Act is an effort to protect individuals and provide transparency related to health care costs. Instructions as well as samples of the required notification and the Good Faith Estimate are included.
Teledentistry
Q&As, coding information and a sample notice and consent form required by the Dental Board.
Understanding Dental Benefit Plan Coverage
Overview of the types of dental coverage and the differences between dental and medical coverage, in order to aid dentists in explaining dental coverage to patients.
Verification and Explanation of Dental Benefit Coverage
Tips for verifying coverage with a patient's plan and providing explanation to help patients interpret benefits, limitations, exclusions, financial responsibility and how to maximize coverage.