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DentalCare

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The Business of Dentistry: Financial Management for the Dental Office

Natalie Kaweckyj, LDARF, CDA, CDPMA, COMSA, COA, MADAA, BA; Wendy Frye, CDA, RDA, MADAA; Lynda Hilling, CDA, MADAA; Lisa Lovering, CDA, CDPMA, MADAA; Linette Schmitt, CDA, RDA, MADAA; Wilhemina Leeuw, MS, CDA

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Upon completion of this course, the dental professional should be able to:

  • Define HIPAA.

  • Describe what HIPAA requires.

  • Discuss how protected health information can be recognized.

  • Identify situations in which information can be disclosed without consent.

  • Describe penalties for HIPAA noncompliance.

  • Identify instances when a parent of a minor may not have access to health information.

  • Identify individuals considered business associates under HIPAA.

  • Explain how to create or maintain financial arrangements with patients or the responsible party.

  • Demonstrate how to maintain patient account records including a record of all charges, payments, and adjustments to the account.

  • Understand why patients should be provided with a receipt or walkout statement.

  • Verify day-end totals for all charges, payments and account adjustments.

  • Show how to prepare a daily bank deposit of all receipts.

  • Verify that daily totals have been accurately carried over to the monthly summary.

  • Explain how to generate patient account statements on a regular basis.

  • Demonstrate how to prepare and verify month-end accounts receivable and related management reports.

  • Explain how to handle delinquent accounts.

  • Understand and describe the different methods of third-party payments including: UCR, schedule of allowances, DMO, HMO, IPA, PPO, direct reimbursement and capitation programs.

  • Understand and be able to explain insurance coverage to a patient and formulate financial arrangements accordingly.

  • Demonstrate how to prepare and submit pre-treatment estimates and claims to third-party carriers.

  • Explain how to follow-up on delayed, lost, and/or rejected third-party claims.

  • Explain how to determine eligibility of benefits.

  • Describe the birthday rule.

  • Give an example of an alternative benefit policy.

  • Explain dual coverage, primary and secondary carriers.

  • Give an example of a non-duplication of benefits scenario.

  • Understand the CDT code categories.

  • Describe advantages of electronic claims submission.

  • Understand the difference between release of information and assignment of benefits.

  • Explain what a pretreatment estimate is, and what factors can affect the estimate.

  • Give examples of reports for tracking claims.

  • Identify key information on an EOB.

  • Understand what actions can constitute fraud.

  • Understand how to differentiate between invoices and statements.

  • Demonstrate how to verify a packing slip.

  • Describe how to manage expense records by appropriate categories.

  • Discuss how to balance a checkbook.

  • Explain how to reconcile bank statements.

  • Discuss how to manage the petty cash fund.

  • Explain what information is required for payroll deductions.

  • Explain how long payroll records should be maintained for tax and government purposes.

  • Explain how to establish and maintain an inventory system to assure adequate quantity of supplies in the most cost-effective manner.

  • Demonstrate how to determine the reorder point and reorder quantities of consumable supplies.

  • Explain how to order supplies in accordance with practice policies.

  • Discuss the different types of inventory systems.

  • Differentiate between expendable, non-expendable and capital items.

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