5 Reasons You Do Not Bill Medical for Dentistry

Episode #438 with Laurie Owens

There is a list of dental procedures that medical insurance might pay. So, why do dentists avoid billing medical? Today, Kirk Behrendt brings back Laurie Owens, director of medical billing at Devdent, to share five reasons you don't bill medical, why you should start, and what you can do to increase claim acceptance. And the benefits go beyond reimbursement! To learn how medical billing can add value to your practice, listen to Episode 438 of The Best Practices Show!

Main Takeaways:

Get a complete health history of your patients.

Understand why a procedure needs to be done.

Ask the right questions — not yes or no questions.

Don't give up billing for medical after one try.

If your claim is denied, call and find out why.

Medical billing won't answer all of your problems.

Quotes:

“We sometimes are so rushed in dentistry that we forget that these are people with stories. And literally, medical billing is telling their story. And I think if we [don't] slow down a little bit and realize that there could be a story here, we’re not going to get it. We’re going to just rush, rush, rush, fill the schedule, and not realize there was a story that we missed.” (3:13—3:38)

“My number one [reason you don’t bill medical], you have an incomplete health history. And sometimes, it’s not the practice’s fault. But here’s what the patients think: ‘This doesn't have anything to do with my mouth.’ But are we asking? Are we making sure they understand the importance of — there's actually a video out by Delta Dental that talks about how many diseases the dentist can find. This is not something the medical doctor finds, it’s what the dentist can see. And people see their dentist more than their medical doctor. I've seen my dentist five times more than my doctor. So, if that's the case, and you know that these are all within the scope of your license, why should you not be paid for them?” (8:18—9:11)

“Are you letting your patients know, ‘This complete health history provides us enough information that if we can maximize your benefits through medical, we would have the documentation to do so’?” (10:11—10:22)

“We have to learn how [a health condition] has affected their lives in order to be able to tell the story. If you have a cancer patient, and now you're seeing them, and they can't eat because of the sores in their mouth, and you don't know it, how is that really effective treatment planning for a patient? It’s not. So, we have to ask them how these things have affected their lives, how they're physically feeling — especially if they have to change medications.” (13:04—13:35)

“A lot of people will say, ‘Well, it’s a lot of work.’ But did you know it could help your dental insurance claims too? By being thorough, you are helping your dental claims go through faster when you have all this documentation.” (14:10—14:25)

“In medical, they say, ‘If a patient says it, put it in quotes.’ You don't have to say that that's what you said. If the patient says it, put it in quotes. But asking the right question — quit asking yes or no. Ask them to tell you about it. ‘Tell me about when they found your diabetes. Tell me about when the doctor diagnosed that GERD for you. Tell me what happened. When was that? Were you older, younger? Did you have any other complications, other than what we’re sitting here for today? Tell me about that.’ They're always interested.” (14:27—15:04)

“[Reason] number three [for not billing medical], you're only looking to fill the schedule. Now, I'm all for filling the schedule. Please don't get me wrong. I agree, you should fill the schedule. But my number one is, if I say, ‘The doctor has some open time today,’ then, apparently, he’s not very good at his job. Or you're going to...