The dental insurance industry is such a unique niche market. There is not an actual school, university, or even trade school that one can attend to learn dental insurance specifically. Medical billing tends to have more Healthcare certifications and degrees qualifying those in the medical field. The dental field is however limited in the field of study and is ultimately limited to industry experts for training.
Unfortunately, there is no requirement, certification, or degree necessary to process dental claims. Most dental practice business team members have limited experience and knowledge in the area of dental coding and dental claim administration. By limited experience, one may have been in the industry for 15, 20, 25+ years however had no formal training when it comes to understanding the ins and outs of dental insurance. They may have the knowledge to get claims paid for their office, but limited experience in that particular office or two to five offices they may have worked in over their career. The dental insurance industry is known for its self taught team members who have learned through trial and error and/or prior experiences with previous team members. Processing claims their way may be fine for some practices, but a lot of the time their way is not the correct and ideal way to post payments, adjustments, write offs, as well as handling dual insurance properly.
The good news is that the industry has some great teachers and leaders that ALL dental practices can benefit. Sending an Office Manager or Insurance Coordinator to attend a class or webinar is not only suggested, but HIGHLY recommended. While there are many speakers and educators with knowledge of dental coding and billing, there are two that we here at Dental ClaimSupport highly recommend. Each of these speakers provide invaluable information and resources. The world of dental coding and insurance administration is constantly changing so it is imperative that you stay up to date.
- Dr. Charles Blair – Dr. Blair has authored several publications on dental insurance from coding to administration. Dr. Blair’s knowledge and expertise is considered to be the “Gold Standard” by many in the industry and his CDT coding book is often referred to as “The Blair Bible” by most. The books are titled Coding with Confidence, Administration with Confidence, and Medical Dental Cross Coding with Confidence. The books are updated each year as procedure and diagnosis codes are updated each year. Along with the books, The Insurance Solutions Newsletter, a bimonthly publication is also published by Dr. Blair. The newsletter has a number of regular contributing authors such as Dilaine Gloege,CDA, CPC and Glenda Hood, MA, CPC and is a must have resource for all dental practices. Dr. Blair is also the founder of PracticeBooster.com, his online coding and insurance resource and is available to dental practices by subscription and includes a subscription to Insurance Solutions Newsletter. This information can be found on Dr. Charles Blair’s website. https://www.practicebooster.com/store.asp
- Teresa Duncan – Teresa is a terrific dental insurance speaker, author of Moving Your Patients to Yes: Easy Insurance Conversations, and podcast host of “Nobody Told Me That!” She is also a member of the Academy of Dental Management Consultants. More information can be found on Teresa at her website. http://www.odysseymgmt.com/about
It is imperative for a practice to provide resources and educational opportunities for your team members on a regular basis. Invest in your team members to ensure coding and insurance administration compliance.