1 CE Credit

You will receive 1 unit of continuing education credit upon successful completion of this course.

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ADA Member: $28.00
Nonmember: $42.00
Dental Team Member: $15.00

Author:

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ADA, Council on Dental Practice and Saleable Materials

Learning Objectives:

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Upon completion of this course, participants should be able to do the following:

1. Explain the basics of a dental benefit plan
2. Explain the difference between various types of plans
3. Work with third-party payers
4. Be knowledgeable about dental claims submission (including predetermination and/or preauthorization)
5. Be familiar with dental coding

Abstract:

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The course on Handling Dental Claims, Codes, and Processes explains how to deal with the intricacies of benefit plans. There is information about the many aspects of the insurance claim and dental reimbursement process. Instruction on how to handle a claim form and how to monitor the progress of the submitted forms are so valuable. An overview of coding, including dental/medical cross coding, simplifies the process of completing the claim forms and helps to assure that all of the possible savings to the patient and benefits to the dentist are realized. The fairly new, but very necessary, use of the National Provider Identifier (NPI) is explained and readers are given specific guidance on how to begin the process of applying for an NPI.

The reader will become familiar with all of the terminology used because the course includes definitions in the plan information/contract language section. Definitions of terms such as customary fee, usual fee, and reasonable fee help to make forms understandable instead of confusing. The course also includes a glossary of dental terms.

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Outline:

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References:

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