Course Offerings

This course introduces the dental revenue cycle including dental insurance types, verification, breakdowns, estimates and how to avoid errors when filing dental claims. Once the student has a basic understanding of insurance and filing guidelines and requirements, the course will transition to dental coding and review the most current dental CDT codes and their descriptors and clinical documentation requirements. This will include case studies that review the appropriate use as well as clinical scenarios.

Course Objectives

• Identify the purpose of dental insurance and the difference between medical insurance
• Describe the various types of dental insurance plans and their guidelines and requirements
• Review terms related to the claims process including insurance participation, insurance estimates, verification, breakdowns, treatment planning, EOBs and AOB
• Defend insurance denials with the appropriate documentation, including appeals
• Compare the dental front office job duties including the role of the dental insurance coordinator
• Evaluate complex, real-life case studies and apply the concepts retained from the course material to defend billing against clinical documentation
• Analyze the layout and organization of the most recent year CDT book and properly code procedures from clinical documentation scenarios
• Examine and study dental coding related to various specialties and subspecialties

Outline of Instruction

What is Dental Billing and Coding?

Types of Insurance & In/Out of Network

Dental Insurance Verification, Breakdown and Estimates

Dental Claims

Explanation of Benefits & Assignment of Benefits

Avoiding Claims Errors and Denials & Non-Covered Services

Understanding Discounts and Fraud & How to get Paid for Commonly Denied Services

The Role of the Insurance Coordinator

Case Studies

Dental Coding - How to use the CDT Book

Diagnostic and Preventative Services

Restorative, Endodontic and Periodontics

Prosthodontics & Implant Services

Oral and Maxillofacial Surgery

Orthodontics & Adjunctive General Services

Contact Hours

128

CEUs

No

Industry Standard, State or National Certification

Certification

CDC - Certified Dental Coder and CDBS - Certified Dental Billing Specialist

Website

adcaonline.org

Certification Learning Outcomes/Requirements

CE or CU Articulation

No

Prerequisites

Dental Terminology or appropriate background working with dental terminology

Learning Supplies Needed

2024 CDT code book (ADA)
Dental Administration with Confidence 2024 by Charles Blair, Greg Grobmyer and James DiMarino ISBN: 978-1-7373947-8-5

Clinical Site/Special Facilities

None

Requirements for Successful Completion

80% attendance
Active, online, regular weekly attendance and participation is vital for successful completion of the course.
Regular online weekly participation is required to be successful in this course.

Accreditation/Special Approval Requirements

N/A

Intended Audience

The intended audience for this course is all dental office staff - from the front office to the patient care workers.

Specific Industry or Business Support Needs

Dental Office Managers, Dental Front Office staff (Receptionist, Office Assistant, etc.), Clinical Documentation Improvement, Dental Coders

Wake County Need for Industry Positions

N/A

Industry or Job Titles Related to Training Outcomes for Employment

Dental Front Office

Dental Coder

Dental Biller

Related Courses

Course Contact Information

Samantha Bray
919-532-5844
[email protected]