Periodontal Billing is constantly changing. With more and more perio procedures being covered by medical insurance, the periodontist and/or staff are obligated to coordinate your patients benefits between medical and dental insurance.

...is a small sample of challenges you and your staff face daily, managing billing & coding for Periodontology.

Did you know the following procedures may be covered by the medical carrier and/or require a denial before dental insurance will pay... Osseous Surgery, Gingivectomy, Gingivoplasty, Soft Tissue Alograft, Subepithelial Tissue Grafts, and many more.

Managing this properly will maximize your reimbursement and decrease the patients out-of-pocket expense.

In order to accurately code reports, bill procedures properly and submit promptly to all carriers it is necessary to have a competent employee or billing service who is knowledgeable in both the medical and dental fields.

In addition, procedures billed must be supported with proper documentation and submitted on the proper claim form.
i.e. CMS-1500 (HCFA) 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!
Remember - "NOT Documented = Can't Prove it Occured"

You’re busy enough being a periodontist, your staff is buried in paperwork and now the fight for your money has become
quite tedious.

Billing Medical Insurance Coordinating Benefits Pre-Auth vs. Pre-Cert. Coding Reports Supporting documentation ICD-9-CM, CPT, CDT Codes Appealing denials

Insurance guidelines Claims follow-up Timely filing Deductibles Classic insurance response; "We didn't get your claim"