Menu
Cart

News — Recordkeeping

A Case for Auditing Your Dental Records

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...

Read more →

What Medicaid Dentists and DSOs Need to Know About Corporate Integrity Agreements

When a dentist or DSO (or any other healthcare entity) get busted for Fraud, Waste or Abuse (FWA) issues the government may decline criminal prosecution in favor of a civil settlement known as a Corporate Integrity Agreement (CIA). There is much to unpack about CIAs. Here is what I know: Corporate Integrity Agreements have become a favorite tool of the federal government. You can gain valuable insights on how to protect your practice by reading CIAs (and other government enforcement actions). Every CIA includes requirements that the organization incorporate the OIG’s seven core elements (8 if you're a New Yorker)...

Read more →

Do Your Claims Say "Liar, Liar Pants on Fire?"

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...

Read more →

What is your Medical History Policy?

As healthcare practitioners, dentists may be the only doctor some of your patients may see. This is a great opportunity for you to connect with your patients about what's important to them. Written review of medical history, like treatment consent, can seldom be over-documented. This is another issue where state boards may differ.As a general rule, I suggest you and your staff update patient medical histories prior to performing any clinical procedure. This also applies to orthodontists, who often believe they are exempted because they don't perform invasive procedures. Keeping updated medical histories can help prevent terrible medical tragedies. Know your patients' health...

Read more →

Consent Considerations

How often do you and your staff obtain a new written informed consent for treatment? State laws vary some, but let me throw this out there.... I frequently see dentists disciplined for not having signed consent when they should have had it. Conversely, I have never seen a dentist disciplined for having consent forms signed for every clinical procedure (or too many consents). When in doubt as to whether or not you need consent, err on the side of caution and get it!Some principles to remember about consent: Always get consent in writing Consent forms should give patients enough information to...

Read more →