Answers to insurance coding questions

Jan. 1, 2012
As a child asks an adult, “Why is the sky blue?” many dental team members ask similiar questions related to dental insurance ...

by Ann-Marie C. DePalma, RDH, MEd, FADIA, FAADH
[email protected]

As a child asks an adult, “Why is the sky blue?” many dental team members ask similiar questions related to dental insurance during many continuing education programs. Christine Taxin, a seasoned practice management consultant and speaker, answers these questions in her coding and insurance programs, “Beginning and Advanced Dental Medical Cross-coding” and “Advanced Methods for Insurance Claim Collections.” She answers similar to how she would answer the child: She doesn’t have the exact answer, but that through years of experience she has found that the coding methods she teaches, work.

Billing and insurance have changed over the years and are a constant challenge for many dental teams. Christine enables teams to think creatively regarding patient needs by taking a holistic approach to coding and patient insurance benefits. She encourages practices to learn about the cross-coding of dental procedures with medical codes for periodontal patients while promoting the medical model of care, including DNA testing and stem-cell storage, along with other cutting-edge modalities.

Christine realizes that many dental teams lack true team mentalities. Many team members have never been taught about billing and coding and see themselves only in a “back office” role where they believe that it is the “front office’s” responsibility for handling all of the business end of the practice, including insurance.

With today’s economy and dental practices, this is far from reality. All team members need to understand the basics of insurance and coding to be able to motivate and educate patients to enroll in the treatments that they need. Christine’s goal with her programs is to provide hygienists and dental teams with the tools that allow patients to complete treatments using the maximum benefits allowed.

Another program presented by Christine is “Working Together to Reach Your Goals in Difficult Times.” The course educates dental teams to view organizational issues in a different light. Sharing examples of the best practices from the business plans of companies such as Disney, Marriott, and Hilton, Christine identifies specific philosophies that dental teams can use within their own practices to achieve practice and patient goals.

All of her programs are presented in PowerPoint with extensive handouts that can be used the next day in practice. The strength of any of Christine’s programs is the exchange of information and discussions that occur as participants relate real-life stories and challenges.

Christine began her journey into the insurance realm while an administrator at New York City’s Mt. Sinai Hospital. While there, she learned that working with doctors to provide the proper diagnostic codes was a key to successful practice. She transferred this knowledge as a manager in a multispecialty dental practice and currently provides private practice consulting services through her firm, Links2Success. She offers teams ways to improve effectiveness and job performance while providing successful financial goals for the team and practice.

Christine received certified training from the Las Vegas Institute (LVI) and Coach Training Alliance and is a member of a number of professional organizations including American Association of Dental Office Managers, the Speaking Consulting Network, and the Academy of Dental Management Consultants.

Christine enjoys educating dental professionals on ways to maximize their skills and help patients afford the treatment they want and need. Empowering teams to lead and save lives while providing the latest that dentistry has to offer is Christine’s mission and passion.

For more information about Christine or Links2Success, contact her at [email protected].

Thought of the month: “Great adventures await those who are willing to turn the corner.” — Chinese fortune cookie.

The featured course this month is: “Dental Adhesives for Direct Placement Composite Restorations.” RDH magazine readers will receive a 47% discount using code AMJAN12 through the end of January 2012.

Dental adhesives used to bond composite resins to tooth structure have evolved over the last several decades. The earliest bonding systems required an acid-etch technique and were compatible only with enamel, and the challenge has always been to predictably bond to enamel and dentin simultaneously. There can be confusion as to what bonding agents are being described, because there are a number of different labeling categories.

With a simplified, logical category description, the clinician is better able to understand what each bonding agent is and how it is used. Bonding systems can in fact be differentiated into two distinct classes: etch-and-rinse and self-etch. Both classes of bonding systems work well as long as one understands which to use for different treatment conditions. There is no one universal bonding system that does it all, but recent advances in the chemistries of these adhesives allow many of them to be bonded to all intraoral substrates — to enamel; to dentin; and to all types of dental resins, ceramics, and metals. The key to success is to provide your patients with materials and techniques that you can reproduce to achieve the best, longest-lasting clinical results.

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. Ann-Marie is currently a business/clinical advisor for Jameson Management, Inc., a comprehensive coaching firm and also presents continuing education programs for dental team members on a variety of topics. She is collaborating with several authors on various books for dental hygiene and can be reached at [email protected] or [email protected].

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