A start-up founded by a dentist with more than 20 years of experience in dental insurance coding strategies is now making this information available via a secure, Web-based service that gives dental professionals 24/7 access to information about dental codes and billing.
The Practice Booster Coding Advisor was launched September 15 by Charles Blair, DDS, who is also publisher of the Insurance Solutions Newsletter (ISN). The service, which already boasts nearly 400 users, leverages 20 years of data compiled by ISN and is designed to help users with the following:
- Find the correct dental code for a new procedure.
- Write narratives for those dental procedures that require them.
- Know which procedure codes are likely to have frequency limitation and/or receive an alternate benefit.
- View clinical video clips to better understand certain services and procedures.
- Access decision trees to help troubleshoot administrative billing issues such as refund requests and Medicare participation.
- Be notified when dental insurers change processing policies that will affect reimbursement.
"This is the first lookup system for CDT [Code on Dental Procedures and Nomenclature] codes," said Tripp Blair, Dr. Blair's son and vice president of Practice Booster. The ADA CDT manual "is nothing like this," he added.
The heart of the Practice Booster Coding Advisor is its search engine, which allows users to search the database either by the CDT code or topic and find the correct dental codes for any service performed by a dentist, as well as commonly used products and materials.
For example, if you type in "prophylaxis," the system yields a list of codes and descriptors related to that topic. Mouse over any of the codes or descriptors and you get a pop-up with a description of what the code covers, based on the 2010 ADA CDT codes. You then click the "view code" button to see the full code description, plus any associated warnings, comments, limitations, tips, notes, narratives, and flow charts.
Other features on the Practice Booster site include news alerts, discussion forums, articles about coding and other administrative and billing issues, and overviews of state laws pertaining to the coordination of benefits, insurance refunds, record keeping, dental practice acts, and more.
"Not everyone knows every code, and we want to make sure the dental staff is aware and educated," Blair said. "We are seeing the government, the Justice Department, really cracking down on dentists, and they are going after the person who files the claim. So if you are the one who used the wrong code, you are responsible. In some cases, the doctors don't even know they are committing fraud -- they were just coding wrong."
Practice Booster is also designed to maximize reimbursement for dentists through proper narratives and coding, he added.
"You should always be paid for what you do," Blair said.
Practice Booster Coding Advisor costs $297 a year, which includes a subscription to ISN. There is also a one-day free trial. The paid subscription allows a user to access Practice Booster from a single IP address for up to nine hours in a single 24-hour period, although there are limits on how many codes a user can look up in that nine-hour period. It is also compatible with the iPad and most smart phone platforms.
"Practice Booster is designed to be an educational resource for the front desk," Dr. Blair said. "The administrative side of insurance is getting beyond many practitioners, and dental practitioners need these kinds of skills and resources."