Answers to: Medical Billing Commonly Asked Questions

Let’s dive into the answers on medical billing commonly asked questions. This article will help you understand how medical billing can help your patients get the treatments they need while simultaneously helping your practice get the reimbursements it should.

Most practices are surprised to learn that medical billing can help their dental practice to achieve more revenue and reduce overhead by helping patients provide more financial options. Those in dentistry have been discussing medical billing commonly asked questions for what seems like decades. Unfortunately lots of confusion and bad experiences still linger in this subset of the industry. As a leading medical billing company handling claims to get medical reimbursements with dentists across the nation, Onemedall has reason to raise our voice and clarify the misconceptions and inaccurate answers regarding medical billing commonly asked questions.

“Medical Billing Is NOT just to make more Money, It’s a way for Dentists to treat patients’ overall health not only focusing on just teeth.”
– Kim Lee, CEO OneMedAll

Medical Billing Commonly Asked Questions: Can Dentist Bill Medical Insurance, How?

The Medical Insurance reimbursement process is very important to understand before you can start your own integration of Dental treatments billed to Medical in your dental practice. Just like how you have learned about human biology before learning dentistry, Medical insurance covers the benefits of the insurer’s health head to toe.

The 10 Essential Benefits in
Billing Medical Insurance.

Outpatient care, Prescription Drugs, Pediatric Services, Preventative care, Laboratory services, Emergency services,Hospitalization for surgery, overnight stays, and other conditions,Rehabilitative and habilitative services Pregnancy, maternity, and newborn care.

Dentists qualify in the category of OUTPATIENT CARE  “Office of Physician and other health Professionals”. Medical Insurance is the reimbursement system for all licensed Physicians diagnosing and treating patient’s health under the scope of their specialties when billing medical insurance.

Yes, Dentists can bill medical Insurance. Mouth is part of the head, and the head is part of our body.  

Yes, Dentists can bill medical insurance as a physician of the mouth.

Under the federal law;SEC. 2706. NONDISCRIMINATION IN HEALTH CARE. The Federal health care law states the following:

“(a) PROVIDERS. A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.

Doctor’s of Dental Medicine and Doctor’s of Dental Surgery are specialties that meet all state & federal government requirements as a Physicians

Medical Billing Commonly Asked Questions: What Is the Scope of Dentistry for Medical Billing?

According to the ADA, (American Dental Association) the description for Scope of Dentistry is “the evaluation, diagnosis prevention and/ or treatment (Nonsurgical, surgical related procedures) of disease, disorders and/ or condition…”

In the Medical world that is the work you do in the musculoskeletal system. and under that section, you find the mandible and skull. Who better to do work in the maxillary, mandible, sinus and tissue of the mouth than a DDS or DMD.

“I started looking into medical billing because I felt guilty turning my sick patient’s away simply because I was not taking the only coverage they had “medical insurance”.
– Dr.A Materia in Chicago

Medical billing is not about how to find the best ways to get paid more, it’s more about how to find the best ways to expand the specialty of dentists to serve the patients, because no other professions are licensed to do so.

Medical Billing Commonly Asked Questions:
How to determine the appropriate protocol for Medical Billing? And, what is Commonly Billed ?

Medical billing is not What but Why and How you do the procedures that determines the diagnosis. The most commonly billed and best reimbursement for scope of dentistry is probably BoneGraft on Lower Jaw, if you were to ask.

CPT(Current Procedural Terminology) Code 21215 describes the procedure as; Graft of Bone to Mandible. CMS(Centers for Medicare and Medicaid Services) has an allowed fee of $5,400.00/ per units and paying up to 2 units. 

Can all bone grafts you place be appropriate to bill for medical insurance?

NO! The medical necessity and evidence of why the dentist has diagnosed the “Bone Graft”  and how performing the procedure will better the patient’s overall health will be required.

There are more procedures that can be billed to medical insurance including: Exam,Consult, CT, Pano, Trauma/Accident, Surgical; and non-surgical, Appliances and medical equipment, Process of the Surgeries, Osteotomy, Bone Grafts and related procedures, Osteoplasty-Facial Bone, Sinus, Denture/Stayplates, Cover the surgical site,etc. 

Medical Billing Commonly Asked Questions:
“How does medical billing work in dentistry?”

Medical billing is for physicians of the Mouth providing the best resources to patients not only clinically but financially. Being able to implement these services ensures patients can come in, receive treatment, and move forward without risking not just their oral health but overall health.

A dental practice shouldn’t have to turn the patients away because they are simply not accepting medical insurance. Think about how many patient’s lives can you save tomorrow by offering better financial options for your patients. If you’re dealing with sick patients in the scope of your specialty and finances is the only reason you’re tuning those patient’s becoming a provider who can accept and bill medical insurance will definitely help.

It seems that implementation of the process in dealing with medical insurance is confusing, and some doctors might have had bad experiences. To avoid this happening in your practice, we suggest not delegating these particular tasks to someone who may not be familiar with medical billing (such as your office manager). The best recommendation we can make of course is outsourcing your medical billing and coding needs to a company that has experience with medical billing for dentists. Find a company who shares the same passion and beliefs as you do in providing medical billing in your dental practice.

To learn More about the best ways to grow your practice Get our FREE 43-page report. As always, remember to practice smarter and live better.


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