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New Dental Billing Codes and Descriptor Changes for 2023

As with most things in life, dental billing codes and descriptors are changing again for 2023. Dental billing coding may be one of the most difficult aspects of working in a dental practice. Dental coding is essential to the billing process, and your practice may suffer without the proper knowledge of billing processes. Many dentists are missing out on revenue due to claims that can’t be processed because of incorrect coding or documentation.

Every change in coding means more opportunities to be specific with your billing process so you get the most out of your hard work. If you don’t know about these changes, you aren’t giving your practice every opportunity to be as successful as possible. Make sure your dental staff stays updated on changes to help you keep business booming and profits rolling in.

What Are the Changes?

One of the most significant changes is the introduction of new codes for teledentistry. With the COVID-19 pandemic changing the way we live and work, teledentistry has become an increasingly important option for dental practices. While dentistry is a difficult service to provide without being up-close and personal, more practices have found a way to provide some services like consultations or follow-ups via telehealth.

Although it may be a tool used to take precautions and limit exposure to germs, it has become quite convenient for patients and dentists alike, allowing patients less time away from the important parts of their daily lives and allowing dentists to prioritize the patients who need to be seen in-office.

With the new codes, it’s easier to bill and manage the telehealth services your practice provides for patients.

The new codes include D9995, which is for synchronous teledentistry services provided in real-time, and D9996, which is for asynchronous teledentistry services that are provided on a delayed basis. These codes are particularly helpful for practices that offer remote consultations or follow-up appointments, allowing for more efficient billing and reimbursement.

Other New Codes

Aside from those codes related to teledentistry, more codes have been created to help your practice be more specific about the services you provide and procedures you perform. While it is a challenge to remember new codes and apply them, it can be a positive change to help you get the money you’ve earned from your work.

Among the new codes, things like diagnostic imaging, 3D scanning, guided tissue regeneration, and HPV vaccinations are addressed.

Another important notation is that, while there are 6 new codes related to guided tissue regeneration (GTR) procedures, another separate code has been created for removal of non-resorbable barrier. While this surgical procedure may technically fall under GTR procedures, the ADA made the decision to make a specific code related to the removal of a non-resorbable barrier, because the procedure may take place at a different time than the other procedures under GTR codes, and possibly by a specialty dentist.

Descriptor Revisions

Several of the codes have undergone revisions to descriptors, so the meanings of what the codes describe have varied slightly. For example, the descriptor codes D0210, D9110, and D4355 are among those that have been revised. These codes don’t have large changes to their descriptions, but rather a single specific word that changes their meaning. This trio of codes all had language that included the word “complete,” which has now been changed to “comprehensive.” While only a word has changed, it seems to clarify the procedures further to ensure correct billing.

What Do These Changes Mean for Your Practice?

These code changes can mean important things for your dental practice. Without updating your code information, you could be looking at an increase in claim denials for services, which means several things for your practice.

Claim denials will mean a longer waiting time for reimbursement after a procedure or other patient care. Unfortunately, equipment repairs, payroll, and utility bills don’t wait until claims reimbursements come in, so delays in payment for your practice can be detrimental to your patients and employees.

Claim denials also take up more time than necessary from your hardworking secretarial staff. Denied claims mean redoing work that could’ve been done the first time and the potential for upset customers correctly when insurance hasn’t covered a procedure.

The measure twice, cut once mentality applies in this situation. Double-check that your billing codes are correct before bills are submitted and you’re less likely to have to do more work or do the same work over again later.

If you’re looking for assistance with filing dental claims and increasing your dental practice’s revenue. PPO Negotiation Solutions can help. PPO Negotiation Solutions can help you get the highest claims reimbursement possible and make sure none of your hard-earned money is left on the table. Visit us online to schedule a consultation or utilize our complimentary assessment.

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Harnessing the Power of Dental PPO Negotiations

Harnessing the Power of Dental PPO Negotiations

As a dentist, you likely understand the importance of negotiating with PPOs (preferred provider organizations) to maximize your practice’s revenue potential. And if you don’t yet understand, you should. PPOs are a type of dental insurance plan that contracts with dental providers to offer discounted rates to their members.

For instance, a patient may purchase a healthcare plan through an insurance company and that insurance company may contract with you to be one of their preferred providers. If you are a preferred provider, patients who see you will pay a lower cost because you are in-network, meaning you have a contract agreement with the insurance company. While PPOs can increase patient volume, they can also come with challenges like low reimbursement rates and limited treatment options.

Fortunately, there are several strategies you can use to effectively negotiate PPO contracts and increase your practice’s profitability. Here are some things you should know about the basics of PPO negotiations. Also, here are some tips that will give you the ability to successfully navigate the process.

Understanding Dental PPO Negotiations

Dental PPO negotiations can be complex and time-consuming, but they’re also a crucial part of growing your dental practice. There are a few key concepts to keep in mind if you want to negotiate a PPO contract:

You need to know your numbers. Before you enter negotiations with a PPO, it’s essential to understand your practice’s financials inside and out. If you’re already involved in a contract, you need to have a crystal-clear idea of the following:

  • your dental practice’s revenue
  • dental practice’s expenses
  • profit margins
  • how much you receive from PPO reimbursements

Knowing your numbers will give you a clear picture of your practice’s finances and help you make informed decisions during negotiations.

You also need to have a clear understanding of the PPO’s policies. It’s important to thoroughly review the PPO’s policies and procedures before beginning the negotiation process. This includes understanding their fee schedules and payment policies. Remember – this is not only something that can affect you and your staff. A PPO can affect your patients as well. This can affect the treatment options your patients have at your practice, so be sure you understand any limitations on treatment options. Having a clear understanding of these policies will help you negotiate more effectively and avoid any surprises down the line.

Also, it’s worth noting that negotiating with PPOs requires preparation and strategy. Before entering into negotiations, it’s essential to have a clear understanding of your practice’s value proposition. This includes the quality of care you provide and the services you offer. You should also have a plan for how to approach negotiations and a clear understanding of your bottom line.

Tips for Successful Dental PPO Negotiations

Now that you understand the basics of PPO negotiations, you can dive into some specific strategies to maximize your reimbursement and harness that negotiation power.

When walking into a negotiation, know what you have to offer and be confident in your value – know what you can use as leverage. As previously mentioned, understanding the value of your practice’s proposition is key to successful PPO negotiations which involve:

  • being able to effectively communicate the quality of care you provide
  • communicate your treatment philosophy
  • convey the services you offer

By highlighting your practice’s strengths, you can demonstrate your value to the PPO. You can also negotiate for higher reimbursement rates and fewer restrictions.

Another powerful tool you have available to you is knowing the data from your practice and making that data available as proof of your value during negotiations. Track your practice’s performance metrics so you can demonstrate its value and negotiate for better reimbursement. Patient retention rates and treatment case acceptance are just some of these performance metrics that you can track. You can also use data to identify areas where you can improve your practice such as:

  • increasing patient volume
  • optimizing your treatment options

While knowing your worth is potentially the most important thing you can do, it can help to build relationships with PPO representatives. If you’re able to cultivate positive relationships, you may find that you can negotiate more effectively. Moreover, building a more profitable practice which includes the following:

  • communicating with representatives regularly
  • providing feedback on their policies
  • being willing to negotiate in an honorable, trustworthy manner

By building trust and rapport with PPO representatives, you can increase your chances of successfully negotiating for higher reimbursement rates.

Finally, it’s important to remember that you always have the option to walk away from a PPO contract if the terms are not favorable. While it can be tempting to accept lower reimbursement rates or unfavorable policies to bolster the number of incoming patients, accepting that lower offer may ultimately harm your practice’s bottom line. By being willing to walk away from unfavorable contracts, you can protect your practice’s financial health and remain open to negotiating for better terms in the future.

If you’re ready to learn how to harness the power of negotiation and sign the dotted line under the most favorable terms for you and your patients, PPO Negotiation Solutions can help. We can get you started with assessments for your practice available at no cost to you and a consultation to discuss the terms you’re looking for in a PPO. Contact PPO Negotiation Solutions today!

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A Comprehensive Guide to Dental PPO Negotiation Solutions

As a dentist, you want to provide high-quality care to your patients while also running a profitable practice. One way to do this is to participate in a Preferred Provider Organization (PPO), which can help increase your patient volume and bring in more revenue. However, optimizing your PPO may be necessary. This means you may have to negotiate with insurance providers to ensure your costs are covered while also getting the added benefits of a PPO, which can prove to be a challenging task.

Here’s a comprehensive guide for dentists wanting to negotiate the costs of your practice being a PPO.

Understand and Prep

Before entering PPO negotiation, it’s essential to understand the negotiation process. The negotiation process involves several steps, such as preparation, initiation, negotiation, and agreement.

To prepare yourself before entering negotiations, you first need to identify your goals. Before negotiating anything, you need to know what you want. Figure out what it is that you need in return from your insurance provider.

Before negotiations start need to have a very idea of your dental practice’s financial situation. Be fully aware of things like revenue, expenses, profit margins, and how much you currently receive from PPO reimbursements. Knowing your numbers will help you make informed decisions during negotiations.

It also helps to have have a clear understanding of the PPO’s policies. Review the PPO’s policies and procedures before beginning the negotiation process so you understand things such as their fee schedules and payment policies. This has the potential to affect treatment options for your patients and procedures that your staff can perform, so be sure to understand any limitations.

Initiation and Negotiation

Once you feel you’ve properly prepared yourself to negotiate with success and you’re ready to initiate the process, call your provider’s representative or submit a request for negotiation. If you’re feeling a little shaky, don’t be afraid to bring in some reinforcements. Agencies like PPO Negotiation Solutions are here to help negotiate the lowest fees and the highest amount of revenue.

During the negotiation process, be strategic about asking for what you want. Don’t be shy about laying out what it is that your practice needs to be successful, but being flexible and willing to compromise is also important. Some strategies you might find useful include using your own data to back up requests, leveraging unique or valuable aspects of your practice, and simply just building rapport with your insurance provider.

Just as it was important to know your practice’s financial health, it’s important to know what your practice is doing. Go into negotiations with a clear goal in mind from your prep work and when you ask for what you want to achieve your goal, use the data from your practice to provide a sort of collateral to your insurance provider. Reports from practice management software may help to be persuasive.

Also, using unique aspects of your practice to your advantage can be a good negotiation strategy. For example, if you are the only dental practice in your region with a certain piece of technology or you’re located in a very rural area, insurance providers may be willing to negotiate with you to keep their customers happy.

Just generally good relationships never hurt anyone either. You want to stay on the good side of your insurance representative. A muffin basket never hurt anyone now and again.

Agreement

If you have done all the work to create goals for your dental practice, you understand what your practice requires to be successful, you’ve researched PPO policies, you’ve built strategies, and you have at last won the battle of negotiation with your insurance provider, then it is time to sign the agreement. Be sure to take a good look at the contract and make sure it spells out clearly the requirements of each party and that everything documented in the contract was thoroughly discussed and agreed upon.

In this stage of the process, you may find that an attorney or an agency such as PPO Negotiation Solutions can be especially helpful. It’s important to understand that you do have the option to walk away from a PPO contract if the terms are not favorable or the contract is not what you agreed upon in negotiation.

While it may be tempting to accept terms even if they have you seeing less revenue just for the added benefits of seeing an increased number of incoming patients, accepting an offer you didn’t want may ultimately harm your practice. Terms are still negotiable before you sign the contract, so be sure that what you agree to on paper truly agrees with the goals you set for your practice.

Negotiating fees and reimbursement rates can be a lot of work. Let PPO Negotiation Solutions take the hard work out of PPO contracts. Contact us to schedule a consultation and get started increasing your revenue today!

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Managing Your Dental Office: Common Challenges and Solutions

Managing a dental office can be a rewarding experience, but it can also present many challenges. From patient flow management to equipment maintenance, regulatory compliance to financial management, managing a dental office requires attention to many different areas. In this blog, we’ll explore some of the common challenges you might face while managing your dental office. We’ll also discuss some solutions to address those challenges.

Patient Flow Management

One of the biggest challenges a dental office might face is managing patient flow. Managing patient flow is crucial in ensuring patients are seen on time, and their appointments do not interfere with other patients. Patient satisfaction should be a driving force for any dental practice. That’s why it’s important to ensure that patients are able to be seen on time. One of the biggest issues dental offices face is patient no-shows or late arrivals. When patients don’t show or arrive late for appointments, it will inevitably leave someone waiting longer than necessary.

To address this issue, try using dental management software that allows you and your staff to do the following:

  • schedule appointments
  • monitor the progress of appointments
  • send reminders to patients.

This software can also help offices keep track of cancellations, rescheduling, and if you have a waitlist for an appointment.

You may also want to consider creating a buffer time between appointments to accommodate unexpected delays. If you already have a buffer time built into your schedule, you may need to evaluate the protocol for how long staff are to wait on a no-show or how long after a scheduled appointment time staff can still see a patient.

Staff Management

Another challenge dental offices face is staff management. Staff management involves scheduling, training, and supervising staff. A common issue you may run into with staff management is high turnover, which can disrupt the quality of care patients receive and it can affect the overall environment of the office, among other things. The staff members at your dental office are a major contributor to patient satisfaction.

To address high turnover rates, work to create a positive work environment that promotes job satisfaction, career development, and work-life balance. Additionally, make sure your dental practice has clear policies and procedures in place, and communicate them to your staff members. Offer regular training and feedback to ensure everyone is on the same page. Staff meetings and team-building activities can also help to build morale and grow a sense of community between staff members.

Equipment Maintenance

Dental equipment is expensive and needs proper maintenance to ensure it lasts for a long time. Another big challenge your dental practice may face is equipment breakdowns, which can disrupt the schedule and cause delays in patient care. In this case, you might say an ounce of prevention is worth a pound of cure. If you’re able to prevent the problem by maintaining machinery and equipment properly, breakdowns are less likely to occur and less likely to disrupt your appointment schedule.

Try creating a maintenance schedule for all your equipment and ensure that all staff members are trained in the proper use and care of the equipment. Additionally, it’s important to consider the quality of the equipment you’re purchasing. Although better equipment that is built to last or is more easily replaceable may cost more, you’re less likely to be losing out on profit when a machine malfunctions. Regularly updating equipment can also help to ensure that the office is using the latest technology to provide the best patient care.

Regulatory Compliance

Dental offices are subject to numerous regulatory requirements, including infection control, HIPAA compliance, and OSHA requirements. It can be difficult to stay up-to-date with these regulations and ensure compliance. Resolving this issue may be as simple as ensuring your staff members are frequently trained and reminded of the regulatory policies in place. You also may consider partnering with consultants or outsourcing services to ensure your office is meeting all regulatory requirements.

Marketing the Dental Office

Marketing your dental office is essential to attract new patients but also to retain current patients. It can be a challenge and knowing how to do it effectively and with limited resources makes that challenge even larger. To address this issue, create a marketing plan that includes strategies like social media marketing, patient referrals, and community events. Social media marketing can be a low-cost way to attract new patients and keep patients up to date with what is going on with your office.

Financial Management

While your top priority as a dentist is the health of patients, your dental practice does have to make money. Financial management is a challenge you may find yourself struggling with, which involves managing expenses, revenue, and cash flow. Fortunately, there’s software that can help resolve this problem as well! You can use dental management software to track financial information, create budgets, and monitor cash flow. Regularly reviewing expenses and revenue, and implementing cost-saving measures where possible can also be helpful. Dental offices can also consider partnering with dental insurance companies and third-party payers to ensure they are getting reimbursed for their services.

If you find that you’re especially struggling with financial management and you would like to learn more about partnering with insurance companies to increase revenue for your dental practice, PPO Negotiation Solutons can help. Contact us today to schedule a consultation and let us help you navigate your dental practice through the challenges of managing your dental office.

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The Benefits of Automating Front Desk Operations

Owning a dental practice is no walk in the park. Being a dentist with your own practice means you’re worried about staying up to date with new technology, continuing education, taking care of patients, leading a team, and probably more things swirling around in your brain. While you’re taking care of patients, you need someone you can trust to do the following:

  • handle payments
  • schedule appointments
  • check-in patients for appointments

Office delays can’t be added to your worries with everything already on your plate. And while you can’t replace the friendly smile and reliable nature of a fantastic office secretary, they probably wouldn’t mind a little extra helping hand.

If you find yourself needing that extra help around the office, consider automating your front desk operations. Automating front desk operations in a dental practice can bring a host of benefits to both the practice and your patients. Some of the key advantages of automation include improved efficiency, increased accuracy, and enhanced patient satisfaction.

Efficiency

One of the most obvious benefits of automating front desk operations is improved efficiency. When patients arrive at the practice, an automated system can make quick work of the check-in process, and quickly and accurately capture a patient’s information. This eliminates the need for manual data entry, which can be time-consuming and prone to errors. Automated systems also enable patients to check in on their own. This reduces the need for staff assistance and frees up staff to focus on other tasks. It’s also a possibility to reduce the risk of HIPPA violations due to patients being able to enter the information themselves instead of having to verbally give private information to a secretary in front of other patients.

Accuracy

Another key advantage of automation is increased accuracy. Automated systems are programmed to capture specific information, such as patient demographics, insurance information, and appointment details, reducing the risk of errors. Billing requires many things to go right such as:

  • having correct patient information
  • filing in the correct time frame for each specific insurance
  • using the correct billing code

These pieces of information are especially important when it comes to billing and insurance claims. Because errors can lead to denied claims and lost revenue for the practice. Normally, correctly filed claims may be paid in as little as 15 days. Having to re-file an incorrect bill to an insurance company costs more time that you could’ve been getting paid and potentially more stress and confusion for your patient.

Patient Satisfaction

In addition to improving efficiency and accuracy, automating front desk operations can also enhance patient satisfaction. Patients appreciate the convenience of being able to check in on their own, and automated systems can also provide them with important information, such as wait times and appointment reminders. This can help to reduce patient no-shows as well, which is a positive thing for your patient’s health and a positive thing for your revenue.

Cost-Effectiveness

Automation can also be a cost-effective solution for dental practices. Automated systems may be an investment upfront, but in the long run, they may be less expensive than hiring additional staff, and they can also help to reduce the need for expensive paper forms and filing systems.

Data Collection

One of the key benefits of automating front desk operations is the ability to collect and analyze data. Automated systems can capture a wealth of information about patients, appointments, and billing, which can be used to improve the practice’s operations. For example, data on patient wait times can be used to improve scheduling and reduce wait times, while data on billing errors can be used to identify and correct issues. All this data can help you to create maximum efficiency in your office while also making sure patient data is kept private and secure.

Patient Care

Automating front desk operations can also help to improve patient engagement and care management. Automated systems can be integrated with patient portals, enabling patients to view their appointment information, update their contact details, and even pay their bills online. This can help to make it easier for patients to manage their own health care by seeing what procedures took place when they’ve attended appointments, and potentially even direct messaging you with any issues they face.

Automating front desk operations can bring many benefits to dental practices, including improved efficiency, increased accuracy, and enhanced patient satisfaction. If you’re a dental practice owner, it’s worth considering automation as a way to improve your practice’s operations and better serve your patients as well as maximize your profits. If you’re looking for more ways to ensure that you’re getting the maximum revenue possible for your practice, let PPO Negotiation Solutions help you. Visit us online to complete a complimentary assessment of your practice and schedule a free consultation with us today.

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Reduce Costs and Increase Revenue in Your Dental Practice

Running a dental practice can be challenging, especially when it comes to increasing revenue. It might have crossed your mind that you signed up to take care of a patient’s teeth and not run a business, but here you are! Running a dental practice does include wanting the best for your patients and their health, but also figuring out how to keep the cash flowing. However, there are a few strategies you can implement to help boost your bottom line.

Improve Patient Relationships 

First and foremost, you’ll want to focus on providing excellent patient care. This means investing in the latest technology, staying up to date on the latest dental techniques, and hiring a skilled and friendly staff. By providing top-notch care, you’ll be able to attract new patients and earn positive word-of-mouth recommendations.

It’s also important to focus on patient retention. You want new business, but you also want to keep the business you have. This means keeping in touch with patients after their visits, asking for feedback, and addressing any concerns or complaints promptly. By retaining a strong patient base, you’ll be able to increase revenue through repeat business.

Market Your Business

In addition to expanding your services, you can also increase revenue by promoting your practice through marketing and advertising. This might include things like creating a website, setting up social media accounts, and running ads in local newspapers and magazines. Utilizing these tools are all low to no-cost ways to market your dental practice while benefiting from the business you will hopefully receive in return. By getting the word out about your practice, you’ll be able to attract new patients and build awareness of your brand.

Satisfied patients are typically more than willing to give out a referral, so a refer-a-friend link for a social media page or adding it to your website design is a great way to utilize two of those marketing tools you have at your disposal.

Expand Your Services

Another strategy to consider is expanding the services you offer. For example, if you currently only provide basic dental services, you might consider adding cosmetic procedures like teeth whitening or veneers. This can help attract new patients and increase revenue, as these types of procedures often come with higher price tags. If you already have services like these, consider offering them to a patient before they even ask. Just offering a patient an extra service like teeth-whitening during a routine cleaning could add $100 to the typical service if they accept.

Although it may seem counterproductive, it might be a good idea to consider investing in new technology that would allow patients the ability to receive a new type of procedure at your practice or to make a common procedure less invasive or painful.

Be Precise When Working with Insurance 

Since patients aren’t normally paying out of pocket for procedures when they come to visit you, someone in your office is going to be filing a claim with an insurance company. This is an especially important job because claims that are filed incorrectly can take away time and revenue from your dental practice. When working with insurance claims, there are lots of things to remember. There are codes for specific procedures (which may change frequently), there are time frames as to when claims may be submitted, and of course, there is personal information from the patient that must be submitted. All these things must go right to have a claim successfully filed and paid, which means you need to be careful and precise when working with insurance.

Aside from this, there is just the fact that you may have to reconsider what financing options you offer, including what insurance providers you accept; make the decision that will garner the most profit and the best patient care at your practice.

Stay Organized

Finally, it’s essential to stay organized and keep accurate records of your finances. This means keeping track of expenses, monitoring your cash flow, and analyzing your financial data to identify areas where you can cut costs or increase revenue. By staying on top of your finances, you’ll be able to make more informed business decisions and grow your practice over time.

Increasing revenue for your dental practice takes hard work, but by focusing on providing excellent patient care, expanding your services, promoting your practice, being precise when working with insurance, and staying organized with your finances, you can boost your bottom line and grow your practice. Remember, it’s not always about the money, but you need to make sure that you can pay your bills and have a healthy and profitable business.

If you think you may need some assistance when it comes to boosting your practice’s revenue or cutting some costs, PPO Negotiation Solutions can help. We offer a complimentary assessment for your practice, so you can get an idea of where your practice can improve. Contact us today to schedule a consultation.

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