In this episode, Ben and Naren discuss the challenges of period billing and period denials in dentistry. They highlight the rising denials for periodontal disease claims, attributing it to increased treatment and insurance companies’ efforts to reduce payouts. Ben explains that many dental practices underreport period treatments due to misinformation and insurance complexities, leading to financial and liability issues. They discuss the underdiagnosis in HMO practices due to financial constraints and emphasize the need for better billing practices and patient communication. The episode concludes with a call for greater industry awareness and improved reporting of periodontal treatments.
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Time stamps
- 00:01:16 – Why are denials for perio-related claims on the rise these days?
- 00:03:04 – If you were to guess, what percentage of adults have perio disease?Â
- 00:04:58 – How are most practices performing when it comes to “perio performance?”
- 00:06:53 – Why do you think perio performance is so low in most practices?
- 00:11:14 – I hear that HMO practices, practices that offer HMO capitation dental plans, don’t diagnose things like perio. Why is that?
- 00:13:13 – What is the reason why the code D4346 isn’t more widely used, considering that the majority of adults have gum disease?
- 00:13:53 – What resources do you recommend so that I can learn more about resolving denials for perio-related claims?
Resources
