In order to be successful as a dentist, you must know the dental billing laws. Find out what they are and how they affect you.
This advice is being provided by the Board of Dentistry to inform dental billing laws and regulations in effect regarding the obligations of Minnesota-licensed dentists when working for a professional firm, assigning tasks to others, hiring dentists, and being aware of the unauthorized practice of dentistry. Current license holders may receive advice from the Board regarding how to apply the dental billing laws and regulations that the Board has the authority to enforce. Any court or other adjudicatory body is not bound by the advice provided here.
Background of Dental Billing Laws
Delivery of dental healthcare has changed dramatically during the past ten years. There has been a surge in group practices and dentist-owned businesses that have been incorporated as professional firms; many of these businesses enter into agreements with vendors or third parties to provide business support services. This article is intended to answer frequently asked questions about regulatory topics that we heard from dentists and other licensees offering dental billing services in situations where professional firms are present.
The chosen legislation and regulations listed below are meant to serve as quick references for licensees to help them comprehend their obligations as Minnesota licensees in terms of both the law and their profession. Each dental and allied dental professional licensee, regardless of their roles as owners, partners, or employees, is fully responsible for compliance with all statutes and rules. This advice does not cover all legal requirements.
Professional companies: Decorating Services
In Minnesota, dentists have the option to provide dental professional services under the Professional Firms Act (319B). 123 Smiles LLC, for instance, is owned by Dr. Number, a licensee in Minnesota.
- Dentists have the option of hiring qualified dental experts to work for their business.
- A professional company may not adopt, implement, or adhere to a policy, process, or practice that would provide the Board justification for disciplining a professional who adheres to, concurs with, or acquiesces in it.
Examining the Records of a Professional Firm
In all cases involving the professional firm’s operations covered by sections 319B.01 to 319B.12, the board’s rules, or the generally governing dental billing law of the professional firm, the board may inspect all books and records of the firm and summon and oath-swear the owners, directors, governors, officers, managers, people holding positions of governance authority, and employees of the firm.
- Dental billing laws by the Board of Dentistry is obligated to hold specific licensees accountable for competence and actions that affect patient care, public health and safety, and adherence to Minnesota Statutes Chapters 150A, 214, and 319B.
- Dentists are still responsible for understanding how their environment affects compliance with state legislation, the standard of care, and the suitability of their professional judgments, regardless of how they decide to set up their clinics.
- The individual dentist is accountable for the way in which patients are treated, the means by which they are treated, and the dynamics of the dentist-patient relationship.
- The state of Minnesota’s laws and regulations governing the practice of dentistry are applicable to any contracts that dentists sign, and they are held accountable for any such violations.
DENTISTRY RECORD KEEPING:
Diagnosis, Treatment Planning, and Informed Consent
- The dentist is in charge of keeping the dental record, which must contain the treating provider’s diagnosis, treatment plan, and informed consent.
Patient Records: Transfer and Retention
- Regardless of the status of the patient’s account, providers must transfer dental records.
- Records must be kept by providers for seven years after the patient’s final dental visit.
- Seven years after the age of majority, providers are required to keep underage patients’ records on file (25).
Billing, coding, and refunds for patients
“Overpayments by patients to providers shall be repaid to the patient by the provider within 30 days of the date claim adjudication is received by the provider,” states the policy regarding insured patients.
Utilizing CDT codes for billing
Dental Billing laws states that dentists must bill for dental services with up-to-date, accurate CDT codes. The goal of the CDT Code is to establish accuracy in dental treatment documentation through uniformity, consistency, and specificity. The CDT Code is used in several ways, including to efficiently process dental insurance claims and to fill up an electronic health record.
- Requires appropriate names and addresses in advertisements.
- Requires appropriate disclosure of advertising dental fees and dental billing services.
Identification of Dental Suppliers
In each location where the individual practices, the initial license and subsequent renewal certificates must be prominently displayed in front of patients.
Each dentist’s name, as it appears on their current license certificate, must be prominently posted at the practice entrance.
Professional responsibility is important
Why spend the time learning about the provider’s obligations and the relevant laws and regulations of the jurisdiction in which the provider operates?
The Dental billing laws and regulations governing dentistry practices might differ from state to state. Non-compliance could result in licensing measures if there are reasons to penalize someone. They offer a structure for dependable and professional dental care.
What are some of the matters included as grounds for discipline
- fraud or deception involving the practice of dentistry or the submission of a license application.
- acting indecently or acting against the general welfare of the community.
- Loss of a dental license in another jurisdiction or other disciplinary action.
- failing to maintain dental offices in safe and sanitary conditions.
- An unauthorized person hiring, assisting, or otherwise facilitating the practice of dentistry.
Accepting that a dentistry business may face significant financial difficulties that slow down steady cash flow, make it challenging at times, and seem unachievable is entirely typical. However, relying on a professional for dental support services can really help. Of course, dental billing services are sophisticated and complex. Additionally, it calls for extensive customization and knowledge of the fundamental operations of the organization.
The most important aspect of running a dental office is keeping a steady stream of income. The corporation can accomplish its objective much more quickly by outsourcing dental billing the processes involved in dental insurance verification. The overall cost of outsourcing is reduced, your workers work more effectively, and there are fewer technological requirements to keep up with the current electronic data exchange.
By outsourcing dental billing services, everything is completed correctly, freeing up the front desk staff to handle the schedule and concentrate on explaining treatment plans.
Without taking into account taxes, workman’s compensation costs, vacation time, and bonuses, the average hourly wage for employees who process claims is $18. When all is said and done, these costs close to $50,000 a year. Are you certain that the outcomes correspond to the money you spend?
150A.11 Illegal Actions
Section 1. Illegal Practice
Dental billing law states that anyone who “enables an unlicensed person to practice dentistry, practices or attempts to practice dentistry without a license, practices dentistry under the name of a corporation or company, practices dentistry under any name that may tend to deceive the public, or engages in any of these activities is prohibited.”
“No corporation shall practice dentistry or engage in its administration, or represent itself as having the right to do so, or offer dental billing services or dentists, or advertise as a dentist, dental surgeon, or other analogous title. No corporation may provide dental advice, advertise or represent that it operates a dental office, provide dentists or dental surgeons, or solicit business from patients on behalf of any dentist or dental surgeon through itself, its agents, officers, employees, directors, or trustees.
In accordance with the specific provisions of a corporate practice statute for dentistry, “this section… Does not restrict dentists from incorporating their practice of dentistry for business purposes.”
In the Dental billing law, “If a dentist practices under another name, the name shall include some designation that makes clear that the person is practicing dentistry or a specialty of dentistry, and that the names of all of the participating dentists practicing under that name be clearly identified.”
“Any communication between dentist and patient shall clearly indicate the name of the dentist treating the patient.”
“It shall be unlawful for any dentist to divide fees with or promise to pay a part of the dentist’s fee to, or to pay a commission to, any dentist or other person who calls the dentist in consultation or who sends patients to the dentist for treatment or operation.”