Create more cash flow

One of my favorite and most challenging jobs I ever held in the dental practice was Financial Coordinator. Not only was I responsible for maintaining a healthy Accounts Receivable, but also creating financial systems that were effective, efficient, and manageable. After working in the dental practice for more than 20 years, I am super excited to now teach these systems to you.

If you and your team will be attending The Business of Dentistry Conference this year, I will be teaching some of the systems I developed and have implemented into many dental practices. If you want a sneak peak into the courses I will be teaching, keep reading.

 

 

Even out the cash flow

Do you dread the day that you have to run statements? The mountain of paper that sits on your desk for three to four days while you sort through it, piece by piece, writing personalized messages or stamping a page with color-coded stickers to draw attention to the fact that the balance is past due. On top of that, the entire following week is spent fielding phone calls from patients with questions about their bills. Sound familiar? What if you could do away with this archaic routine? Well, listen closely … because I am about to tell you how. CLICK HERE to continue reading

Show me the money

Each week, I am amazed at how many offices I visit that not only are not using the Collections Manager Report, but don’t even know what it is. When I am working with an office on its collection routine, I always ask, “What are you currently using for your collection calls?” The typical answers are, “The Aging Report” or “The billing statements.” Crazy I say! CLICK HERE to continue reading

The Business of Dentistry Conference is only a month away and it is not too late to join me in my two classes and register for some of the other amazing learning opportunities that are available. CLICK HERE to be directed to the registration page.

 

ePrescribe . . . eKnowledge . . . eAccess . . . EHR

Our dental world is slowly changing from a world of pens and paper to a world of clicking and typing. Until now, the only state to mandate Electronic Health Records (EHRs) is Minnesota. However, many states will be following in its footsteps in the very near future. Having a paperless chart is more than just typing in the clinical notes or painting pictures on the tooth chart. It is about being able to coordinate your patient care with other providers and sharing information within the medical and dental communities. Even though this accessibility of patient information is still evolving, we as dental providers can start using what we have available right now.

Dentrix has partnered with Allscripts® to bring you electronic prescriptions. Being able to partner with your patient’s pharmacist will give you the ability to know potentially dangerous drug-to-drug interactions, drug allergies, dosage errors, and other problems that can occur with written or phoned-in prescriptions. This is what EHR is all about. Providing better patient care is why we do what we do.

If you have read any of my other blogs about going paperless, you know how much I stress efficiency. With ePrescribe, there are many features to create more efficiency.

• Speed the medication process when you send and track electronic prescriptions with any participating pharmacy
• Provide a seamless patient experience when you store pharmacy favorites by practice or patient for automatic prescription fulfillment before the patient leaves your office
• Improve patient safety with automatic drug interaction checking, dosage checks, adverse reaction checks, and duplicate therapy checks
• Access any information reported through the Surescripts network by other providers
• Simplify prescription renewals by receiving and managing refill requests from pharmacies online, with accessible patient medication history

ePrescribe is available now in all but four states (Washington, Oregon, Idaho, and Montana). There is no download or hardware required. It is a subscription model that is a web-based solution for your practice to send prescriptions electronically to retail and mail order pharmacies directly from Dentrix. The only requirement within Dentrix is that you must enable secure passwords to use it and be using Dentrix G5 or later.

CLICK HERE for more information or if you are using G5 click on the ePrescribe icon on the toolbar.

CLICK HERE if your office needs HIPAA training or a Risk Analysis.

Jump Start your Medical Billing

Last week, I wrote about how to set up medical cross-coding inside your Dentrix software. However, medical billing is not just about setting it up in Dentrix. Today, I am bringing in Christine Taxin, a medical billing and coding expert, to give you some information and resources that will help guide you through some of the insurance rules you need to know.

Dayna: If an office sees Medicare patients, what does the office need to know about the new rules with Medicare and the Affordable Care Act?

Christine: Attached is a Medicare information sheet that every dental office should have if they are billing medical. Medicare has rules, whether you are participating or non-participating, and you need to know what these rules are. For copies of these information sheets, please e-mail me directly at Dayna@raedentalmanagement.com.

Dayna: Where can offices find out more information? Where can they obtain the proper paperwork? What about all the other medical insurance rules? Is there anything new the offices should know?

Christine: If you want to start medical billing, you need to sign up for one of the Medicare formats. This allows you to bill secondary. If they have no insurance for any medical treatment besides Medicare, the legal issues are covered. I also added the Electronic Health Record (EHR) information that you can use for other information. For copies of these forms, please e-mail me directly at Dayna@raedentalmanagement.com.

Dayna: Under the Affordable Care Act, if the parents have medical coverage, their children (under the age of 19) are covered for a list of dental procedures. How does a dental office bill for these procedures? Do they bill dental or medical?

Christine: You should use the medical claim form. You can use the dental claim form, but it has to be the one with diagnostic codes (DX2012). You also have to mail or send electronically to the medical company. This is only for patients who have private insurance, not the marketplace. That is totally different and a doctor does not have to participate so he or she can refuse to either see a patient or bill for insurance. If you are already in network with an equal dental plan, such as United Health Care, then you are already signed up as an in-network provider.

Dayna: We all know that the 2014 ADA claim form has a place for dental diagnostic codes. How can the dental office learn how to use these codes correctly?

Christine: The DMB workflow sheet is how to set up for medical in-office. If you want to refer out your medical billing, you can do that through Dental Medical Billing, which specializes in dental to medical billing. You can find out more information at http://dentalmedicalbilling.com/or contact Christine at ctaxin@links2success.biz.

Note from Dayna: I highly recommend Jump Start Diagnostic Coding, written by Patti DiGangi and Christine Taxin. If you e-mail me for a copy, you can get the book for discounted price of $20. You can also e-mail Christine directly at ctaxin@links2success.biz .

Help patients say "YES" to treatment

When I was working in the dental practice, my doctor became passionate about treating the whole body and learning about how occlusion affected the rest of the body. With this continuing education, my office took a path of treating patients for head, neck and facial pain, as well as general dentistry. It was fascinating and, not only did I learn a lot about the human body, but also the world of medical billing.

What I loved most was being able to say “YES” to helping patients receive benefits from their medical insurance companies. This helped many patients be able to say “YES” to treatment because the financial burden was being spread out between medical, dental and the patient. Even though I found it very satisfying to help the patients, billing medical can be a little time-consuming and tricky.

If you are willing to jump in and learn something new, here are the steps to a successful implementation to billing medical insurance out of Dentrix.

First, call Dentrix at 800-336-8749, opt 1 to get to Dentrix inside sales. They sell a Medical Cross Coding CD for about $80 that will download all the CPT and ICD-9 medical diagnostic codes into Dentrix for you.

Now you can start to do the setup in Dentrix. Go to the Office Manager > Maintenance > Practice Setup > Procedure Code Setup. Here, you will see six tabs across the top (the first two are for dental billing and the next four are used for medical billing). After you have installed the medical cross coding CD, you will find information downloaded in these last four tabs. If you have not purchased the CD, this is where you will go to add the billing codes. On the ADA-CDT code tab, open one of the dental procedure codes that you will be billing to medical insurance. In the edit window, you must check mark “flag for medical cross coding.”

 

Next, go to the Office Manager > Maintenance > Practice Setup > Medical Cross Coding Setup. This is where you will tell the system which dental codes match up with which medical codes and the diagnosis that would be associated with it. You will need some knowledge of matching up the appropriate dental code with the correct medical code. If you want an info sheet on common cross coding in dentistry, please email me directly at Dayna@raedentalmanagement.com.

 

Now that your medical coding is set up in the Office Manager, you can add the medical insurance to the patient’s family file just like you would a dental plan … but make sure you are entering it under the Medical Insurance tab and you will select the HCFA claim format. You are ready now to send a claim. Double click on the procedure code you have posted on the patient ledger and you will now notice a new medical cross coding section on the procedure code box. You must select the appropriate codes for each box. When you click OK, you will notice there is a blue solid triangle next to the procedure code and this indicates it is cross coded for medical billing. Now click on create insurance claim and it will send out a medical claim first. After the medical insurance pays, Dentrix will automatically prompt you to send a dental claim.

Be patient. Medical reimbursement requires a lot more documentation, re-submissions and follow-up than a dental claim, so be prepared and make sure you keep your patients in the loop on the status. Don’t be afraid to ask your patients for help with follow-up or calling their insurance company (you might need it). With that being said, though, I feel that medical billing can be a huge value-added service for an office and your patients will be so happy you went the extra mile for them.

Is your email HIPAA compliant?

I recently attended the annual Dentrix Train the Trainer conference and, during the banquet, I sat next to the HIPAA compliance manager for Henry Schein, John Mertz. My commitment to you, my readers, is to try and give you new and relevant content, so while I was chatting with John I asked him, “Can I interview you for my blog?” and he accepted. 

Q:  John, being the compliance officer for Henry Schein, what are the top two HIPAA issues offices are asking you about?

Great question Dayna, and thank you for this opportunity.

The top two questions I get are: 1) What kind of paperwork do I need between Henry Schein and our practice to be HIPAA-compliant? 2) Is the email I submit from my office HIPAA-compliant when sending directly from Dentrix?

Q:  How do you respond to their concerns? Do you refer them back to their own legal team or do you have resources you can pass along?

It depends on what the concern is. To maintain HIPAA compliancy, it is very important to have a Business Associate Agreement between the practice and Henry Schein on hand. To make the process much easier for our customers (and Henry Schein), we have a BAA available that can be downloaded, from our website, where it can be printed out (for their records) and submitted online. One aspect of utilizing this BAA is that it will cover our customers for anything they utilize from Henry Schein (practice management software, eServices, eClaims, TechCentral, training, support, etc.), avoiding the need to have multiple agreements on file. Last year, Congress passed what is called the Final Omnibus Rule of 2013. Anytime there are significant changes made to HIPAA regulations, it is necessary to update the Business Associate Agreement. Our BAA has been updated to reflect the changes made to HIPAA and we strongly encourage our customers to contact Henry Schein if they have not yet renewed that agreement since the Omnibus Rule had gone into effect. If anyone is unsure whether or not their BAA is current, they are encouraged to contact Henry Schein Customer Support.

In regards to email, if you are transmitting any PHI (Protected Health Information) data, the short answer to that is “No, your email is not HIPAA compliant.” Our practice management software does not encrypt email. There are a several methods that can be utilized to protect email and patient data. We encourage our customers to consult with their IT staff, or whoever setup their network regarding email encryption. If there is no one available, Henry Schein has a department dedicated to hardware and network configuration (Tech Central) that would be able to assist with that as well.

Dayna, the only times I would refer a customer back to their legal counsel is if there are questions regarding what they should do internally to comply with HIPAA. Henry Schein is unable to consult customers on HIPAA compliancy. Every customer would have different needs and each situation will vary. We strongly encourage our customers to have a well-documented HIPAA security and privacy policy on hand and their staff trained on HIPAA at least annually. There are several great resources available that can be utilized to help answer specific HIPAA questions. I will list a few of them below:

Disclaimer: the following websites are listed as information only. I intend no endorsement of their content and imply no affiliation with the organizations that provide their content, nor do I make any representation or warranties about the information on those sites, which I do not control in any way.

• U.S. Department for Health and Human Services: http://www.hhs.gov
• U.S. Department for health and Human Services; Centers for Medicare and Medical Services: http://www.cms.hhs.gov/
• U.S. Department for health and Human Services; Office for Civil Rights: http://www.hhs.gov/ocr\
• U.S. Department for Health and Human Services; Office of Assistant Secretary for Planning and Evaluation: http://www.aspe.hhs.gov
• Council of Inspectors General on Integrity and Efficiency: http://www.ignet.gov
• Electronic Code of Federal Regulations: http://www.ecfr.gov
• U.S. Department for Health and Human Services; Health Information Technology for the Future of Health Care: http://healthit.hhs.org
• Health Information Technology Standards Panel: www.hitsp.org
• National Institute for Standards and Technology; Information Technology Library: http://www.csrc.nist.gov

Q:  What is your answer for email?  How can the office be HIPAA compliant with email?

This is certainly a common question. I would refer to the answer I have given above to address this inquiry.

Note from Dayna:  Corresponding with your patients via email is one of the most common questions I receive from offices. As John stated above, sending email the common way is not HIPAA-compliant. For some HIPAA compliant options for your practice, CLICK HERE to be directed to the resources page on my website.  CLICK HERE if your office needs HIPAA training or Risk Analysis.

Opting out of virtual credit card insurance payments

The issue of using a virtual credit card for insurance payments has not only become a frustrating situation for the dental practice, but also costs the office money they don’t need to be spending. My friend and colleague, Jennifer Schultz, who is owner of The Virtual Dental Office Manager, is also having the same issues with her offices. She recently wrote an article on the same topic, CLICK HERE to read it.

When I received one of these virtual credit cards for an insurance payment, I was like, “What the h*%# is this and how am I suppose to post it?” Since I needed my deposit slip to balance with payments and credit cards, I ended up posting a $0 payment to the claim and adding a note in the claim status notes that it was a credit card payment and how much it paid on the claim. Then I posted it as a credit card payment and also made a note in the payment that this was an insurance payment. If it is not critical for your office to balance the credit card total on the Dentrix deposit slip with your credit card batch, then you could post the virtual credit card as an electronic payment and then make a note on the claim that it was a credit card. What a pain!

I would highly recommend you try and opt out of this method of insurance payments because it is costing your office a merchant fee of 2-4% of the total payment that you don’t need to be spending. This could add up to hundreds of dollars per month of unnecessary fees for the practice.

You can opt out of this payment method by calling the insurance company and asking to be removed from this method of payment. See if you can opt for a direct deposit instead. After you have opted out with the insurance company, make sure you follow up with the merchant that issued the credit card payment to see that it was done. Hopefully by making these two phone calls, you can avoid these virtual credit card payments in the future.

 

 

 

Success with your dental software implementation and training

 

Dental Software Advisor’s podcast series focuses on software technology topics relevant to dental users. In this interview with Dayna Johnson of Rae Dental Management, a longtime industry implementation and training expert, we have a frank discussion of software implementation ands how to build acceptance and increase rewards for using appropriate technology.

 

 CLICK HERE TO LISTEN TO PODCAST

One of the key topics during software implementation is to identify fears around software implementation and work to figure out what can be shifted to improve efficiency and reduce frustration. Solutions come from incorporating many different strategies.

 

For any dental practice implementing new technology, this discussion will cover common issues, frequent mistakes, and how to make the process easier and more complete. Efficiency, consistency and protection are the mantra Dayna Johnson uses for successful software implementations.