Compliance is not sexy nor fun to talk about. As a healthcare professional, you need to take steps to stay compliant, especially if you accept government programs like Medicaid, and Tricare. Medicare only in surgical and reconstruction cases are covered. But even if you only accept private insurance plans, you still want to make sure that all of your claims are submitted thoroughly and accurately.
The private insurance contracts in most cases ask if you have a compliance program, which they will evidence of in a post payment audit, in some cases. If the claims are not accurate, and pay, they could come back in an audit with more questions and possibly deny the claims. So, it is vital to start things off with effective compliance training, and then maintain your success through continued efforts in education and practice culture.
We’re here to help. At Dental Auditing Solutions, we work alongside dental professionals, their staff, and their attorneys to provide tools so they can avoid audits through accurate billing and coding. Does the clinical note include the tooth and surface, not just the ledger? Do the radiographs include the crown to the apex? Is each procedure documented or are all caries documented together?
Being proactive gives you the opportunity to implement education and change the process before an external audit. And should you experience an audit or government investigation, we can help you and your team navigate the situation. If you’ve been notified of an upcoming audit, our team is ready to be your guide; contact us today to discuss your next steps during a dental claims audit.
Effective Compliance Can Save You Effort
The dental world centers around prevention. You tell your patients every day that their brushing and flossing are important, but are you taking your own words to heart?
If your team is lacking the tools that they need to be successful, then you could be setting yourself up for failure. Our team understands that being prepared for an audit means knowing your stuff; that’s why we offer compliance training and resources to help your team navigate the shifting landscape of billing and coding. Things change quickly in this industry, so it is important to keep yourself aware of how they do. That way, your team can better manage your claims and avoid audits in the first place.
When Audits Do Arrive
Sometimes, even with proper compliance training, things can slip through the cracks. While we know that you are an ethical provider, it’s the duty of insurance companies and government agencies to ensure that you are taking all the right steps. If they didn’t, our healthcare system would be full of waste and fraud.
But when an audit does come to you, you want to have a team of professionals around you to give you accurate and complete information. With audit services from Dental Auditing Solutions, you have someone by your side who knows the process and is ready to help you move forward.
Be Prepared With Dental Auditing Solutions
When you need a guide to the world of compliance and auditing as a dental professional, give us a call. To find out more about how to be prepared for questions from a private insurance payor or government agency, contact Dental Auditing Solutions at (972) 459-1508 today!