Prosthodontics

Maximizing Insurance Reimbursement Success for Prosthodontists

As specialists in tooth replacement and reconstruction, prosthodontists perform a highly skilled set of procedures to restore optimal oral function and aesthetics. However, getting properly reimbursed for these complex services requires in-depth knowledge of dental billing and coding. This is where our dedicated prosthodontics billing experts can help. With robust expertise in CDT codes, payer policies, authorization protocols, and claim submission guidelines specific to prosthodontics, we handle the entire billing process to ensure you receive timely and accurate insurance reimbursements.

What We Offer

Correct Coding for All Procedures
We accurately code for services ranging from crowns and bridges to partial/full dentures, implants, occlusal guards, TMJ therapy, and maxillofacial prosthetics. Our coding optimizes reimbursement for:

Initial prosthodontics exam and assessment
Radiographs, oral scans, and diagnostic casts
Teeth extractions and bone grafting
Implant placement surgery
Implant-supported prosthetics like crowns, bridges, and dentures
Follow-up prosthodontics care and repairs

Managing Pre-Authorizations and Eligibility
We verify dental insurance eligibility upfront and obtain any necessary pre-approvals for upcoming treatment, such as:

Multi-stage implant placement plans
Full mouth reconstruction
Orthodontic procedures as part of rehabilitation
Maxillofacial prosthetics like obturators
This prevents surprise claim denials so you can focus on patient care.

Handling Claim Submission, Follow-Up and Resolving Issues
We flawlessly complete claim forms with all required details and submit them electronically to insurers to expedite processing. Our team rigorously follows up on any pending, denied, or underpaid claims – identifying reasons, appealing erroneous denials, and solving problems until your practice gets paid correctly.

Improving Patient Collections
We assist in collecting patient responsibility amounts like copays and deductibles. Our customized statements and payment plan options help improve collections while maintaining goodwill.

Providing Actionable Analytics and Insights
Our regular reimbursement analytics highlight common denial causes, most frequented procedures, collection metrics, and other KPIs to pinpoint opportunities to refine processes and boost revenue integrity.

Guidance on Navigating Evolving Payer Policies
Insurance policies related to prosthodontics billing change often. We stay on top of all updates and guidance to ensure continued compliance and optimized reimbursements. Our advisory helps practices adapt seamlessly.

Let us take the headache out of prosthodontics billing and collections so you can focus on excellent patient care. Our experts become an invaluable extension of your practice, using our knowledge of policies, codes, and guidelines to improve cash flow. Contact us today to learn more about our comprehensive billing solutions for prosthodontics specialists!