MBC Deciphers the Intricacies in Medical & Dental Billing In A Dental Office


On–going advances in dental billing and coding are gradually leading to the involvement of the medical carrier for obtaining payments. Hence various dental practitioners across US facing these new complexities have been finding a way out with Medicalbillersandcoders.com dental billing services.

Identifying significant differences between Medical and Dental Billing in a dental office –

  • Coding– Compared to dental carriers; medical carriers require more than just a procedure code. In case of medical carriers the reason for the procedures needs to be conveyed which is the patient diagnosis.
  • Medical necessity – This is very important for successful dental-medical cross coding. A suitable diagnosis that supports and establishes the medical necessity of the procedure is mandatory in order to be paid.
  • Updates frequency– Though medical codes go through the same process as dental codes in case of additions, deletions and revisions, which  are published in their respective manuals,  the most significant difference is the frequency and time period between these updates. All medical code sets update yearly; with no grace period offered for using outdated codes by medical carriers.
  • Claim form- The medical claims form is different from the ADA claim form. Most medical carriers claim forms need to be red in color and not copies of the form in order to be scanned correctly, moreover hand-written claims and hand-written comments are not accepted.

MBC experts believe that understanding these differences and implementing them can tremendously help while billing for a procedure which involves both the dental and medical carrier.

Prioritizing between the medical and dental payer at your dental office-

As more and more dental carriers recognize the medical nature of certain dental procedures; opportunities of filing dental claims with medical carriers also increase.

Though it is common for trauma-related dental services to be billed to medical plans, there are other dental services that can also be billed to medical. Currently procedures which can and are beneficial to be filed with medical carriers include– Trauma procedures, TMD procedures, Sleep apnea appliances, Oral cancer screening,  Medically necessary oral surgical, laser, periodontal procedures, implant, endodontic, and prosthodontist procedures. In addition any medically necessary exams and X-rays (including CT Scans) which may be associated with these procedures.

MBC dental billing experts have been successfully filing medical claims for all these dental procedures. With their keen understanding of the relation between oral health and overall body health; they have been able to easily procure maximum payments along with handling the added documentation.

MBC has provided multiple benefits to various dental practitioners across US – With their in-depth industry knowledge MBC comprehends most variables attached to dental-medical cross-coding and have positively impacted various dental practitioners across US –

  • Dental practitioners revenue has increased due to increased case acceptance for procedures that fall under medical
  • Higher patient satisfaction as dental patients with both medical and dental insurance plans have been able to switch to their medical plan for medically-necessary procedures, while saving dental plan yearly allowances for dental procedures
  • Higher patient satisfaction has led to increased number of referrals and patients for these dental practices

Each payer has its own plan as to how they will cover certain dental expenses, and as dentists realize the need of a certified professional to manage the billing side of their practice, there has been a steady increase of MBC’s billing requirements by various dentists across US.

MBC’s highly-trained medical billers have the experience and know-how on billing medical-related dental services to medical insurance plans. Dental billing experts at MBC are committed to recovering 100% of revenue as they stay updated with the latest billing regulations, industry changes and coding updates. Additionally MBC experts regularly enroll in continuing education managing to constantly decipher new changes in the dental industry hence managing to increase reimbursements and save 30-40% of the practice’s operational costs.

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