Bill insurance on crown seat date

For users or potential users.
Post Reply
User avatar
doctordoom
Posts: 41
Joined: Tue Sep 25, 2012 10:39 am
Contact:

Bill insurance on crown seat date

Post by doctordoom » Wed Apr 30, 2014 6:18 pm

How are you guys doing this? I had been billing the insurance on the prep date, but now i realized they want to bill on the seat date.

I read one thread on here where someone made fake procedure code for example N2750 for crown prep, then used the D2750 as the crown seat. And then just billed the insurance so that way the D2750 will reflect the seat date as opposed to the prep date.

How are you guys doing it? Are there other ways?

boboffice
Posts: 89
Joined: Sun Mar 29, 2009 7:11 am
Location: Poway, San Diego County, CA

Re: Bill insurance on crown seat date

Post by boboffice » Wed Apr 30, 2014 10:24 pm

I solved this problem with my CEREC. :D
Robert Marcus DMD
Univ. of CT '93
Poway, CA

User avatar
doctordoom
Posts: 41
Joined: Tue Sep 25, 2012 10:39 am
Contact:

Re: Bill insurance on crown seat date

Post by doctordoom » Thu May 01, 2014 7:33 am

boboffice wrote:I solved this problem with my CEREC. :D
LOL yeah, i don't have a cerec.

Can someone chime in who does crowns the traditional 2 appointment way?

efeuer
Posts: 7
Joined: Tue Apr 08, 2014 7:24 am

Re: Bill insurance on crown seat date

Post by efeuer » Thu May 01, 2014 8:01 am

I am having the same issue; several insurance companies have started rejecting crowns that are billed on the same day as a core buildup for us.

drmaximus
Posts: 75
Joined: Wed May 26, 2010 7:51 am

Re: Bill insurance on crown seat date

Post by drmaximus » Thu May 01, 2014 8:46 am

Yep. I have the same issues with insurance companies

User avatar
Jorgebon
Posts: 502
Joined: Mon Jun 18, 2007 2:25 pm
Location: Mayaguez, PR
Contact:

Re: Bill insurance on crown seat date

Post by Jorgebon » Thu May 01, 2014 10:01 am

I have a code for crown prep and a code for crown seat. I set complete the crown code on the date of the crown seat.
Jorge Bonilla DMD
Open Dental user since May 2005

efeuer
Posts: 7
Joined: Tue Apr 08, 2014 7:24 am

Re: Bill insurance on crown seat date

Post by efeuer » Thu May 01, 2014 10:52 am

Jorgebon wrote:I have a code for crown prep and a code for crown seat. I set complete the crown code on the date of the crown seat.
What procedure do you schedule for during the actual crown prep then?

Or do you schedule the crown prep and then just leave the procedure as "TP" for a few weeks until you cement the crown?

User avatar
Hersheydmd
Posts: 700
Joined: Sun May 03, 2009 9:12 pm

Re: Bill insurance on crown seat date

Post by Hersheydmd » Thu May 01, 2014 8:08 pm

I think my solution is the best.
This may sound complicated, but it really isn't.
Let's say your fee is $1000. You want the patient to pay half on the prep date and the other half on the seat date.
I have a dummy code for C&B prep (could be N9991 or anything), and the fee for it is half or $500.
I have another dummy code for C&B delivery (could be N9992...) and the fee for it is $-500 (yes, that is negative 500)
When I set up the tx plan for the tooth I set up 3 procedures:
a) C&B Prep code $500 (NoBillIns)
b) C&B Delivery code -$500 (NoBillIns)
c) C&B procedure code $1000
(I set up a procedure button, so clicking on the tooth and the procedure button creates both the prep & delivery code at the same time)
On the first appt I attach the prep code, mark it complete, and the patient pays $500. The account shows a zero balance to date, but the tx plan shows another $500 left to do ($1000 & -$500)
On the seat date, I attach both the procedure code (full fee) and the delivery code (credits back the original prep fee). We mark both codes complete, the patient pays the $500 balance, and the procedure is submitted to insurance, with the full fee and the correct (seat) date.
If it is a more complicated case with more intermediate steps you can split the fee among any number of appts as long as the delivery fee credits back any prior fees so everything balances.
The main benefit is that it enables you to collect fees as you go along and the patient's register shows what is actually owed to date (hopefully zero if your front desk is doing their job)
Last edited by Hersheydmd on Fri May 02, 2014 10:08 am, edited 1 time in total.
Robert M Hersh DMD, FAGD
Univ. of Penn 1982
Brooklyn, NY 11234
https://www.facebook.com/pages/Robert-M ... 1471599429

User avatar
Jorgebon
Posts: 502
Joined: Mon Jun 18, 2007 2:25 pm
Location: Mayaguez, PR
Contact:

Re: Bill insurance on crown seat date

Post by Jorgebon » Fri May 02, 2014 6:49 am

efeuer wrote:
Jorgebon wrote:I have a code for crown prep and a code for crown seat. I set complete the crown code on the date of the crown seat.
What procedure do you schedule for during the actual crown prep then?

Or do you schedule the crown prep and then just leave the procedure as "TP" for a few weeks until you cement the crown?
Yes, I schedule the crown prep and leave the crown as planned until cementation.
Jorge Bonilla DMD
Open Dental user since May 2005

babysilvertooth
Posts: 129
Joined: Sat Jun 12, 2010 3:18 pm

Re: Bill insurance on crown seat date

Post by babysilvertooth » Fri Jun 06, 2014 12:48 pm

I enter the procs code on prep date, make a claim (but don't send it) so I know what to bill patient and what is remaining. ON seat date, i enter seat crown code (internal code), and write a narrative on claim of seat date, which goes out with the X-ray showing the seated crown. KISS

macadoo
Posts: 3
Joined: Wed Jun 11, 2014 6:49 am

Re: Bill insurance on crown seat date

Post by macadoo » Wed Jun 11, 2014 6:51 am

babysilvertooth wrote:I enter the procs code on prep date, make a claim (but don't send it) so I know what to bill patient and what is remaining. ON seat date, i enter seat crown code (internal code), and write a narrative on claim of seat date, which goes out with the X-ray showing the seated crown. KISS
Does your front office staff ever mistakenly submit the claim on the prep date? Do you have a system in place to flag a crown prep claim to be held until the seat date?

babysilvertooth
Posts: 129
Joined: Sat Jun 12, 2010 3:18 pm

Re: Bill insurance on crown seat date

Post by babysilvertooth » Wed Dec 10, 2014 9:05 am

I have one person in charge of claims, so 99% of the time, she knows to send on seat on date, unless I have a few insurances that allow on prep date (but less and less often).
When it is procedure and protocol, things don't get messed up....

Post Reply