A powerful reading of "Chapter 4: Built from Grit" from the book "I'm Just the Biller" shares the journey from humble beginnings to nationwide success in dental billing education. This authentic narrative speaks directly to the unsung heroes of dental practices, reminding listeners that success isn't about where you start but the invisible grit that carries you forward.

• Started career while dealing with a workplace bully who undermined confidence and flaunted material possessions
• Worked two jobs simultaneously as a dental biller and ER tech to save for first home
• First workshop in 2011 had just nine attendees who paid $19 each
• Evolved from Craigslist marketing to hosting 156 people at the JW Marriott in Los Angeles
• Experienced a full-circle moment when former bully became part of an office requiring billing consultation
• Built a nationwide platform over a decade of dedicated work in dental coding and billing education
• Recognizes that setbacks, disappointments and closed doors ultimately contributed to growth and resilience

Share this episode with your co-worker, office bestie, or that teammate who needs to hear they're just getting started. Follow the show, leave a review, and connect on Instagram @dentalbillingcoach for behind-the-scenes content, billing tips, and support for the people holding the dental profession together.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

Artificial intelligence has quietly revolutionized how dental insurance claims are processed, and most dental offices don't even realize it. Today we pull back the curtain on Novo Dynamics and their Novo Health Dental AI system that's scrutinizing your x-rays, documentation, and billing patterns before a human reviewer ever sees your claim.

The game has changed dramatically. Insurance companies have trained AI systems to review claims using very specific criteria determined by their own dental consultants—not treating clinicians. These systems don't just look at individual claims but cross-check x-rays across multiple insurance carriers, analyze your practice's billing patterns, and compare you to other providers in your area. If your practice performs more crowns, SRPs, or implants than what AI considers "average," all your claims face increased scrutiny regardless of their legitimacy.

This technological shift demands we evolve from merely submitting "clean claims" to creating "AI-proof claims." High-quality, clear x-rays that perfectly demonstrate necessity, concise standardized narratives, and meticulous documentation are no longer optional—they're essential. When AI improperly denies claims, request human review promptly. Document patterns of improper denials and report systematic issues to your insurance commissioner. The days of assuming a person will review your claim are over, but by understanding how these systems work, you can adapt your strategies to overcome these new barriers to reimbursement.

Ready to level up your billing skills and connect with fellow dental billers? Join us for our upcoming live workshop in Dallas! Send "Dallas" in a direct message to @dental_billing_coach on Instagram for your chance to win an all-expenses-paid trip to the event. Looking forward to diving deeper into AI and dental billing in our next episode where we'll share real-world denial stories and more strategies to beat the algorithms at their own game.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

Dental billing has undergone a dramatic transformation since the carefree days of the late 1990s. What was once a straightforward process—send a claim, get paid, move on—has evolved into a complex system demanding meticulous attention to detail and strict compliance measures. The reason? Insurance companies have woken up to the staggering $12.5 billion lost annually to dental fraud, and they're scrutinizing claims like never before.

You don't need to be committing actual fraud to get caught in this web. Cutting corners, skipping steps, and clinging to outdated "backyard billing" habits can quickly put a target on your practice. Are you submitting claims without checking clinical notes? Skipping attachments to get claims out faster? Using coding loopholes that worked a decade ago? These practices aren't just inefficient—they're potentially putting your practice at risk for denials, audits, and recoupment demands.

True billing expertise isn't defined by years of experience but by commitment to compliance and continuous education. It means verifying clinical documentation matches what you're billing, understanding dental necessity requirements, staying current with coding changes, and implementing robust follow-up systems. It means knowing when to push back when insurance companies request additional information despite receiving sufficient evidence the first time. Most importantly, it means understanding your state's prompt pay laws and holding insurance companies accountable when they attempt to delay payment beyond legal timeframes.

The transition from backyard billing to compliant billing isn't complicated, but it requires intentionality. Start by implementing daily report monitoring, creating standardized billing protocols, and ensuring your team understands compliance requirements. The reward? Fewer denials, faster reimbursements, and significantly less stress from chasing payments that should have been received the first time. Remember: the goal isn't just getting claims paid—it's getting them done right.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

Uncover the critical connections between HIPAA compliance and dental billing practices in our episode featuring host Ericka Aguilar. Discover how safeguarding patient privacy extends beyond ethical boundaries to play a pivotal role in averting billing fraud in dental practices. We delve into the cutting-edge strategies employed by insurance companies, such as predictive analytics, to detect inconsistencies and initiate audits without relying on whistleblowers. Erika sheds light on the risks associated with common pitfalls like inappropriate code adjustments and the negligent waiving of co-payments that insurers might interpret as fraudulent activity. By gaining a deeper understanding of insurance audits and adhering strictly to HIPAA's privacy, breach, and anti-kickback policies, dental professionals can uphold their practice's integrity and maintain the trust of insurance companies.

Explore the heightened scrutiny dental offices face due to the rise of AI in insurance auditing, as Ericka highlights the dire consequences of billing inaccuracies, including high denial rates and the ominous threat of clawbacks. With the potential for significant financial repercussions, she emphasizes the importance of accurate billing and the dangers of fraudulent resubmissions. Learn how diligent denial tracking and effective appeals can be your defense against unnecessary audits and penalties. Hear practical advice on how to navigate the complexities of maintaining compliance, including when to involve the insurance commissioner to protect your practice from potential pitfalls and maintain ethical billing standards.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

Tired of bureaucratic inefficiencies and missed technological opportunities? Join us as we analyze the healthcare workforce, dissecting the tough reality of supply and demand in medical residencies, with a special focus on the rising field of pediatric dentistry. We'll reflect on personal encounters with government red tape and ponder how the tech boom of the 90s could have spurred a much-needed modernization of government systems. We'll even speculate on how influential figures like Bill Gates and Elon Musk could have further propelled these advancements.

Thinking about launching your dental career in an underserved area? Discover strategic insights on how to capitalize on dental care shortages by using data to pinpoint opportunities, and learn how buying out retiring dentists can set the stage for a prosperous practice. We also debate whether specialization in high-demand services like endodontics requires extensive schooling or if ambition and a good attitude can suffice. Expect candid discussions on the importance of self-care and reassessing your career path to ensure it brings you joy, much like evaluating the health of your personal relationships.

As technology continues to transform industries, we'll highlight why it's crucial to keep your skills sharp, whatever your field of expertise. From the evolution of dental billing practices and the indispensable role of consultants to the need for continuous education in today's rapidly changing world, our conversation covers it all. Enjoy a light-hearted wrap-up as we share personal family anecdotes that remind us of the importance of gratitude and the fun quirks of familial bonds. Prepare for an engaging episode that combines professional insights with personal charm.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

Legendary dental expert and Founder of Dental Town Howard Farran joins me, Ericka Aguilar, for a compelling exploration of the future of dentistry, challenging the conventional norms that govern the industry. We embark on a fascinating journey through Howard's personal story, from Kansas to Arizona, navigating the complex economic barriers and education demands that define the profession. Together, we unravel the financial intricacies of being a dentist, contrasting the roles of general practitioners, specialists, and practice owners while scrutinizing the implications of operating within a cartel system.

The digital age is upon us, and AI is set to redefine the landscape of dental practices. We dissect the inefficiencies plaguing current practice management software and uncover how AI innovations, like the pioneering dental AI chatbot, promise to streamline operations and unlock new levels of efficiency. Drawing from a wealth of experience, the conversation paints a vivid picture of how AI can transform the way dental practices operate, enhancing both user experience and operational effectiveness, setting a new benchmark for the industry.

As we navigate the evolving business dynamics and global challenges in dentistry, the conversation broadens to encompass healthcare access in America. We shine a light on the disparities in dental and women's health services, particularly in rural areas, and consider the potential of international specialists to bridge these gaps. Our discussion also highlights the pivotal role of Dental Service Organizations in capital formation and their strategic influence in the market. Through it all, we stress the importance of ensuring quality and integrity by having industry-specific professionals at the helm, safeguarding the core values of dentistry amid shifting economic and regulatory environments.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

This episode focuses on the critical issue of managing credit balances in dental practices and the associated legal implications. Various state laws dictate how these balances should be handled, with non-compliance leading to potential fines, making it essential for dental offices to incorporate credit balance reports into their regular billing processes.

• Overview of why credit balances are often ignored 
• Importance of credit balance reports in financial management 
• Explanation of state laws and dormancy periods for unclaimed property 
• Consequences of failing to manage credit balances 
• Practical steps to take for compliance and management 
• Resources provided for state-specific compliance information 
• Call for proactive measures in managing credit balances

Link to check your states laws for unclaimed property:

https://unclaimed.org/state-reporting/

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

The episode encapsulates a life-changing mastermind weekend experiences shared by three female entrepreneurs. They explore themes of accountability, personal growth, and overcoming mind trash, highlighting the necessity of supportive networks in elevating one’s entrepreneurial journey. 

• Erika reflects on her long-held dream of hosting a mastermind 
• Participants share breakthroughs and insights gained from their connection 
• Discussion around "mind trash" and how to overcome limiting fears 
• Focus on the importance of accountability among peers for business growth 
• Vision setting for the upcoming year, emphasizing positivity and clarity 
• A call to action for aspiring entrepreneurs to pursue their dreams and seek support

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

This episode highlights the essential components of a streamlined and effective daily workflow for dental billing professionals. Emphasizing critical reporting, compliance, and continuous education, we aim to empower new and experienced billers alike.

• Overview of the Dental Billing Mastery Course 
• Importance of establishing a daily rhythm in billing 
• Running Procedures Not Attached and Claims Not Sent reports 
• Verifying clinical documentation and quality attachments 
• Role of the clearinghouse in claims submission 
• Timely follow-up procedures for older claims 
• Monthly reporting and reconciliation tasks 
• Importance of understanding compliance regulations 
• Continuous professional education for successful billing practices

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]

Imagine transforming your career by launching a home-based dental billing business that aligns perfectly with your lifestyle and personal commitments. In this episode, I guide Esmeralda, a seasoned dental biller, through the exciting and challenging transition from working in a single dental practice to becoming an independent entrepreneur. We promise you’ll gain invaluable insights into how resilience, strategic planning, and a keen understanding of business fundamentals can pave the way for success in this evolving industry. Join us as we explore how boutique approaches can offer a competitive edge against larger companies, drawing from my own journey that began back in 1998.

We delve into the advantages of managing a small client base, highlighting how this focus can lead to both financial prosperity and a healthy work-life balance. As we discuss the critical steps of consulting a CPA and a small business attorney, the emphasis is on building a solid business foundation and safeguarding personal assets. The importance of having robust contracts and financial reserves cannot be understated. We also touch on the significance of excellent customer service and leadership in sustaining growth. Whether you're contemplating a similar career change or adapting to the shifting dental billing landscape, this episode is packed with inspiration and guidance for your entrepreneurial journey.

Send us Fan Mail

Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:

https://dentiqhub-diagnosis-codes.vercel.app/

Get your Dental Billing Toolkit Here:

https://www.dentalbillingdoneright.com/the-dental-billing-toolkit

Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=header

Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Email Ericka:
[email protected]

Email Jen:

[email protected]