How Our Process Works
Getting started with Elite Dental Medical Billing is easy. We will work with you to get all the necessary information and documentation to get started.
During this call, we will discuss your practice’s specific needs and answer any questions you may have. We will also review our service agreement with you.
You will receive a follow-up email with an onboarding packet and checklist of what we need to set you up in our system. In this packet, you will find everything you need to get started, including a list of the information and documentation we will need from you. Once you have completed the checklist and gathered all the necessary information, you can send it back to us.
After we have received all the information and documentation we need, one of our billing specialists will reach out to you to walk you through the process and answer any questions you may have. They will also ensure that everything is set up properly for billing.
Team Training on SOAP Notes
Once everything is set up and ready to go, our team will provide training on SOAP notes. The length of this training will depend on the practice’s availability, but is typically 1-2 weeks.
Submit Your Claims!
After the training is complete, you will be able to submit your claims for easy processing. We will handle everything from there and keep you updated on the status of your claims.
Dental Billing Services
- We are able to remote in to your existing practice software system to be able to verify insurance, enter detailed breakdowns and eligibility, bill services, and complete claims follow up.
- We act as an extension to your team and operate more efficiently without interruptions. Our experience allows us to bill with less errors.
- For verification, we log in and complete verification for all clients 2 days prior to the appointment. We can do 1-3 days prior depending on your office’s preferences. The office customizes their benefit check form and lets us know exactly how they want their information verified. We verify the insurance and do complete breakdowns annually on all plans (this allows an office to be able to provide correct quotes on treatment plans if treatment changes). We enter this into the DPMS and enter notes into the appointment for specific eligibility.
- For claims submission, we log in to your DPMS, review the clinical notes against the completed claim, read the insurance plan information, and submit the claim electronically with the correct required attachments. If there is missing or insufficient information, we contact your practice in order to correct prior to claims submission.
- For claims follow up (aging report follow up), we follow up on the claims every 10 business days on claims over 30 days in order to ensure that claims are paid promptly. Appeals are sometimes needed, and this is something we assist with as well. We keep on the insurance company until an office is paid 100% of what is rightfully owed. Rightfully owed means that we collect everything that should be paid out based on the patient’s individual remaining benefits and policy coverage. We make all notes regarding these follow-ups in the Claim Status Notes on the DPMS. We do not close out claims that are unpaid unless an office requests it. If an office would like unpaid claims to be closed, we enter into the notes the reason for unpaid claims (e.g. dental max reached or not a covered benefit).
- For payment submission, we log in to the insurance websites to obtain these, enter all payments into the DPMS remotely and put the EOB into the DPMS document center. We keep track of all deposits made by EFT and send that report weekly to your office for balancing on your end from the bookkeeper. This service cuts back on incorrect office adjustments since our billers are certified, trained, and fully understand the laws and coding regulations to know what is a true write-off. We do not accept write-offs that are not part of the plan, and fully understand laws per state in regards to insurance contracts. We are able to maximize claim payment for the patient by requesting alternative processing when applicable. This also protects practices from embezzlement.
- Contracting – if an office would like assistance with becoming in network or dropping an insurance contract, we offer this as an additional service and fee.
- Your office will receive a weekly call to check on any questions or roadblocks the team has had with insurance billing. The office also receives a detailed weekly report of work completed, including number of verifications, claim payments entered, claims follow up, and appeals processed.
- Consulting – if an office is processing claims incorrectly or not properly documenting- we provide consultations in order to correct any issues and create more efficient practices. We offer annual SOAP notes training with any billing package, and an annual coding update webinar with a detailed list of new codes.
Medical Billing Services
- For medical billing, we use an application that can be downloaded on a phone or tablet in the office. It can also be accessed via website.
- We assist your practice with proper setup for medical billing, including customized coding and documentation based on what services we are billing for. We train the team on SOAP notes, and ensure that everything is automated in their DPMS for easy submission.
- Once we are set up, your office completes out procedures in your DPMS like normal. You also will go into the app or website and click on which diagnostic codes and procedure codes you wish to bill. You’ll enter the patient into the app with basic information including name, date of birth, and chart number from the DPMS. From there, we are able to remote into the DPMS in order to access any notes or documentation that we need to bill medical.
- We then complete any insurance follow-up to ensure proper payment. Claim follow up is the same as it is for dental. For EFT payments, the process is the same as it is for dental.
- We offer 2 options for verification. One option would be that your office uses our website only and is able to verify insurance yourself. You would complete any pre-certifications required by the insurance and track this. Another option, is that we complete the insurance verification and request any pre-certification necessary. If we complete the pre-certification request, we work with your office and the insurance company until it is processed and the patient is ready to schedule for treatment. Again, we remotely log in to get any information, and your office puts in a request on the website or app with patient info and suspected diagnosis code and procedure code.
- Credentialing – we offer credentialing as an additional service. We collect the data from your practice through a questionnaire and then we work with the medical insurance companies to ensure that the doctor is properly credentialed in their automated systems in order to avoid claim processing delays. This step is critical when setting up a doctor for medical billing.
- CBCT – we do the same process for CBCT as we do for medical billing.
- For medical billing, your office is able to see all pending claims and any notes by logging on to the portal. We also put these notes into the DPMS.
- Weekly calls and reporting are the same for medical.