Dental Claims Cleanup®, LLC

National Dental Billing Services

1810 Erie Blvd. Syracuse, NY 13210

[email protected]

800-652-3431

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Blog

This page is intended for personnel in the dental industry.  Please be respectful in your comments.  

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Best Advice in Dental Billing

Posted on March 12, 2018 at 8:35 PM Comments comments (38)


As the Dental industry becomes insurance dependent in a volatile economy and rapidly changing healthcare system, offices struggle with key aspects of the financial picture: estimations of patient’s portion, collection at time of service, and patient balance recovery, if their estimation was wrong or the balance was uncollected at time...
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Simply Overlooked Task-Electronic Claim Submission

Posted on March 12, 2018 at 8:30 PM Comments comments (1223)

One of the most important tasks in dental billing, to ensure fast insurance payment, is the claim submission. You are probably thinking it is the easiest task and takes no time. But that's exactly it! If it takes you no time you are probably missing something. Let me explain. The claim submission task is a 4 part process.
1) all completed pr...
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Claims Not On File After Submission-Big Struggle with Insurances

Posted on August 21, 2017 at 2:10 PM Comments comments (5)

Electronic claim submission is amazing and provides a tracking mechanism for claim submission.  However, many insurances are still non participating in the electronic payer process.  In fact, it probably works to their benefit to keep it that way so they can delay claim payment.

The most frustrating aspect of dental billing is the "claim not on file" claim status.  We work diligently to send clean claims and when the claim is unresolved for over 30 days, we call the insur...

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Interesting Dental Billing Tips

Posted on April 25, 2017 at 10:50 AM Comments comments (2)

Medical & Dental Billing News

BENEFITS VERIFICATION TIP


For insurances that have a long wait on hold to speak to a representative, try calling the patient line instead of the provider line. Then, ask to be transfered to the provider extension. Your wait should be significantly decreased. Also, find out what the hours are for provider line and patient line. We have found that the patient line is opened 1 hour earlier than the provider line, giving you the oppor...

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Dental Insurance Credentialing & RetroActive Credentialing

Posted on April 25, 2017 at 10:45 AM Comments comments (0)

As the landscape of the Dental Industry changes, and we engage in increased insurance contracts, it is difficult for providers to repeat the credentialing process annually and remember the dates to re-credential. As a result, many providers found themselves receiving an out-of-network status notification and were dropped by the insurance. Recently, Delta Dental did...

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Billing Medical Insurance for Dental Services

Posted on December 10, 2016 at 8:10 AM Comments comments (3)


In response to the changes in the healthcare reimbursement plans, billing medical insurance for dental procedures is becoming a necessity. Currently, the dental industry may not be ready for billing medical insurances for dental procedures. Dental Claims Cleanup has been developing cross over systems and protocols to aid Dentists in the task of billin...

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Solution to a Problem in Every Dental Office

Posted on December 10, 2016 at 8:10 AM Comments comments (2)


The health and wealth of a dental practice is highly dependent on accurate, efficient, and consistent dental billing. With the changing landscape of the Dental Industry, increased dependence on dental insurance, the increased debt of the young Dentists, and the gobbling up of practices by Dental Service Organizations, the private practice needs help. Th...

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Most Valuable Asset in Your practice

Posted on December 10, 2016 at 8:10 AM Comments comments (2)


Believe it or not, Doctors, it is not you. It is your front office person/team. These are the magic people who project the image of your office to new and existing patients. These are the people who can make or break your practice without you even knowing. This team needs to have above average abilities in communication, with your patients, vendors, cli...

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Solution to Decreased Cash Flow

Posted on December 10, 2016 at 8:05 AM Comments comments (1)


Cash flow is a problem in many dental offices today.

 

There are several reasons for decreased cash flow. For instance, insurance payments are delayed, insurance claims are backlogged for submission, and claims need corrections and follow-up—but there is lack of manpower or time to do it.

 

The dental industry is ...

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Solution to Decreasing Taxes this Year

Posted on December 10, 2016 at 8:00 AM Comments comments (0)


Solution to Decreasing Taxes this Year

Don't Delay....

December is the month that we need to run our profit and loss statements and evaluate the projected income on which we will be paying taxes. The year CANNOT end without meeting and planning with your accountant and your financial advisor. In fact, the meeting should take place mid-year (...

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Anti-Theft Protection Safeguards in a Dental Office

Posted on July 31, 2016 at 6:00 PM Comments comments (3)


I am compelled to write this article due to the number of clients that started our service this month as a result of theft in their dental office.

 

The subject of theft stirs something in my core. Dentists, as a group, are good, honest, people, trying to make a living. They are also the MOST vulnerable profession exposed to the poten...

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Insurance Benefits Verification-a dreaded task by the Dental Front Office

Posted on July 19, 2016 at 4:05 PM Comments comments (3)

One dreaded task for the dental front office is insurance benefits verification. Here are some of the issues that the front office has to deal with:

 

Length of time on the phone keeping front office away from live operations due to waiting for insurance reps to answer the phone and the length of the actual phone call. On average, there are 6 new ...

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Out of Control Overdue Patient Balances in Dental Billing

Posted on March 19, 2016 at 8:45 PM Comments comments (2)

Out of Control Overdue Patient Balances Working with practices across the nation provides us with trends and common struggles in dental offices. One denominator is that many offices have the patient balances over 30 days are out of control. It is our job to clean those up, but if we do not help the practice change their protocols there will be more balances rolling over as fast as we clean them up. Here is what must happen in the to make sure that your cashflow in healthy and the accoun...

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Benefits of outsourcing dental billing

Posted on November 23, 2015 at 9:55 AM Comments comments (2)

Outsourcing dental billing is a novel concept in the Dental Industry. The fact is, that medical billing has been common practice for decades. The reason why is that medical offices have a high volume of insurance claims and need dedicated people with expertise to handle this job efficiently and effectively. It is expensive to have that team on site. As the landscape of Dentistry has changed, and the private practices increased their provider participation, the insurance claims volume incr...

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Appointment Pre-Booking Interview

Posted on October 19, 2015 at 11:30 AM Comments comments (1)

So here is a concept that might be new to you- "Appointment Pre-Booking Interview". This is a series of questions from your scheduling coordinator to our patients to discover if they truly should be given an appointment. What we have found is that the no shows kill practices and the financial burden that they place on the practice is unacceptable. So we researched what are the top 4 reasons that effect a patient showing up for their appointment. Research showed that they sequence from hig...

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Accomplish Your Goals!

Posted on October 17, 2015 at 9:50 PM Comments comments (0)

Based on "The 4 Disciplines of Execution by Chris McChesney & Sean Covey" 

Gives you a guide how to achieve a goal successfully with results in the office and track results. Take this example: if you want to decrease no shows in the office

1. focus: widely important goal must be set (decrease no shows)

2. leverage (find out 2 to 3 things that effect people showing up to their appointme...

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Charge full fee on not covered procedures by dental insurance in certain states

Posted on October 17, 2015 at 5:10 PM Comments comments (0)

from website:

https://wf.employeebenefitservice.com/wps/wcm/connect/Storefronts/obc/1398878240638

 

NON-COVERED PROCEDURES LEGISLATION BY STATE

 

Lawmakers in several states have passed new legislation that no longer allows insurers to require dental providers to give discounts for services not covered under an insured dental plan. Listed below are the states that have passed this legislation and links to the actual laws.

 

We encourage...

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Periodontal Disease and Insurance Billing

Posted on October 17, 2015 at 11:35 AM Comments comments (3)


Perio and Insurance Billing Q: There are 10 things you need to know about getting paid for your perio services or services related to perio procedures.

 

A: Here are 10 FYIs with perio insurance billing: 1. New patients needing perio maintenance: need to find out when last quads were done. The quads ...

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What is the most ridiculous, confusing, most denied procedure dentists bill insurance for?

Posted on October 17, 2015 at 11:30 AM Comments comments (4)

Q: What is the most ridiculous, confusing, most denied procedure dentists bill insurance for?

A: The simple core buildup has been redefined by both the insurance companies and the ADA in the past 2 years. Somehow, over the years, insurance companies have decided that the core build-up is part of a crown procedure and thus have avoided paying us for it. Delta Dental, Metlife, Guardian, Pomco all guilty of selling a plan to employers with the clause of...

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HIPAA Compliance in a dental office

Posted on October 15, 2015 at 8:40 AM Comments comments (0)

Rid Your Practice of Old Operating Systems (Windows XP and Server 2003):

Since April 2004, Windows XP has been left unpatched by Microsoft. You may notice on newer operating systems that updates are periodically installed when you restart or shut down - these come out every 2 weeks to patch security flaws that allow hackers to access your system remotely. If your office is even running one XP or Server 2003 computer, hackers have had almost 2 years to find holes in the system and tho...

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