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Technology is great a reminding but does it really confirm an appointment?
Technology today offers many ways to confirm dental appointments: email, text, calls to cell phones, home phones and work phones, cards and letters. We can inundate with reminders to the point that the patient may tune us out altogether! There is a distinct difference between a reminder call and a confirmation call. When the clinical message is clear that the patient must keep the appointment, it is up to the scheduling coordinator to explain to the patient about appointment policies.

Use the following script: “Mrs. Brown, your time with us is reserved only for you. It is considered confirmed. We will be calling (or email/texting) two business days prior to your appointment as a courtesy reminder only.”

A reminder contact is a courtesy for a confirmed appointment. A confirmation call requires a call or contact back to personally acknowledge the appointment. If there are “left message” indicators on the computer schedule, this is a red flag that the patient did not get the message or is waffling about committing to being there. Patients who receive text or email messages must opt in by pressing the confirm button on the message, otherwise it is an unconfirmed appointment.
This information is critical to providing value to good dentistry. Long-term value realized in good dental care is one of the best investments a person can make. Demonstrate how the service and product is meant to last a long time and that you will warranty the product against defects for a year and pro-rate the value if the product fails within five years. When comparing long-term value of an implant versus a bridge, show that implants on average last 35 years, compared to a bridge which has an average five years of life and does not retain the bone, etc. On the treatment option sheet write the estimated long-term value of the service and the responsibility of the patient to keep routine maintenance visits to be considered for the warranty.

If the patient needs an implant and a crown but wants the third option of a “flipper” or interim partial because it is affordable, spell out that this option will solve only part of the problem. The flipper is to fill the gap but is not functional as a tooth and is a short-term solution. Write on the treatment plan how many “repair” visits or adjustment visits you allow in six months and a timeline to replace the flipper. Patients often expect that if you do a service, even though it has a high failure rate, you will continue to replace or repair it. If it is determined the treatment has a guarded to poor result, then it is a gamble to do the treatment at all and will most likely result in an unhappy patient.
Patients want to know which dental treatment option lasts the longest
When a patient is covered by more than one dental benefit policy, the term “coordination of benefits” applies. This can change from one insurance company to another so it is important to determine correctly which plan is in the primary position. This can get complicated when a married couple have their primary plans and are also covered by each other’s plans and the children are covered by both. The primary plan must be billed first and when it is paid the Explanation of Benefits (breakdown of payment) is then copied and sent along with the secondary claim so payment may be determined. The documentation sent with the primary plan must also accompany the claim. The secondary insurer’s reimbursement, if any, takes into consideration any outstanding dollar amounts for covered services received up to the allowed amount. In any case, the secondary plan will never pay more than they would have paid had they been primary.

In researching claim denials the reasons can be as simple as wrong date of birth, missing relationship to provider,
no subscriber ID or wrong social security number. Check all fields in the claim body to make sure information is correct. Other mishaps concerning improper coding can cause your claims to be red flagged by the insurance company. Remember that a miscode of a procedure may be innocent, but from the insurance company's view it can represent fraud. Relying on the business staff to choose the right code for what was performed clinically can lead to errors in claim filing and subsequent claim denials.
Coordination of benefits for primary and secondary insurance policies
Writer, LLC
Belle DuCharme,
RDA, CDPMA, CDC