Navigating the Dental vs. Medical Billing Maze

OMS procedures often blur the lines between dental and medical insurance coverage. Understanding whether to bill dental or medical insurance—and knowing precisely how to approach each is critical. At Medicodentals, we expertly navigate this complex landscape, ensuring accurate claim submission and optimal reimbursement.

Mastering Complex CPT & ICD-10 Coding

Procedures in trauma, pathology, and orthognathics require meticulous CPT and ICD-10 coding. Any inaccuracies can trigger denials or delayed payments. Our coding specialists have deep expertise in AAOMS guidelines and detailed knowledge of specific modifiers, ensuring your claims are precise and compliant.

Proving Medical Necessity for Insurance Approval

Insurance payers, especially Medicare and medical plans, require robust documentation to prove medical necessity. Leveraging detailed understanding of CMS rules, including Medicare Article A56006, our team ensures your documentation meets payer expectations, significantly increasing approval rates.

Overcoming High Denial Rates & Claim Rejections

High claim denial rates directly impact your bottom line. Our proactive denial management strategies target the root causes of rejections, employing robust appeals processes to recover lost revenue and secure rightful reimbursements swiftly.