The three most common Oral Surgery billing errors.

Oral & Maxillofacial Surgery Billing has increasingly become a more complex task and even innocent mistakes may jeopardize your practice. The Oral Surgeon along with his/her staff face billing and coding challenges unlike any other specialty.

There are several costly mistakes Oral Surgeons and their staff make when it comes to billing and coding, this article will review the top three mistakes and how to avoid them.

Billing error #1 -  Selecting the correct insurance company to bill

The first and most common mistake  is understanding when to involve the patient’s medical insurance and which procedures require coordination of benefits between the patients medical and dental carriers. If you are able to capitalize on this concept you will not only maximize your reimbursement but you will in most instances  decrease the patients out-of-pocket expense.  Educating yourself and your staff on how to properly read and insurance card, check benefits and acquire authorization for treatment will eliminate this common billing error.

Billing error #2 – Properly coding operative reports

The second most common mistake is being able to accurately code reports, this tends to be the most difficult task for dental billers and doctors alike.  As a doctor you are trained in several aspects of dentistry, however, your training rarly if ever includes learning how to properly extrapolate and assign codes for your procedures.  As  for most dental billers assigning proper CPT and ICD-9-CM codes seems like a  foreign language.  It is imperative that your biller or billing service have experience in both dental and medical coding to effectively code and submit your claims. Learning how to properly assign codes will not only maximize your reimbursement it will reduce audit risk and eliminate this common billing error.

Billing error #3 – Having Proper documentation

The third most common billing error is proper documentation and submitting the claim on the proper claim form. (i.e. CMS-1500  formerly HCFA-1500 or ADA).  Proper documentation is imperative to protect you and your practice. Any insurance company you contract with has the right to audit your charts to ensure your documentation supports the procedures billed. If your documentation does not support what was billed to them, they can re-coup what they paid you along with penalties and interest. This can add up fast and become very costly! The old saying goes  ”If  it’s NOT Documented, it’s not billable”.  Having you and your staff trained in proper code assignment and utilization of coding books could eliminate this common billing error.

Any one of these mistakes is not only costly to your practice but may have devastating effects on your practice if audited.  Make sure your practice is capturing all the revenue it is ethically entitled to by scheduling a chart review and education piece today… for pricing and available dates e-mail

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