Outsource Strategies International (OSI) is dedicated to providing dedicated dental insurance verification services. With us, practices can get their verifications done 3 to 5 days ahead of schedule!
In today’s podcast, Amber Darst, one of our Solutions Managers discusses the importance of verifying insurance benefits for root canal procedures.
Podcast Highlights
00:45 Is Billing for Root Canals Complex?
01:48 Importance of Insurance Verification
Read Transcript
Hi, this is Amber Darst, Solutions Manager for Managed Outsourced Solutions and I’ll be discussing the importance of verifying insurance benefits when it comes to root canal procedures.
Root canal therapy is a treatment that is used to repair a badly decayed or infected tooth. The steps to completing a root canal are to take an X-ray of the affected tooth, administer local anesthesia, create a sterile environment through a dental dam, drill the affected tooth, removed the dead pulp tissues and nerves, disinfect the inside of the canal, shape the affected area for filling and then apply the filling.
00:45 Why Billing for Root Canals is Complex
Billing for root canals can be a bit complex. There are different codes to report different locations of the teeth affected, also while sometimes a filling is enough to complete the root canal, oftentimes a tooth may need a much larger fill, which is called a core build up along with a crown. If the tooth does need a core build up in crown, this typically means extra visits to complete the procedure.
Understanding the coverage for a root canal, core build up or crown is very important. It’s also important to know when you are allowed to bill for these additional procedures. For instance, oftentimes an insurance won’t pay you on a core build up, if it’s placed the same day that the root canal was completed. They’ll consider it inclusive to the procedure. And then for a crown, most insurances will only pay according to the seat date and not the prep date. These details can make all the difference in your reimbursement.
01:48 Importance of Insurance Verification
The best way to ensure you’re getting the highest reimbursement available is to have your patient’s coverages checked ahead of their appointment. By knowing what their insurance will cover in advance along with any exclusions or limitations, you can work out payment options with the patient and collect any uncovered portion up front.
Hiring an experienced dental insurance verification specialist to get the most comprehensive benefits before the date of service will prove beneficial. By outsourcing this task, it allows your staff to focus on what’s most important – patient care.
And that’s all on this. Thanks for listening in.
Amber Darst is our Solutions Manager in the Healthcare Division, Practice and RCM. With a rich background in dental services, her expertise ranges from insurance coordination to office management.