CDT codes or Current Dental Terminology codes are standard codes for dental diagnoses and treatments. Insurance companies use CDT codes to allocate which dental procedures are eligible to get reimbursed as per the patient’s insurance plan.
Here’s where a dental insurance verification company can play a key role. These dental codes based on the CDT system ensure dental procedures are billed correctly. This accuracy reduces the likelihood of claim denials due to coding errors. It also offers a common standardized language for a dental practice, insurance organization, and the patient. A common understanding clarifies correspondence and communication regarding treatments and insurance coverage.
The dental team needs to understand and incorporate these defined codes. The codes need to be incorporated in claims sent to the insurance organization. The codes outline the treatment and services rendered to the patient. Based on the insurance plan and the coverage, patients can be informed about the plan benefits and out-of-pocket expenses.
Verification of patient insurance details is an important task that needs to be done at the earliest and before any treatment has commenced. The dental team needs to validate the patient’s insurance coverage and outline the benefits that are offered by the insurance plan.
This ensures that the patient is eligible for receiving recommended procedures and the practice gets reimbursed for services rendered.
The verification process involves collating and conforming essential patient data that includes the coverage period, policy number of the plan, insurance ID, co-payment requirements, deductibles, and pre-authorization requirements.
Using the right codes can be a challenge for the dental team. One must use the right code for the right procedure as using the wrong code while submitting the claims for reimbursement can cost the practice money due to claim denial.
Moreover, an incorrect code can result in a different reimbursement amount, This can increase the out-of-pocket amount that has to be paid by the patient, or the claim be denied which means a loss of potential revenue for the practice. One must note that even a typographical error can have significant consequences.
Confirming insurance coverage details of the patient in advance as well as using the right codes and terminology helps the dental team to raise accurate bills and considerably lowers the
probability of billing errors. The patient thus doesn’t receive any surprises at the time of payment and leaves the practice satisfied. Accurate verification and billing also impact revenue cycle management.
Inaccurate insurance information can lead to claim denials and this results in delayed or lost revenue for the dental practice. An insurance company relies on dental codes to ascertain processing and reimbursement of bills to the practice. Accurate verification helps to recognize issues and errors that can lead to claim rejections. Thus, the practice can lower the risk of claim denials and maximize revenue and reimbursement rates.
A deep understanding of codes ensures adherence to compliance demands set by the healthcare authorities. Inaccurate coding leads to claims being misrepresented and the possibility of the dental practice facing legal issues.
Validating insurance eligibility and benefits of the patient before providing services enables the dental practice to plan and allocate resources and render services effectively. It also simplifies the scheduling process while reducing the wait time of patients.
Technology can be used to utilize the right codes, streamline the verification process, and automate the billing process.
CDT codes are an indicator of diagnoses, procedures, and services that have been rendered into universal codes. This helps any dentist to bill the services undertaken accurately. Apart from an understanding of codes, accurate insurance verification of insurance plans benefits the patient and the practice.
