Hi, all............I have a couple of questions:
first a little background: i've always worked as a coder in a teaching facility doing coding for the physician side but just moved to FL and now work for a dentist (DMD) that is practicing "sleep medicine" with oral appliances (DNA, Somnodent and Moses are our 3 appliances). we are OUT OF network with ALL medical insurances because she's a DMD, not an MD. Every time we call BCBS, or UHC or any ins for that matter to find out what the patient will be responsible for since we are out of network they will tell us "we will cover xx% of the allowable", but NO INS company will give me the allowable amount. does anyone have any tricks up their sleeve on how to find this out. I've been in coding for 10 yrs, but haven't done actual billing/reimbursement in about 8 yrs so I feel as if I'm starting from scratch. And the challenge of getting a medical ins to pay a medical claim under a dentist license/NPI is a challenge in and of itself. I would greatly appreciate any and all help.
You may email me at klpich@aol.com if you'd like or post a reply here.
thanks!!!
Robin
first a little background: i've always worked as a coder in a teaching facility doing coding for the physician side but just moved to FL and now work for a dentist (DMD) that is practicing "sleep medicine" with oral appliances (DNA, Somnodent and Moses are our 3 appliances). we are OUT OF network with ALL medical insurances because she's a DMD, not an MD. Every time we call BCBS, or UHC or any ins for that matter to find out what the patient will be responsible for since we are out of network they will tell us "we will cover xx% of the allowable", but NO INS company will give me the allowable amount. does anyone have any tricks up their sleeve on how to find this out. I've been in coding for 10 yrs, but haven't done actual billing/reimbursement in about 8 yrs so I feel as if I'm starting from scratch. And the challenge of getting a medical ins to pay a medical claim under a dentist license/NPI is a challenge in and of itself. I would greatly appreciate any and all help.
You may email me at klpich@aol.com if you'd like or post a reply here.
thanks!!!
Robin