Billing and Reimbursement Strategies that Work

Eight tips to help you get paid.

Updated 6/30/20

In her class called “Billing and Reimbursement Strategies that Work” at the Business of Dentistry Conference, Lois Banta taught several proven techniques for improving billing and reimbursement. She described how writing a detailed narrative, documenting in the patient’s chart, using dental coding systems to maximize reimbursement and developing the key communication techniques that win with insurance companies.

Here are eight tips to help you get paid for the work you perform:

1- Give patients responsibility for their own benefits. Don’t allow patients to depend completely on you for the accuracy of their dental benefits and the outcome of their dental claims. This should be a shared responsibility. Read “Helping Patients Own Their Insurance Benefits” for more information.

2- Get the correct information in the right order. When a patient initially calls the office, always ask the relationship-building questions first, such as, “Who may we thank for referring you?” and “Who was your previous dentist?” This lets the patient know you are interested in them and their dental care. Read “Preparing for the New-Patient Phone Call” for more information.

3- Collect at time of service. Be sure to collect the estimated balance due (after approximate insurance payment is calculated) at each appointment and explain that patients are responsible for all balances regardless of insurance payment outcome. Read “Are Your Collections Processes Proactive” for more information.

4- Use your dental software correctly. Let Dentrix work for you. Get ongoing training, whether live in-office or web-based. Knowledge is a powerful tool. Visit www.dentrix.com/training for more information.

5- Involve the patient in each step of the process. Always reassure your patients of your shared goal in getting them the optimum result. This is why you partner with them. The more your patients know about their dental benefit plans, the more they are able to help you help them resolve claims. Read “The 5 Things Never to Say to Your Patients About Insurance” for more information.

6- Be accurate. This is where dental practices stumble most often. Make sure you mark the appropriate boxes on major claims. Most dental benefit guidelines are very specific on what is required to accompany a claim on major dentistry, such as diagnostic film, photograph, initial or replacement. Read “Using Screen Capture for Claim Attachments” for more information.

7- Use the right codes. Chart the correct procedure code for each procedure you perform so you are paid for your work. But make sure the code you use is actually the procedure that was performed. Altering a code specifically to obtain a benefit is fraud. Read “How Does ICD10-CM Affect You?” for more information.

8- Track your claims. Every computer system has a report you can generate to track claims status. If you accept assignment of benefits, you must track your claims. They will not pay themselves, and the insurance company won’t contact you to let you know the claim is past due. Read “Follow Through for Successful Claims” for more information.


Learn More

Visit www.dentrix.com/solutions/billing-collections to learn about other tools to help you improve your billing and collections processes.


By Lois Banta, CEO, president and founder of Banta Consulting, Inc.

Lois Banta is CEO, president and founder of Banta Consulting, Inc., a company that specializes in all aspects of dental practice management. Lois has over 37 years of dental experience and consults and speaks nationally and internationally. She is also the owner of the Speaking Consulting Network, and a member of the Academy of Dental Management Consultants (ADMC), American Academy of Dental Practice Administration (AADPA), American Dental Assistants Association (ADAA), National Speakers Association (NSA) and American Association of Dental Office Managers (AADOM). To contact Lois for consulting or a professional speaking invitation, call 816-847-2055.

Originally published in the Dentrix eNewsletter, November 2012