Marianne Harper's Abra-Code-Dabra course bridges medical/dental coding
BY ANN-MARIE C. DEPALMA, RDH, MEd, FADIA, FAADH
As hygienists, our days are filled with educating patients about their oral conditions, maintaining oral health, and treating periodontal disease. Our thoughts are not preoccupied with how the patient or insurance company will pay for that care. That often falls on other team members to discuss, but it should still be something we understand and can communicate about with patients.
Some hygienists understand the dental insurance components of care, while others have no knowledge of this complex arena. But most hygienists and dental team members lack understanding in the medical coding world. As dentistry becomes a more holistic, oral-systemic-connected world, dental professionals need to understand both dental and medical coding. Marianne Harper has bridged the gaps in that knowledge with her program, "Abra-Code-Dabra."
Other articles by DePalma
- A course about the end of life: Kelsch coaches professionals on palliative dental care
- Heart disease among women
- Identifying implant candidates: Seminar aids search for solutions to edentulism
Marianne understands that dental insurance providers often require dental practices to file medically necessary procedures with the medical carrier prior to dental plan consideration. Dental teams do not understand the diff ences in diagnosis vs. treatment coding between medical and dental insurance plans, and this can delay treatment and payment. Marianne's program offers an in-depth look into the process of medical cross-coding, thereby increasing revenue and profitability for the practice.
The program allows participants to:
• Understand the benefits of cross-coding
• Learn how cross-coding is important in billing for medical necessity
• Review the dental procedures that can be submitted medically
• Discuss the differences between medical and dental coding
• Demonstrate how diagnosis coding works
• Understand the importance of thorough documentation
• Complete a medical claim form
• Review ways to implement cross-coding into the practice with concentration on each team member's role.
Marianne provides participants with extensive handouts since she believes that any course that deals with coding requires detailed handouts so they can be used in the practice right away. Her handouts provide multiple resources to help attendees with implementation of cross-coding in their practices.
In addition to the cross-coding program, Marianne offers practice management programs including:
• "Too Little - Too Late," which focuses on accounts receivable and collection, from the initial patient contact to sending the account to collections.
• "ASAP - Achieving Success as an Awesome Practice" focuses on achieving optimal efficiency with business systems that achieve greater practice success and profitability.
• "Stuff Happens" reviews the need for a practice disaster contingency plan and the steps required to implement the disaster recovery.
In the cross-coding program, hygienists learn their role in implementation of insurance cross-coding by determining patients who would benefit from medical insurance submission, and then being able to communicate their findings to the dentist. By initiating cross-coding, hygienists will help patients achieve better systemic health because hopefully they will be able to better afford the necessary dental treatment through their medical plans. It also establishes the idea that insurance submission is not the job of just the business team, but rather an entire practice philosophy. Cross-coding takes the entire team to be effective.
Marianne started her journey into cross-coding as a dental office manager. After her children were born, she developed an interest in dentistry and studied at the J. Sargeant Reynolds Community College in Virginia to become a certified dental assistant. She eventually became a dental office manager, and while wearing many hats in the practice, insurance processing was one of her responsibilities.
During that time, she received a letter from a dental insurance company stating that a trauma case had to first be filed with the patient's medical plan. She was shocked and had no knowledge of where to begin. She contacted a friend who was familiar with medical coding and learned as much as she could. Marianne even worked part-time in the insurance department of a busy medical practice to learn how to submit claims! With all of her newfound knowledge, she decided that other dental teams also needed to learn how to process medical claims, and she decided to become a resource for practices. She began her speaking career after she took a dental insurance program presented by a retired dentist. During the program he asked if anyone had filed medical claims, and after mentioning that she taught cross-coding, the doctor invited Marianne to speak for Cross Country Education.
Although not a hygienist, Marianne sees her greatest accomplishments as the positive changes she instilled in practices that she worked with as an assistant, manager, consultant, and speaker. Marianne describes herself as caring, decisive, and determined. She enjoys spending time with her husband, two children, four grandchildren, and two dogs at their beach home in North Carolina. Marianne is a watercolor artist but doesn't have much time to pursue the hobby.
Her favorite part of presenting CE is the participants. Her programs have limited seating in order to provide participants with individual attention, so she can really learn about them and their practices. She finds it gratifying to know that she has made a difference in people's careers and practices. What she dislikes about presenting is getting to a speaking venue and finding things not set up properly or technology that doesn't work. Participants say'her information is invaluable in tackling medical claims, and it's helped reduce processing delays from medical insurance carriers.
Marianne says that participating in a cross-coding course is one of the best ways for dental teams to become comfortable with the medical insurance arena. Cross-coding can be difficult to implement without the proper education. Once medical coding and claim forms are understood, implementation can effectively be achieved. Hygienists learn they are an integral part of the cross-coding world.
Thought for the month:
The secret of getting ahead is getting started. - Mark Twain RDH
This month's INeedCE course is "Dental Professionals and HIV - Part 1."
RDH magazine readers will receive a course discount of $29.50 (regular price $59) when code AM915 is used. The code is good until Oct. 31, 2015.
Dental Professionals and HIV - Part 1
With the introduction of highly active antiretroviral therapy (HAART) for HIV, AIDS is now manageable and patients are living relatively free of the many oral conditions that characterized the disease prior to and during previous treatment regimens. Although the incidence of oral diseases has improved, many patients with HIV and emerging AIDS may still develop one or more oral conditions that dental professionals need to be aware of when examining the patient with AIDS.
Effective office infection control procedures to prevent spread of the disease are as important today as they were 30 years ago when AIDS was first confronted.
This educational course is divided into two parts. The first part reviews current science related to the immune events associated with the oral route of transmission of the virus, new information on the pathogenesis of the disease, concepts related to the oral cavity as a viral reservoir for HIV, and oral pathology that is associated with AIDS. The second part deals with the practical clinical considerations that need to be addressed when treating the AIDS patient.
ANN-MARIE C. DEPALMA, RDH, MEd, FADIA, FAADH, is a Fellow of the American Academy of Dental Hygiene and the Association of Dental Implant Auxiliaries, as well as a continuous member of ADHA. She presents continuing education programs for dental team members on a variety of topics. Ann-Marie is collaborating with several authors on various books for dental hygiene and can be reached at [email protected].