The correct and timely reimbursement of the procedures done is one of the important aspects of managing a dental practice. Here is where medical billing services of OMS will come in really handy. OMS (Oral and Maxillofacial Surgery) billing services also bear the advantage of giving the dental surgeons the opportunity to concentrate on the treatment of the patients and leave the administrative part of the task to a professional staff.
This paper shall discuss the significance of OMS medical billing services, function of dental billing and coding services, and their role in ensuring effective management of a dental practice. We will also learn how outsourcing of the services could lead to greater profitability and productivity of the practice, claims denials, and generally enhance patient experience.
How to predicate OMS Medical Billing
Oral and maxillofacial surgery (OMS) is a segment of dentistry regarding surgeries, which refer to the mouth, jaw, face, and neck. OMS practices are complicated and in most cases they need accuracy and superiority of both the medical procedures and dentistry. Whether it is an extraction of the tooth to the jaw operation, the procedure demanded its own coding, records and billing to guarantee that it was suitably reimbursed.
The OMS medical billing services will consider the billing and coding of these surgeries. They make sure all the procedures are properly written and coded to the industry standards such that the dental surgeons receive payment in time and in the correct way. Such services deal with the following:
Checking insurance cover: Such insurance checks are done to ensure that the procedures are carried out with the insurance cover of patients verified.
Medical coding: The assignment of appropriate codes on every procedure employing the related billing code sets such as the ICD-10, CPT and HCPCS.
Claim filing: making correct and on time claims to insurance companies.
Follow up and denial management: When a claim is denied, there is the need to manage the denial and re-file the claim to get payment.
Revenue cycle management: Management of the billing and payment process in totality
This is because with efficient OMS medical billing services, dental surgeons are assured of payment of their work accurately, reduce delays and elimination of billing errors which may result in claims being denied.
The Dental Billing and Coding Services Role
Billing and coding of dental care are part and parcel of a dental practice. The provision of dental billing and coding services is aimed at the effective classification and filing of dental claims to the insurance companies. This is aimed at making sure that the dental treatments are properly recorded and the insurance claims are taken up effectively.
Dental billing is taking care of all of the financial transactions concerning the patient. This involves all the basic insurance details verification and pre-authorization as seen as well as making claims and handling payments. Dental coding on the other hand deals with the assigning of particular codes to procedures and services based on standardized codes with the following being examples:
The code sets of CPT (Current Procedural Terminology) are used as code sets.
AC00.6XAX.B71.9X C72.9XA3.X74.9XA5.XA7.X7D.XA8.XA9.XBXC7C10C12C13C16 X17C20C21C22C23C24X C25.X C 26.X C27.X C28.X C29.X C30.X C31.X C32.X C3
Codes used in healthcare, known as HCPS = Healthcare Common Procedure Coding System.
Dental code system ensures that procedures are strictly outlined and this is one of the reasons why the insurance companies are able to know what kind of treatment they are offering. Billings and coding properly reduce the errors and they stand a better chance of a successful reimbursement process.
Although most general dental practices can handle most simple procedures, the dental billing and coding services are particularly significant to the specialists such as oral surgeons, who, in many cases, have more complicated procedures and require more specific codes.
The Differences between OMS Medical Billing and General Dental Billing
Although general dental billing and coding include the most frequent operations such as cleanings, tooth fillings, and regular checkups, the services of OMS medical billing are specially adapted to the oral and maxillofacial surgery that may include complex operation. These are services that demand thorough knowledge of the dental and medical insurance policies which is essential because of the following reasons:
Complexity of OMS Procedures
OMS treatments usually entail complicated treatment procedures which may include:
- Wisdom tooth removal
- Bone grafting
- Dental implant placements
- Facial trauma repairs
- Orthognathic surgery
All these demand special medical codes and medical records and OMS medical billing services are much more specialty than general dental-based billing. As the example of an oral surgeon, some procedures might require him to resort to medical code instead of dental codes. This would need a billing service that has specialized knowledge in the field of medical billing systems.
Communication with Medical Insurance
OMS procedures seem to be in contrast to general dental services which mainly can relate to dental insurance. The agencies of medical billing need another system of codes and procedures that dental billing has. The presence of a sound OMS medical billing service will make sure that dental insurance as well as medical insurance policies is synchronized towards making sure that medical procedures by patients are paid accordingly at the right rates.
Accurate Code Assignment
One of the issues facing the OMS billing services is the proper coding of complicated procedures. The scope in oral and maxillofacial surgery is usually a combination of dental and medical care i.e. there are many codes that can be used to treat the same. This intricacy requires professional skills in a coding system such as ICD-10 and CPT as well as the understanding of the specific demands of a particular insurance company.
Outsourcing OMS Medical Billing Services Advantages
OMS outsourcing medical billing services will be of a great help to dental surgeons, since they can concentrate on delivering top quality care to the patient, as the administrative work is to be outsourced to the professionals. The following are the key advantages of outsourcing OMS billing:
Better Quality of Accurate Results and Adherence
Miscoding and inaccurate billing may result in the rejection of claims, payment delays and may even result in lawsuits. The probability of mistakes is enhanced when it comes to complex surgeries and it is important that dental surgeons pay special attention to billing specialists that would have special knowledge of dental and medical codes.
By outsourcing to a dedicated billing group, the appropriate codes are employed, insurance regulations adhered to and government regulations (such as HIPAA) are also upheld. This will reduce the occurrence of errors and make claims quick and efficient.
Reduced Claim Denials
One of the causes of claim denials is incorrect or incomplete coding. The medical billing services of OMS have a plethora of experience in operating with different codes and requirements that are required to minimize the claim rejection. They are also skilled in the process of filing correct claims and tracking refusal, and this will mean quicker payments and fewer administration woes on the part of the dental surgeon.
Enhanced Cash Flow
Billing services can be a lot better with outsourcing that will cause a dental practice to have improved cash flow. With the submission of claims on time, proper coding and prompt follow ups, the unresolved claims, a dental surgeon is likely to get paid faster, which in effect increases the revenue cycle of the surgeon.
Cost-Effective Solution
Receiving the in house billing staff would also incur extra overhead costs in form of salaries, training and benefits. Outsourcing OMS medical billing services would enable dental surgeons to save these expenditures and pay the services when they are in need. This renders outsourcing a very economical way of solving a problem, particularly among the solo practitioners and small dental practices.
Focus on Core Competencies
Billing and coding may be time consuming and divert the activities of a running a dental practice. By outsourcing this, dental surgeons will be able to concentrate on giving high quality care to their patients and this will increase patient satisfaction and expansion of the practice.
Knowledge in the management of Complex Claims
OMS billing is associated with complex claims because oral and maxillofacial surgeries are complicated. A billing service specializing will be qualified to do such intricate claims and make sure that such claims are addressed properly. Focusing on bone grafting, facial surgeries, dental implants, and so on, these professionals are aware of the exact billing requirements of a corresponding procedure.
The selection of the Medical Billing Service of Right OMS
When deciding on which OMS medical billing service to select, it is necessary that some characteristics are sought that would make sure that the service is capable of addressing the needs of your practice that are unique to that practice. The themes of some consideration include:
OMS Procedures experience
Make sure that the billing service experience is on any one OMS procedures. The technicalities of the oral and maxillofacial surgery demands special knowledge hence collaboration with a service that understands the specific field is paramount.
Current Experience with Billing Codes and Guidelines
The code of medical and dental billing is under constant change. The right OMS billing service will maintain itself with the new coding systems and regulatory changes in order to keep all the claims in compliance and accurate.
History of claims that were made successfully
Research a billing service that has satisfactory history of handling medical billing claims of oral surgeons with great success. The service must also be well-known in terms of decreasing denials and making sure that claims are handled in the shortest time possible.
Openness and Inter-Apprehension
It is important to communicate with your billing service well. Select a provider, which will provide Internet openness in relation to its operations and can be approached to inform you or to inquire about something. Consistent communication means that you are always aware of the financial performance of your practice.
Cost of Services
Although outsourcing may be cost-efficient, you should always take into consideration the pricing base of any OMS medical billing service that you are planning to engage. Make sure that the price is just within your budget but the quality and reliability is what your practice needs.
Conclusion
In our busy schedule dental surgery, dental surgeons should aim at providing quality care to the patients. The administrative side of billing and coding, however, can be easy to lose track of time-wise. This is where the OMS medical billing services would enter the picture and will be a crucial solution to dental surgeons.
When the dental surgeons pay a professional billing service, they are likely to enjoy an enhanced precision, a decreased number of claim rejections, and better management of the cash flow as the overhead expenses are reduced to a minimum. Through collaborating with a renowned OMS medical billing service, dental surgeons would be able to make sure that its financials are running efficiently and they have more time to look at what matters and offer excellent care to the patient.
The dental billing and coding services are a component and necessary component in this process and the various procedures are documented correctly and reimbursed as required. The sophistication, efficiency, and progressive billing approach of outsourcing allow attaining the desired levels of profitability and efficiency at the practice of any dental surgeon.