News — Compliance Training
I tell all my clients to devise a system to track their credentials and their team members' as well....all of them. Dentists can be disciplined by their state Dental Board, disqualified by insurance companies, excluded from participation in government programs (Medicaid), even criminally prosecuted for practicing with expired credentials. While Dental Assistants and Hygienists are required to maintain their own licensure, Dentists can be disciplined for allowing them to practice with expired credentials, so, for this reason, it is essential that every staff members' credentials are carefully tracked and renewed promptly.Track the following: 1. Dental license2. Medical license (if applicable)3....
Daily perspective (pre-bill) audits help identify and minimizes billing errors by ensuring the accuracy of claims before they are submitted. This step alone can help compliance programs pay for themselves. Periodic retrospective audits involve the detailed review of clinical and billing records for compliance with state and federal recordkeeping and billing requirements. Some items to check include verifying the quality and quantity of radiographs, consent for treatment, proper coding, clinical notes to support each claim that was billed, and medical necessity.
My mantra is: “If It Is Not Written, It Did Not Happen!” Record audits must be documented. In the face of a fraud allegation this documentation can help your defense attorney make their case.
If the government and third-party payors know you maintain an effective compliance program and have your ducks in a row, you are less likely to get picked on in the first place! We have seen it happen.
If you are an administrator or compliance officer for a dental practice and you are looking for solutions to concerns that keep you up at night or you’re looking for an ally for support or an existing compliance program or you are looking to develop a compliance program, but don’t know what to do or how to go about it, we will love to have a chat with you.