Episode 648: Billing in 2023: New and Exciting Updates

 Yes, you read that title right: The world of dental billing is undergoing big changes this year. In this episode, Evolution Dental Billing creator Sarah O’Brien explains how codes, fee schedules, and more have changed in 2023.

For a fast guide to all the updates happening, visit ada.org/publications/cdt for educational resources. You can also buy the Current Dental Terminology 2023 handbook and its companion at store.ada.org/catalog/cdt-2023-book-and-app-102512

Episode resources:

Connect with Sarah: sarah@evolutiondentalbilling.com or 602-318-9396

Learn more about Evolution Dental Billing

Listen to episode 559, Get Your Claims Paid Faster

Listen to episode 296, Unveiling the Art of Negotiating Fee Schedules

Reach out to Kiera: [email protected] 

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0:00:05.6 Kiera Dent: Hey everyone, welcome to the Dental A Team podcast. I'm your host, Kiera Dent, and I had this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives.

0:00:19.8 KD: I've been a dental assistant, treatment coordinator, scheduler, biller, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices, coaching teams. Yup, we don't just understand you, we are you.

0:00:34.3 KD: Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress and create A teams. Welcome to the Dental A Team podcast.


0:00:52.2 KD: Hello Dental A Team listeners. This is Kiera. And you guys, I'm super excited. I'm bringing back one of my dearest friends. We have presented together, she works with tons of our clients. She knows everything that I hate talking about and she's actually real fun and not annoying.


0:01:05.0 KD: Sarah O'Brien, she is the owner of Evolution Billing. She actually works with tons of our offices, so that outsourced annoying billing. Sarah's amazing, she also teaches your team how to do it. So if you are like, "Hey, I don't wanna ever be stressed or trapped," she also teaches doctors how to bill things I don't enjoy doing. And she's coming on to talk to us about new things for 2023.

0:01:27.2 KD: So Sarah, welcome. How you doing?

0:01:31.1 Sarah O'Brien: Hi Kiera. Hi, thank you so much for having me. Doing really good. It's a super exciting year for dental coding. So yay, let's get into this. [chuckle]

0:01:40.0 KD: Yay. Sarah, she emailed me and she said, "Kiera, I think it's time for us to get back on a podcast." And I said, "Okay. What topics do you wanna talk about?" And she said, "Let's talk about the new things for billing." And I said, "Alright, you can definitely lead this one." [chuckle]

0:01:55.8 SO: It's been a few years since there's been any major changes, so I figured it was a really good time to get everyone up to speed and let them know that there have been some new editions and some changes to some really old existing codes. So it's about that time, let's hop on.

0:02:13.8 KD: There are times for setting goals, there are times for new year's resolutions, and there are times for learning more about billing, and today is the billing learning day.


0:02:24.9 KD: But no, I truly love Sarah because I feel... She knows this, when I'm in offices and I don't know what the heck they're asking me, I literally will text her and be like, "Hey, do you know about this? 'Cause I don't even know what this means anymore." So I'm super excited for you guys to definitely get kicked off on the right foot, don't forget fee schedules, 'tis the season for getting those fee schedules in play.

0:02:42.0 KD: So Sarah, I'm not gonna lead any more of it is, I'm surely gonna be here as a spectator and asking lots of millions of questions, but kick us off for 2023. What's new in the billing world, so offices can be prepared?

0:02:54.4 SO: Sure. Well, like you said, it is time to update your fee schedules. Every year you wanna do that, to make sure that you are billing what you're needing to earn for each particular procedure. There's a whole formula that goes into that, and I'm sure that you touch on this with all of your clients.

0:03:11.4 SO: But look at how much your products cost, look at how much it costs to open your office, pay your people. Break that down into a drip by drip for each material and make your bill or your fee for that service according to the criteria. So in addition, fee schedules are changing for all of your insurance companies. Well, not all of them, but probably some of them. [chuckle]

0:03:36.0 SO: Some of them run on a set schedule of when you'll get increases and some of them will automatically update in January every year, so be aware of that. If you have a bunch of contracted carriers start asking for your current fee schedule so that you're quoting correct out-of-pocket fees and expecting correct insurance reimbursements.

0:03:55.8 KD: A lot of offices don't do that. Like I was actually on a coaching call this morning, which is why I'm like, "I've gotta say that when Sarah and I podcast today," because the doctor didn't even realise that you should be updating. 'Cause someone said that they had already updated the fee schedules in December, and I'm like, "They usually update in January."

0:04:13.1 KD: And also, I know MetLife, for example, is ruthless and ships it by, I think pigeon carrier across the seas. It takes forever for MetLife to get there. I don't know what they do. But it is something that you gotta make sure you're updating. And also, I'm gonna put a plug, guys, inflation was ruthless last year.

0:04:29.2 KD: It is not abnormal for a dental practice to go up 5% to 10% on their actual fees of their office. So don't feel like you're being ruthless. If that concerns you, a lot of offices won't increase, say, their preventative as much. Because if you've got a lot of out-of-pocket patients who are paying out of pocket who know, "Oh, my cleaning is always $200," and they're used to writing you a check, you bump that 5% to 10%, they're probably going to notice.

0:04:53.3 KD: So you can keep those a little lower but don't hesitate to put that 5% to 10% increase on your crowns, your fillings, it's really going to help. Even if it's not gonna pay anymore with insurance, you can still bill that out. But definitely get those fees increase. I think that's a brilliant idea.

0:05:07.0 SO: Yeah, for sure. And you know what, when you submit those new fees on your insurance claims, the insurance is keeping track of all of that, that's where your UCR money comes from. So having them see what we're currently charging for a certain procedure helps them know what they need to increase their fee schedules by hopefully some time in the future, maybe years from now, but you never know.

0:05:28.3 KD: For sure. I love that.

0:05:29.4 SO: So the ADA has given us its new CDT codes for 2023 also. This is the kind of most exciting thing I've had come across my billing life in a while. You know, we've talked about this before, and I recommend that most offices don't need to buy the current CDT book every year. There's just no reason for it.

0:05:53.7 SO: This is a really good year to get it, so if you don't have one or it's a few years old, to check out on the ADA website. Or you can even get them on Amazon if you want to. The new coding book, which will have all of the things that I'm gonna tell you, plus a million things more that I won't tell you.


0:06:12.9 SO: But basically, the CDT codes have updated a lot, there's a whole bunch of new ones that they've added for the year, and there's a whole bunch of changes to existing codes that have been around for a real long time. My first really exciting one is FMX code, the 0210 code has a new descriptor, which it's been the same forever, right? Like 14 x-rays showing roots and teeth, blah, blah blah. That's what it always was prior to now.

0:06:44.7 SO: The new one... Let me get to my correct page here.

0:06:51.6 KD: This book is pretty thick, guys. There's a lot in these coding books.

0:06:54.0 SO: It's cray. I'll show you the depth we're looking at.


0:06:58.3 KD: For those of you listening, it's like an inch and a half, two inches thick.

0:07:03.2 SO: At least, yeah.

0:07:03.8 KD: Those are your codes, guys.

0:07:05.0 SO: Yeah. This is so important, having the correct code for the correct procedure that you're doing is kind of the number one most important thing for billing. We have to code what we do, we have to bill what we're doing, and we have to know what we're doing to be able to code it.

0:07:19.7 SO: So the book really helps guide you and drive you to those codes. There's a couple of different ways that it works for you. Usually you have kind of an idea of what you're doing, you can look it up by description or you can look it up by title. So if there's any question, say the doctor is doing something outside of their norm and you're trying to dig down and drill into, "What is this actually procedure called?" that'll help you get to that main.

0:07:44.0 SO: So the new code, the 210, intraoral comprehensive series of radiograph images, now says "a radiographic survey of the whole mouth intended to display the crowns and roots of all the teeth". All of the teeth. So if you've got a person with four teeth and you're taking four PAs, that's now an FMX.

0:08:06.1 SO: If you've got someone with 32 teeth and you're taking four bite wings, six PAs, whatever else it is, they're intraoral, you're displaying every part of every tooth, that's now an FMX. So the descriptor includes... It can include over the usual 18 X-rays that most of us have in our minds when we think of that layout for the FMX. It says "14 to 22", but again, if it's a full mouth's worth of X-rays and all of the teeth are being shown, code it as an FMX. Code it correctly.

0:08:38.9 SO: So that was mind-blowing for me because so many offices struggle with their X-ray coding, right? Like, "Panel and four bite wings, do we code that as an FMX or do we code it as a four panel and four bite wings?" The answer is a panel and four bite wings, because you're not taking these images intraorally of all of the roots, and the apexes and all of the interproximals and all of the crowns and everything in between. The panel is an extra-oral image, so code it as a panel, four bite wings are intraoral, code 'em as four.

0:09:11.4 KD: That is really awesome actually, and I don't think people realise, because I do feel like it's always been the thing of like, "Well, it's gonna get denied, but just put it like we took it anyway." I think that that's awesome. I think it's really cool that they finally updated and realised what we had in the past was not accurate, 'cause that's not a true FMX.

0:09:29.7 SO: Correct, that's true. And you know, if you take an FMX and you're taking an intraoral image of every tooth in the mouth, and then you in addition to that, take a panel, bill them both, submit them both. Don't just submit one or the other because you're trying to get what the insurance is gonna do anyway.

0:09:49.4 SO: The secret to dental billing is to ignore what you think the insurance is gonna pay and bill for what you've actually done on the date of service. So that's the correct way to do it. Then, after that exciting bit of information...


0:10:04.7 KD: Who's excited, guys? I'm just curious. And I know all of those attention-to-detail people in this world are like, "Oh my gosh, that's the greatest thing ever. I'm so excited." And a lot of us non attention to detail people are like, "Hey, so an FMX. Why was that exciting?"

0:10:19.8 KD: No, it's exciting because you don't have to get 18 photos, those patients who don't have that, and you can still bill for the FMX and get it approved now. That to me was the cool part of that. So Sarah, I'm excited for our next exciting part of all of this.

0:10:35.9 SO: Okay, so next, they have a whole bunch of codes for tomosynthesis or tomographic X-rays. "What the heck is that?" you might ask.

0:10:43.7 KD: I don't even know.


0:10:46.4 KD: And I should know.

0:10:49.5 SO: I googled the definition. Because I kind of have an idea of what it is, but I wanted to have the actual wording. It is an imaging technique in which multiple X-rays are layered together to create a 3D image. So it's kind of like... I'm sure there's software that do it for you, and then there's also all of these CDCT scans that many, many offices are pulling into place now, and it's a combination of multiple images that they layer together to be able to create an image in 3D.

0:11:18.7 SO: So the new codes, there's probably a handful of 'em, intraoral bite wings, periapicals, full FMX, tomographic X-rays, and then of course, PAs. But basically what it's saying is that if you have multiple images that you're using to create another image, then you don't wanna bill the previous normal PA code or bite wing code, they created new code specifically for the situation. So be aware of those.

0:11:50.7 SO: It's probably gonna be a fairly infrequent code that's used because if you're looking for something in particular, you're gonna be taking that particular image. But for those offices that really have the detail-oriented doctors who wanna look at everything from every direction, this is gonna be a really good code for them to use.

0:12:13.5 KD: That's pretty awesome. I feel like, I do feel we're advancing in dentistry and in technology, and so for you guys to actually be able to bill out what you're actually doing is gonna be awesome. And I do think that there is a geek side of me, a nerdy side that's like, "I actually just wanna know what things have changed, what things have updated."

0:12:32.9 KD: Because in dentistry I feel like sometimes we get into our ruts and we just do the same thing that we've always done, and yet I feel like we're missing so many opportunities to bill out for services that we're already doing, we've just never even known that it was a code for it.

0:12:46.9 SO: Exactly, yeah. There's a saying, speaking of... [chuckle] Suppose your doctor is out of the office and the patient comes in and you're just taking a quick X-ray so that they can review it from home and let you know what to do? They've added codes for that as well. These are your... Let me find the numbers here.

0:13:12.2 KD: This is gonna be awesome too, because I think about... I feel that this actually might change state laws, where in order for us to do anything, a dentist has to be present, and how many times are we without our dentists there? But yet dentists go on CE, you could still see patients.

0:13:29.3 KD: And so if they're already putting in codes for you to see a patient, when the X-ray... And take an X-ray on a patient when doctor's not available, my hunch is things will probably be changing in the future, for can we be seeing care under the... I would say even the guidance of a hygienist. I'm gonna say it's not out there yet, but if they're putting these codes in, guys, I'm guessing the trend will be there.

0:13:52.9 SO: Yeah, it's hopefully moving in that direction, right? Where we're able to do what we know we need to do when we need to do it.

0:14:01.5 KD: Right.

0:14:03.5 SO: So suppose you're taking the FMX and there's no doctor present, but you know that that's been diagnosed and that it's needed to be done. Code D7... No, D0709, "intraoral comprehensive series of radiographic images, image capture only". So they're not being read immediately by a dentist, they're just being captured and then put away in a nice little chart for them to review at the right time or when they're able. Then when the patient comes back and the doctor is visually examining them, you post the evaluation and away we go.

0:14:38.5 KD: So you really could then... 'Cause in the past, there was always like if we do an FMX, you've gotta link it with a comp exam, which I would guess if you're doing an FMX comp should be go together, but if you do this new code, you don't have to bill with that comp code, which would be great for hygienists needing to do treatment. When doctors are out, you're able to bill it, then tack that comp exam on the next one, doctor can review at time. That's very clever.

0:15:02.4 SO: Isn't that awesome? Really cool. They're catching up to real life here, which is even awesomer. [chuckle]

0:15:09.0 KD: I am super curious because I feel dentistry and dental billing has been, let's just say I feel like they're still hanging out in the 1800s, I feel it's so old school, their fees of what they allow. But I don't know, I have this weird hunch. I did a podcast with Pearl for AI the other day, if you guys missed that one, definitely go check it out. It's very interesting how AI is coming on board to start helping with our X-rays and helping with case acceptance.

0:15:36.4 KD: That I just have this hunch that dentistry and billing and these big insurance companies are realising they need to start catching up with the times because AI is coming in. Things that are going to force dental billing, in my opinion, I could be totally off, I think it's gonna force it into the forefront faster than they thought it was.

0:15:53.7 KD: Which I'm curious if that's why 2023's coding is so much more advanced than I think it has been in the past. I don't know what your thoughts are are, Sarah, but I'm kind of feeling like AI technology advancements are truly forcing dentistry into a more current era.


0:16:13.1 KD: Are you guys sick of trying to figure it out on your own? I know I am. When I'm trying to run a business sometimes I just think like, "There's got to be a better way to do this?" And so for me, my answer has been to find someone who's done it and does it really, really, really well.

0:16:28.4 KD: I'm talking the best of the best of the best. I want someone who's been in my shoes, somebody who understands what I'm going through. When I was looking for the consulting business, I found a coach who literally has run a consulting business. Well, that seems like the perfect fit.

0:16:41.6 KD: So you guys, right now we have a few spaces open in our Platinum consulting. That is in the consulting where we actually come to your practice. We help you get systems implemented. We don't just tell you a system to implement, we actually implement them with you and for you.

0:17:00.6 KD: You guys, it is one of the best investments I've ever made, is to hire a coach who understands the business I'm in, who's lived it, who's done it. And that's what we in the Dental A Team do, we literally physically fly to you. So if you're sick of trying to figure it out on your own, if you just want somebody who understands you, join our Platinum.

0:17:16.6 KD: I'd love to have you. I'd love to have our consulting team come out and see you, be in your office, be with your team, and truly help you get on to the easy path of dentistry. It doesn't have to be hard. So join us in the Platinum, we'd love to have you.


0:17:32.1 SO: Yes, you hit that nail in the head, that's exactly my thought at the same, along the same lines. That we're finally getting to the point with the dental coding and the dental industry where we're not 1950 anymore, which is where it's been stuck since it was invented. And hopefully we'll be seeing those advancements in other places besides the actual gear that we get to use. So it's super exciting.

0:18:01.3 SO: Speaking on that, they've added a bunch of new codes for 3D scans. So direct and indirect codes, so pay attention to whether you're scanning a patient or a model, 'cause there is a difference. But 3D dental surface scan, 3D facial surface scan, both direct ore indirect, have been added. It's codes D0801 through D0804.

0:18:26.3 SO: And basically, it's for presenting. In my opinion, it's for being able to utilise that image on a screen to rotate and learn from, both when discussing with the patient and evaluating for future treatment. So those four codes are right along that same alley of advancement and new technology, and things that weren't even able to be done a few years ago.

0:18:51.8 KD: So Sarah, do you think with all these new ones that we're able to bill out, patients maxes are gonna be met a lot faster? Because now there are more codes, and I don't think I've seen a lot of maxes increase, that I'm wondering if this year will be the year where we're billing these things out?

0:19:05.3 KD: 'Cause I can also hear offices say, "Hey, this is really awesome, and I'm super excited to bill this, but I'm gonna max out my patient's insurance way faster. Is that actually going to decline patient acceptance?" Which I think is a valid question to ask, that's why I'm bringing it up. That I would say, "I would bill out, guys."

0:19:22.0 KD: Because if insurances see that they max so fast, the patients are the people who are gonna be livid with their insurance company, calling the insurance company, and hopefully we'll be able to one, either get them out of all the insurance plans, or two, hopefully in the next two or three years, you'll see an increase.

0:19:40.1 KD: So I don't think I wouldn't, I don't think I would as a practice watch that get really good at presenting treatment plans not dependent on insurance, but to Sarah's point, bill out what you do and then assess the cost of benefit. Like I know most offices don't go for oral cancer screens. Why? Because they don't want patients to say no. But if you're doing a scan outside of the mouth to make a better model to be able to do better treatment, bill out for that, guys.

0:20:05.9 SO: Absolutely.

0:20:08.0 KD: So I really think, don't be shy, but this is gonna run maxes a lot faster than I think we've ever seen before.

0:20:12.1 SO: Super quick. It's not unusual for, I would say a seven to $800 preventative diagnostic appointment at any point. If you're coding correctly, if you're billing all of the codes that you've done, then you're gonna perhaps get one preventative appointment plus one treatment appointment covered by the benefits. So yeah, don't be afraid of that.

0:20:38.1 SO: Let that be a discussion that you have with your patients so that they understand really what they're getting from this insurance company. Dental benefits, and I've said this a thousand times, and medical benefits are in no way, shape or size, the same. So don't expect to go to the dentist, and we all know this in the dental industry, that it's not gonna be 100% paid for, you pay your small deductible and then that's it.

0:21:03.2 SO: It just never has been that way. And this, like you said, will hopefully help the insurance companies realise that for it to actually be a benefit, it's gotta be better than a coupon. So get in there, guys. Get in there.

0:21:16.2 KD: I think this is gonna be a year to learn all these new codes, bill them out, and then also get real scrappy and learn how to present treatment plans not dependent on insurances. If you're in office who has always been very insurance pro and you hear your TCs talking about insurance, I hear it still to this day, guys, like, "Oh, it looks like your insurance is estimated for this," 'cause your TCs are scared of them saying no, but it's a $2000 benefit and that's it. This is gonna rack it up very well.

0:21:42.6 KD: So I think this is going to be a year for it. And I mean, you've got inflation, you've got economy, you've got all sorts of pieces coming into the mix this year, that I say this is the time right now to start practicing and getting comfortable. 'Cause I would guess maxes are going to max way faster this year than they ever have in the past, if you bill what you should be billing. Which is a huge benefit for you, but you're gonna have to get real good with that verbiage as well.

0:22:05.0 SO: Absolutely. And I will also say that just because we're billing it, it doesn't mean it's gonna be covered or paid. So don't be surprised when they bundle all of your X-rays together and call it an FMX. Don't be surprised when they totally just say "non-covered, non-billable service".

0:22:21.7 SO: If you're contracted with the carrier, you still have to follow their rules and jump through their hoops, but we need to be submitting the actual services that have been completed so that they are learning and growing and becoming better hopefully. [chuckle]

0:22:38.3 KD: Exactly. My sister's husband is actually an actuary for an insurance company, I've never said the name of the company he works for. Don't worry, we definitely go the rounds about it. But I do know from that side that they are watching the codes that are coming through because they're assessing all the data.

0:22:53.0 KD: So I think as practices, we have a moral obligation to bill it out, see if it can get covered, just to also give data to the insurance companies. 'Cause if they're seeing these new codes are only getting a few submissions, they're not going to cover it. Why do you think they changed the FMXs? 'Cause they saw so many of those coming through, they realise it was different things.

0:23:12.5 KD: Where we are definitely fighting back saying, "No, this person only has four teeth. That's why it's an FMX. What do you want me to do, take 18 X-rays of nothing? This is this patient's FMX." But if we would never have given that information, I don't think codes would have changed. So, definitely, I think do your part, bill it out, because they're looking at those stats and those statistics of how many are billing out there for sure.

0:23:32.2 SO: Yeah, for sure. And I'll also add that if your supposed person's mouth has a lot of crowding and their teeth aren't easy to radiograph, if you've taken 18 X-rays and you don't get every single tooth in their mouth, that is therefore not an FMX, so that would be how many PAs did you take, how many bite wings did you take? If you're not following the descriptor for the code, then don't assume that it has to be billed that way. So keep that in mind as well.

0:24:03.3 KD: That's a good point.

0:24:06.2 SO: Yeah. So other exciting codes, there's a bunch of vaccine boosters and administration, administrative dose, blah, blah, blah. For all the different companies that do the COVID vaccines. These I honestly don't see happen very often in any dental office, so if you're doing 'em make sure you're coding and billing them accordingly.

0:24:23.7 SO: Other exciting stuff. So the full-mouth debridement code 4355, we all know this code, it's a giant pain in all of our you know whats.


0:24:34.0 KD: If you do any type of billing, you that code.

0:24:37.1 SO: It's changed this year. The new descriptor for the 4355 is a full-mouth debridement to enable a comprehensive periodontal evaluation and diagnosis on a subsequent visit. It no longer has to be done all by itself, it no longer has... There was some extra words in there previously that allowed for it to be denied, basically constantly.

0:25:00.8 SO: And what this is now saying is that there's so much build up in bacterial growth on these teeth that we have to remove that supragingivally to allow for a comprehensive periovaluation down the line. It's so much better, so much more accurate to what's being done, I'm sure there's gonna be hygienists like high-fiving and back-flipping through their offices when they realise that this code now makes more sense for what they're doing. So that was a really, really exciting one going for me as well.

0:25:30.9 KD: So definitely share this part of the podcast with your hygienist because they'll be really excited about this new... 'Cause agreed, so many of these codes I can't imagine though. I mean, could you imagine being the person who writes the code and you think you wrote it of exactly what it is, and you missed it by that far.


0:25:48.1 KD: I think I'd apply for a new job if I was defining debridements in the past. Good thing they got that new person in there. For sure.

0:26:00.7 SO: They also updated the irrigation, so a lot of offices will do irrigation when they do SRPs. The new descriptor for gingival irrigation 4921 is "gingival irrigation with the medicinal agent per quadrant". So they cleaned that up a little bit too, probably still not gonna be covered, but at least we can code it correctly and bill accordingly for it. So that's also super exciting.

0:26:18.9 KD: Yeah.

0:26:22.2 SO: Then there's a couple of new ones, let's see, that I really liked. They have a non-resolvable guided tissue generation barrier per implant code. It doesn't include anything but that resolvable barrier, that was never coded before. So it's you do your bone grafting, you put your barrier in, your coding for both of those now. And they also have a remove gingival barrier code.

0:26:52.8 KD: That's awesome. [chuckle]

0:26:53.5 SO: So it's not... [chuckle] You don't always go to the same dentist. Suppose you've moved in the middle of your treatment, suppose your previous dentist wasn't available and you've had to see the associate, these are two separate codes now, so you can bill to place it and you can bill to remove it. So check on those, they're in the 6100 area.

0:27:12.2 SO: But it's making it much cleaner, there's less room for interpretation and much more actual definition for what kind of dentistry is being done, so that's really exciting.

0:27:22.6 KD: And I would say on that note, with these new codes coming in, be sure that you're updating your explosion codes like quick buttons, because you guys have had them in the past where we've got all of our implant parts in there, but now you gotta add in new pieces. So be sure that you're checking all these codes, but then update those multi-explosion codes for treatment planning, for fees, just because you guys will miss them if they're not editing.

0:27:47.7 KD: 'Cause your teams so used to just checking that and then figure out where in the sequencing that goes. I think they're awesome, but don't forget that with new codes, we need to update old things that we put into place before these code existed, just to make sure that you're actually getting your most bang for your buck, that it's easy for your team to incorporate these codes without having a huge burden on them, for sure.

0:28:08.7 KD: For sure. Great. Great tip, Kiera. That being said, also make sure that you have a fee attached for each one of these new codes and you're not billing out any zeros to your insurance companies. [chuckle]

0:28:19.5 KD: Oh gosh, that was me, guys. I think I'm up on the insurance's wall of shame. For every one of them. Because I would bill out zero dollar crowns. That was a good learning piece. It doesn't matter what the freaking fee is, even if they deny it, put something in there. 'Cause if you bill zero dollars they're going to guarantee to pay zero dollars.

0:28:38.4 SO: Exactly.

0:28:39.7 SO: I don't care if that insurance plan doesn't even cover it. 'Cause you can put your office fee in there, so that way it pulls the office beyond it too.

0:28:46.7 SO: Yup, very good, very true. There is about 10 other new codes that I'm not gonna make you listen to me read all of the descriptors for, but be aware that a lot of things have been added this year. So if your office does a lot of surgery, if you do a lot of anything, review those and make sure that you're billing exactly what you're doing every single time, every single patient. And look for these new exciting changes.

0:29:16.1 SO: Even if you don't get your new CDT ADA code book, a lot of your insurance company websites will have those available for you. MetLife I know sent out an updated code guide thing a couple of weeks ago. Also, I wanted to tell you guys, there's a bunch of new insurance stuff happening, so make sure that you have a login and a password for all the insurance portals and are reviewing what is available to you on their websites on a regular basis.

0:29:47.2 SO: United Healthcare is no longer accepting appeals on paper for some plans, so be aware of those. 2023 is vastly different than last year, it's like I don't even know, something, some light went off over there, and people are realising it is 2023, let's get with it. So check in on that as well.

0:30:08.2 KD: Interesting. So Sarah, what would you say is... I mean I'm sure everybody has a lot of time on their hands and would love to just read through this code book. Is there anywhere within the new codes, other than going to the websites where it says all the new ones that have been added or the updates, is there anywhere that's like a quick fast guide to see all the updates? Or is it really I have just gonna scroll through, look at them in comparison?

0:30:28.4 SO: I would go to the ADA website and look for their 2023 updated code last informational section. It should all be there listed basically by what's been added, what's been deleted, which was only two codes that no one ever used anyway, and what's been changed. So they should have one little click that has all that information for you readily available.

0:30:53.8 SO: And if you're really wanting to get the details, the coding companion that goes with this 2023 CDT book has every bit of information you could possibly imagine. It's got examples, it's got scenarios, it's got questions that have been asked and answered. So a lot of information in that as well.

0:31:12.4 KD: That's helpful. And honestly, I'm just gonna throw it out there. Offices, please take Sarah's advice. I have preached on this many times. Get that user name and login to log into every one of the portals, because so many of them... I don't know if you guys have noticed, McDonalds doesn't have employees as much, so now you have a kiosk, restaurants are having you QR code, they're having you pay on QR codes. Because we're in a bit of a labour shortage, if you guys haven't noticed.


0:31:36.9 KD: Who know's when that will switch. I'm sure any of you looking for dental assistant right now know that there's a fricking labour charge out there. But that's I think it was happening with insurances too, they don't have as many employees, so therefore they're changing up the rules, they're going to be looking to deny more often.

0:31:51.9 KD: So be sure that you're looking for that. Get those logins. People who are calling insurance companies, guys, I truly do think calling in will be a thing in the past. So definitely get up to speed yourselves, get online, get familiar with it. 'Cause I think it'll help you long-term.

0:32:07.2 SO: Yup. I was able to appeal a denial through a chat bot on Delta Dental's website.


0:32:15.2 SO: So it's happening there. It's happening.

0:32:19.0 KD: It's there. So Sarah, if people have zero desire to learn how to do billing and they say, "I just wanna outsource this," because guys, Sarah, even though she gets sick, she owns a company and she has to find people to do your billing for you, even if they get sick or call out or decide they wanna have babies or wanna go and move to another state, Sarah has to keep fulfilling for you guys.

0:32:35.9 KD: So Sarah, if people wanna get in touch with Evolution Dental Billing and they want to have you help their practice or they wanna be taught themselves, how can they connect with you and have the Evolution Dental Billing experience?

0:32:48.3 SO: Well, there's two easy ways to do that, check out our website, it is evolutiondentalbilling.com. You can call me, my phone number is 602-318-9396 or shoot me an email at [email protected].

0:33:06.1 KD: That was her real phone number, so you can definitely text her. Be sure to tell her you heard about on Dental A Team because she does have a preferred pricing for Dental A Team listeners. So Sarah, I appreciate that, 'cause honestly guys, I don't take the time to go read up on the new codes. I love people like Sara who are obsessed with that, just like she loves people like me who are obsessed with teams, and we are a real good ying to yang.

0:33:26.2 KD: So Sarah, thanks for that. Guys, truly don't get stuck high and dry when you don't have to, and you guys can just take time to learn these billing codes. Look at them. Doctors and billers, you can literally have a meeting where billers you can take it to your doctors and say, "Hey, here all the new codes, how can we update our explosion codes, our quick button codes? How can we start to incorporate these? What fee do we wanna charge?" Doctors, I know that's always a big thing where you have to come up with with your fees.

0:33:51.6 KD: But update those fees for your office, make sure you do that boost, most of them can go up across the board, so it's very simple. Update all the fee schedules from your insurance plans, that's the annoying part. Add these schedules if you're not already doing that, and then update all these code.

0:34:04.4 KD: And Sarah, thank you so much. Guys, truly Sarah is one of my dearest friends, she's someone I just adore, so guys reach out to her, let us know how we can help you. Sarah, thank you, and thank all of our listeners.

0:34:13.5 SO: Thank you.

0:34:14.9 KD: Yeah, thank all of our listeners for being here today. And as always guys, thanks for listening. I'll catch you next time on the Dental A Team podcast.


0:34:24.0 KD: And that wraps it up for another episode of the Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.




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