News — Dental License

Cyber security threats are continually evolving and they pose a very real and significant threat to dental practices. Ransomware is malicious software that takes over a victim’s hard drive when they click on an infected advertisement, email, attachment, or website and encrypts the contents of a device – and any other connected electronics – which the hacker then demands bitcoin or cryptocurrency payments to unlock. With an adequate data backup, you may be able to recover from a ransomware situation, but you will still have a mess to deal with. The HHS-Office for Civil Rights (OCR) is the federal agency...

More practices today are use electronic dental records. There are certainly pros and cons of doing so, which is beyond the scope of this blog post. What is important is that the software used today allows providers to template their notes, which are often necessarily-detailed. The problem with using templates, especially those with pre-populated answers are whether the answers accurately reflect the patient presentation, diagnostic test results (i.e. x-rays), the dentist’s findings/recommendations, and (ultimately) treatments provided. If yes, great! If no, oh no!

Physician practices and hospitals routinely audit for compliance, risk management, revenue cycle and quality of care issues.  They don’t necessarily like it, but they’ve settled into the routine of doing it to minimize their losses in the ever-increasing fight for dollars between providers and payors. Sadly, few dental practices audit patient records. A lot can be learned from auditing including identification of incomplete or inadequate documentation and/or paperwork, missed billing opportunities, issues that can result in recoupments (even criminal prosecution), and a host of other issues.   A dentist’s work is only as good as his records. It is said...

Okay folks – we need to talk about your data backup.   Dental offices, as covered entities, must meet Implementation Standards to get in compliance with the HIPAA security rules. There are two types of implementation standards: required and addressable. Required means it must be done and there is only one right way to do it. Addressable means it must be done, but you have options. However, if you aren’t going to do it, you must document in writing why. Substantiate. Substantiate. Substantiate.   Backing up your data (the act/action) is an addressable implementation standard. You’ve got to do it,...

As you can see from the title, today’s discussion centers on dental claims, which are utilized to seek reimbursement for services rendered.    Under the HIPAA Transactions and Codes Sets Rule, dentists are required to use a designated code set for billing purposes. These codes are the ADA Current Dental Terminology.   Under the HIPAA Unique Identifier Rule, dentists and physicians are required to obtain and use a National Provider Identification (NPI) number for professional purposes, which is like a professional social security number.   The ADA established a uniform claim submission form which is commonly used for claims submission...