Red Flags to Check for On Claims, TP, & Schedule
Each treatment plan and claim should be checked for these items. While this may seem time consuming and complicated, it will prevent many problems and save a lot of time for us and our patients.
Treatment Plans
Amounts
- Is the insurance paying something for each item?
- Is there a write-off for each item? (except UCR)?
Sealants
- Not covered on adult teeth
Children
- If age four or under should they have Nitrous?
Sedation
- Does this Patient need tasked to the sedation specialist?
Claims
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Pano’s:
If a patient gets one before they are eligible and billing with BW’s, then split off, mark received, and write off today.
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XRAYS:
Only if radiographs are not covered due to frequency, adjust the procedure using a ‘courtesy’ adjustment for the patient portion amount.
Schedule
Tetris Schedule: for 2-3 weeks out
Look for Follow-up items
- Labs: space maintainer, etc.
If appointment is over 90 minutes or services more than 2 family members.
- Leaving a message is not good enough, we need confirmation.
- Remind patient that because of length or the number of people. A missed appointment fee can be more than $100.