Billing issues for dentists

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

ItsGavinC

Full Member
Moderator Emeritus
20+ Year Member
Joined
Oct 7, 2001
Messages
11,749
Reaction score
24
A "hot topic" I've had the pleasure of being immersed in for the last couple of months is the current billing practices of dentists.

Dentists only bill for the procedures they actually do, while our medical counterparts bill for their time as well as their services.

Anybody ever put any thought into this?

We've got to revamp our billing system, or start learning how to use the MD billing codes to bill insurance companies.

Any thoughts?
 
Dental procedures are expensive as it is, why would you think of increasing the prices. I know that means more for the dentist's bottom line but come on prices in this country are really getting out of hand it's ridiculous.
 
Actually, dental prophylaxis and therapy are among the last great bargains in healthcare. Currently, only 6.5 cents of every American healthcare dollar are spent on dental care.

Personally, I view billing for procedures comparable to billing for time. After all, your billable time is generally spent performing procedures. Hygienist prophies don't earn a significant amount, but then again, the exam afterward takes <em>maybe</em> 60 seconds if nothing is wrong. If something IS wrong, you set them up for a second, more expensive appointment to fix the problem.

Right now, I don't see anything screaming to be fixed with the current arrangement. That opinion may change as time passes, but we'll have to wait and see.
 
Dentists can bill their patient for whatever they want. $125 for being ugly, $275 for answering your cell phone while I'm working, $900 for being over 30 and bringing your mother back to the operatory with you.......

Getting someone to pay it and come back again would be a different story.

There are plenty of times we don't "do" anything and bill the patient. An emergency exam where you just Rx, a 2nd opinion, specialists often have a consult visit where nothing gets "done" except filing out paperwork and telling the patient what to expect at the treatment visit.

I agree that we don't place a lot of value on our diagnostic skills. Often an exam will be given away with the extraction, we don't normally charge to call in Rx's, etc.... If we don't think it's worth much why should the patient?

In my opinion the last thing we need is to follow the MD's lead, look where it's gotten them. The less tangled we get with insco's the better. Dental insurance is not really insurance anyway.




JMHO
Bob
 
Dental procedures are expensive as it is, why would you think of increasing the prices. I know that means more for the dentist's bottom line but come on prices in this country are really getting out of hand it's ridiculous.

I realize that many people feel they are priced out of dental care, and this is an issue that certainly needs to be addressed. But I do feel Gavin has a point.

Compared to any other procedure-based healthcare field, dentistry is an absolute bargain. If a procedure is performed by an MD that requires anything more than the most basic equipment, the patient will pay for the doctor's consult, the doctor's fee for the procedure, and a fee for use of the operatory clinic or hospital. Dentists generally provide their expertise and the use of their equipment/operatories for free.

Some might argue that equipment costs are covered in the fee for the procedure, but MDs charge similar fees simply for providing only the service. No $300,000 investment risk required on the doctor's part. However, if the physician does choose to venture his capital and purchase the necessary equipment/clinic space, he will be further compensated for this.

Considering that dentists play a dual role as doctors and entrepeneurs --both of which are highly desired and highly compensated skills in our society-- dentistry is a bargain.

But probably the biggest reason to rethink traditional billing is the increase in preventive care that will presumably be provided by the profession in the future. Ideally, more and more time will be spent by dentists providing expertise and increasingly less time with a handpiece. I actually hope I don't see this so much in my lifetime - I signed up to drill, baby! 🙂 - but it is the ultimate goal of our profession.
 
Sorry if I repeated stuff that was already said. I have a habit of of opening ~8,000 windows and then setting about reading them.
I only had dentoman's first comment in my window when replying. 🙂
 
Originally posted by Dentoman
Dental procedures are expensive as it is, why would you think of increasing the prices. I know that means more for the dentist's bottom line but come on prices in this country are really getting out of hand it's ridiculous.

Because oral healthcare will NOT be accessible to all people until we can bill for time spent as well as procedures.

It simply isn't feasible for a dentist to spend all day in an assisted living or nursing home environment, because the procedures done won't generate enough revenue to cover the expenses/the money lost from not staying in the office.

Physicians have no problem visiting nursing homes because they are able to bill for the number of patients they visit, ie their time is worth money!

I bring this up because there is a huge need for oral care in nursing homest here in Arizona, but dentists can't afford to hang out and serve the needs of the people there.
 
Originally posted by no2thdk999

I agree that we don't place a lot of value on our diagnostic skills.

I think that is the bottom line that worries me the most.

I'm not bringing this up so we can earn more money. Because we only bill for our technical work, the public (and other professionals) still believe that we cannot and do not diagnose.
 
Originally posted by ItsGavinC


We've got to revamp our billing system, or start learning how to use the MD billing codes to bill insurance companies.

Any thoughts?

Just to throw out some conversation here, Do we as dentists really want our "dental insurance" system to more closely mimic the "medical insurance" system?? Do we really want our current basically FFS(fee for service) system to become more HMO like?? I really doubt it.

Often you do bill for your time, just not by a specific procedure code. If you're doing a procedure code where you know it may take a little longer to do and you want to be compensated for that time, you set your fees higher. Since we're basically in a FFS system, the patient is then responsible for the the difference. Since most insurance companies won't pay for the code for oral hygiene instruction, or behavior modification, you just add a dollar or two onto your offices prophy fees or pedo restoration fees.

As bad as this may sound, the entire dental insurance process is more a game than a science. The insurace companies will often initially deny claims, "down code" them (pay for the cheaper porcelain to noble metal crown fee when you actually did a more expensive porcelain to ceramic crown), or "code bundle" (group a prophy, bite wings, exam, and fluoride tx into a cheaper "child recall" fee). Realistically, if the insurance companies played by the letter of the law, then we wouldn't have to adjust fees so that all of our time and knowledge cab be adequately compensated.

Also, you should never feel that the fee you charge for a specific procedure is "too much". Remember all the hours and years and money that comprises your training!
 
Top