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Module 1:
Introduction
Goals Essay
Aptitude Quiz
Training Your Patients
Discussion of Fees
No Surprises!
Phone Conversation
New Patient Objection
New Patient Emergency
Change in Procedure
Agreement Documentation
Educate Your Patients
Module 2:
Confirmation of Benefits
It is Your Responsibility
Calling the Carrier
Typical Conversation
Win, Win Situation
Confirmation of Benefits Form
Confirmation of Benefits Review
Module 3:
How To Utilize Information Obtained
Log of Actual Payments
Estimation of Benefits - Actual Allowance is Not Available
Alternate Benefit Provision
Module 4:
Valid Financial Agreements - A Term Approach
The Doctor's Approach
Documentation
The Difficult Patient
Financial Information For Our Patients
Module 5:
Effective Fee Presentation = Increased Case Acceptance
Sample Fee Presentation Form
Collection Letters
Module 6:
The ADA Claim Form (2006 version)
Header Information
Insurance Company - Dental Benefit Plan Information
Other Coverage
Policyholder - Subscriber Information
Patient Information
Record of Services Provided
Authorizations
Ancillary Claim - Treatment Information
Billing Dentist or Dental Entity
Treating Dentist and Treatment Location Information
Insurance Release - Authorization Form
Module 7:
Positive & Willing Approach
Outsourcing Customer Service
Dealing with a Carrier Rep
Negativity in our Profession
Module 8:
Select the Proper ADA Code for Maximum Reimbursement
Alternate Benefits - Posterior Composites
Alternate Benefits - Replacement of a Missing Tooth
Alternate Benefits - Crown or Inlay / Onlay Restoration
Alternate Benefits - Porcelain Fused to Metal Crown on Post.Tooth
Use of "Pay Codes"
Results of Insurance Fraud
Last Word
Procedure Codes that Directly Affect Benefits
Module 9:
How to Eliminate Most Pre-determinations - Stall Technique
Additional Verbiage
Psychological Aspect
Pre-authorization or Pre-approval
Most Common Smoke Screen
Is Pre-determination Mandatory?
Grey Area of Coverage
Module 10:
How to Maximize Cash Flow by Avoiding Unnecessary Delays
Perio Treatment
Fillings
Endodontic (Root Canal) and Endo Related Treatment
Crown Build Ups
Crown - Permanent - Single Restoration
Fixed Bridgework
Implants and Implant Supported Prosthesis
Removable Prosthesis - Full or Partial Denture
Bite Therapy
Orthodontic Treatment
Oral Surgery
Provisional or Temporary Prosthesis
Module 11:
Take the Guesswork Out of Billing for Periodontal Services
Patients Must Take Ownership of their Problems
Getting Past the Smoke Screens
Periodontal Case Types
ADA Codes - D1110 - D4341 - D4342
ADA Codes - D4355
ADA Codes - D4910
ADA Codes - D4999
Educate Your Patients
I Have Periodontal Disease - What Now?
Estimate Insurance Benefits
Module 12:
How to File with Multiple Carriers
Lost Insurance Dollars
Determine Primary and Secondary Liability
Determine Primary and Secondary Liability - Divorced Parents
Determine Primary and Secondary Liability - Patients Coverage
When More than Two Carriers are Involved
Estimated Benefits - More than One Plan
Estimating Benefits
Module 13:
Effective Insurance Management
What to do with the Claim?
Example
Follow-Up
Review an EOB
Resolve the Problem
Appeals
Completed Claims
Module 14:
Knowledge
Attitude
Patience
Persistence
Acknowledgement
Sample Letter
Reply Letter from Cigna
Module 15:
Our Responsibility
Traits You will find Helpful
Negative Handling of an Insurance Claim
Positive Handling of an Insurance Claim
Can I Make a Difference?
Course Evaluation
Final
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