THE7SINS
A t GoGo Billing , we ’ ve worked with hundreds of dentists over the past 7 years . Every day , we encounter issues that negatively impact productivity and workflow . Sometimes it ’ s due to internal issues or insurance company headaches , but it ’ s often attributable to practices committing the “ 7 Sins of 3rd Party Billing .” The motivation behind each of them is admirable but they actually slow down the claim cycle . My aim here isn ’ t to point the finger outwards . If you can help us help you , then everyone wins .
When faxing documents , please ensure they ’ re all facing upwards and in the same direction . When they ’ re faxed haphazardly , we have to stand on our heads to read one page of the sleep study , use the “ rotate ” function on the
DED
next page , and , well , you get the picture . This is time consuming Abbreviation and prevents
for us
“ Deductible
from processing is how your much claims money as quickly the patient as we is
”
This supposed should to be spend . At GoGo out of , we their ARE pocket honing the our benefit upside of insurance down actually reading
until starts skills . Some , but plans we are have fast doctor turning visits into and hunchbacks preventive . care available that is not subject to the deductible . We are not in that group PRIDE ; for us , deductibles usually apply only to OAT .
You cannot sign your own Letter Of Medical Necessity ( LOMN )
FAM or RX
DED
for the appliance . Only a physician can do this . When we “ Family receive
Deductible an LOMN
” signed by the
This dentist means , we that have each to family contact member you has to their resolve own the deductible issue . That to means meet , but that there we may ’ re be not a processing limit or cap and your once it is met by any family member it starts benefits for the whole family . For instance , the plan has a $ 1500 claims or anyone else ’ s . Instead we ’ re listening to Talk 102.5 on your hold greeting . We appeal pre-authorizations and claims daily but if we are not armed with a strong file we will lose . Reach out to those PCP ’ s and sleep doctors and let them know who you are and what you ’ re doing . It ’ s routine , guarantees your documentation is in order , and it ’ s also a simple , effective marketing opportunity .
We hate paperwork . So do you . It ’ s obvious when you send incomplete superbills with illegible handwriting and scribbles that look like hieroglyphics . We can ’ t decipher who it ’ s from because there ’ s no doctor ’ s name . Patient name ? Who needs it , right ? Wrong . Will sending the superbill with
EXCLUSION no patient name
FOR
, an
DME
illegible doctor name , and an upside down , poorly photocopied insurance card expedite , we have your run claim across ?
Unfortunately some To the medical contrary plans , my that friend have . We an ’ ll exclusion likely be for unable some to discern or all who DME supplies sent the . When information we call for and a benefit
will
verification sit in our Cold or use Case an Files online until tool you we are angrily specifically call us looking wanting for to the know DME benefits why you , as haven they could ’ t been be paid different yet . then For traditional what ’ s worth benefits , if and you services switch . If to the DS3 Medical , then we plan can has eliminate an exclusion the for need DME for supplies superbills , do and not faxing assume entirely representative . is aware of what the specific DME supply you are referring to Please . The plan know may that not I pay ’ m sharing for crutches this and with boots you but because If CPAP I is want covered to , help then OAT you should . These be issues as well aren . ’ t inherent to your office or our billing company . Whether you work with
DED , EOB , WTF ?!?
SLOTH
7
MEDICAL NECESSITY
This is an unknown term in dentistry
LESIA CRAWFORD
OF 3 3RD RD PARTY BILLING : AVOID THESE PITFALLS
WRATH
GoGo or another billing firm , I urge you to avoid these sins . Stay tuned for the next issue when I ’ ll cover Greed , Gluttony , Envy , and Lust . We want to appropriately process as many of your claims as possible in as little time as possible . We just need you to help us help you .
LESIA CRAWFORD LESIA CRAWFORD
CEO of GoGo Billing
GoGo Billing offers help with Tricare registration for no charge and Medicare credentialing services for DME , Part B and Ordering and Referring . Enter code DS3100 for $ 100.00 off DME and Part B credentialing .
Contact me at Lesia @ GoGoBilling . com or call ( 877 ) 874-4646 ext . 1 .
need for treatment should be listed as lifetime . DS3 has the perfect template