Navigating the New Era of Dental Billing - Leslie Icenogle

Dental billing is an ever-changing process. As a dental provider, how do you stay on top of changing regulations and coding? Do you outsource your billing? Leslie Icenogle joins me today to talk about medical billing for dentistry and where it overlaps with dental billing. We also chat about outsourcing your billing and continuing education for your staff. 

Leslie got her start in pediatric dentistry over 30 years ago and has worked in oral surgery for 32 years. She has extensive experience dealing with medical billing and started teaching dental practices how to integrate medical billing. After a couple of years of being asked to take on the work herself, Insurance Billing Outsourcing was born.

Outline of This Episode

• [0:30] Leslie Icenogle’s background in dentistry
• [3:05] ICD-10 Diagnosis in Dentistry
• [8:00] SOAP notes: subjective, objective, assessment, and plan
• [10:45] How do you make the process easier? 
• [13:50] Compliance and cash flow go hand-in-hand
• [16:15] Outsourcing is sharing liability
• [22:20] Cleaning up your billing practices
• [26:05] High turnover in billing positions
• [27:55] Connect with Leslie

Understanding medical billing in dentistry

Dental and medical billing is at a crossroads, where many things will now be required to be billed to medical insurance primary to dental insurance. Many states already require claims to be submitted with the proper ICD10 coding in place. You’ll begin to see (or continue to see) dental insurance denying claims because they were looking for denial or payment from the medical insurance first.

A lot of treatment that dentists could be billing is not being billed—which is a win for the medical insurance and a loss for you.

It will be a learning curve to understand how to begin coding these claims properly. This is where Leslie would step in and offer proper training to your staff. You must learn how to correctly file with the proper attachments, write letters of medical necessity, and learn how to properly read Explanation of Benefits (EOB’s). If this is something you’re not ready to implement completely, consider outsourcing to a company such as Leslie’s. 

SOAP Notes: The importance of documentation

The ‘SOAP’ acronym stands for subjective, objective, assessment, and plan. It is a note-taking system that your practice will need to begin implementing. Medical insurance is all about documenting the details. If you’re doing anything other than a simple cleaning, they want to know why the patient is being seen.

What is the chief complaint? How did it happen? What is the history of the illness/issue and was it properly treated? Document their HPI (History of Present Illness) extensively. 

Your notes must be clear and detailed. Leslie and I both recommend creating a template where you can input the proper patient information. It helps simplify the process and keeps you consistent.

Clean up and simplify your dental billing

As Leslie has worked in the field, she’s found that most dentists are receptive to her feedback or criticisms. After all, the entire goal of cleaning up your billing and learning new processes is to increase cash flow! There are a few ways you can clean up your process as you’re learning the new coding:

• Create a template that allows you to easily input a patient’s information and history.
• Verify benefits for the medical and dental insurance on the front end, and do so correctly. 
• Assign someone—perhaps your office manager—to conduct an audit of patient files. They can assess if the notes are detailed enough, if the insurance was verified correctly, and that the claim was filed properly.

Is the person handling the billing truly able to dedicate all of their time to it? Or are they being pulled in different directions? Another option you can consider to reduce the burden on your staff is to outsource billing.

Invest in education for your billing team

If your practice has designated billing staff—take good care of them. Leslie and I see high turnover rates in billing positions. Often, it’s due to improper training (or lack of training). You must invest in continued education for your billing staff and not let them fall to the wayside. We recommend implementing training annually. 

This allows your staff to stay up-to-date on the changing rules and regulations in medical and dental billing. It also properly equips them for their job. Ignorance is NOT bliss and your practice could be hemorrhaging money. Spend a little money on the front end on training to amplify the cash flow coming in from proper billing. 

Leslie and I talk about the benefits of utilizing ICD-10 coding and why you shouldn’t resist it. Don’t miss this engaging episode of Talking with the Toothcop!

Connect With Leslie

• Leslie on LinkedIn
• Insurance Billing Outsourcing Website
• Call IBO at 317-565-4988
• Leslie(at)USEIBO.com

Resources & People Mentioned

• ADA Lawsuit against Delta Dental
• ICD Coding in Dental Claims

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube