Dental Sleep Medicine Insider August 2016 | Page 22

LESIA CRAWFORD

THE 7 SINS OF 3RD PARTY BILLING:
AVOID THESE PITFALLS,
PITFALLS PART TWO
L

ast issue I tackled the sins of
Pride, Sloth, and Wrath. This time
I’ll touch on the others. Please
know that I’m sharing this not as
an indictment of your practice.
My goal is to shed some light on
the issues that GoGo Billing and
our peers encounter so you can
avoid them. Doing so makes everyone more productive. Skip
to the end for a reference to the
movie Seven that you may or may
not get. Enjoy….

can verify that the claim paid
properly and then we have the
ammo required for re-processing
to have another check sent. We
may only have 30 days to request
the correction and holding on to
the EOB costs us both money and
time.
P.S. Don’t have me do your benefit checks and pre-authorizations
for you claims and then file them
on your own to avoid paying me,
that’s just bad business.

relationships with primary care
doctors and sleep physicians.
Running after the insurance
plans will leave you turned off to
treating sleep apnea patients.

ENVY

GREED

LESIA CRAWFORD

(aka “I think I can do this”) Everyone wants to be a medical billing
superstar but it’s just not that
easy. If you want all the answers,
go to billing school, then learn
the hard way that everything you
learned in school was wrong, revise it all, and then you can be
cool like us. Please don’t call me
and ask specific questions like
“what modifier should I use to
submit my own claim” if you are
not a client. Google it. You won’t
have to pay them a percentage of
collections. You probably won’t
get paid either.

GoGo Billing is happy to bill
based on your fees, but if your
claim hits above $9999.00 there’s
a special place for your claims.
It’s called “audit purgatory.” It’s
a scary place and you don’t want
to go there. Set your fees higher than the allowed amounts and
give yourself room to negotiate
but don’t be greedy.

GLUTTONY
When your claim pays, please
send the EOB and let your biller
know it was paid. Ultimately, we’ll
find out when we are following
up on claims. When armed with
the EOB in a timely manner we

LUST
You want to negotiate the lowest
fees and get in network with all
the plans so you can see all the
patients and be THE DSM practice
in town. Congratulations, you
have done the equivalent of signing up with every horrible dental
plan and committed yourself to
placing MODBL composites for a
capped fee of 69.00 bucks. Have
fun. My advice is to build your
sleep practice by screening your
existing patients and developing

What’s in the box?? No, it’s not
the head belonging to the CEO of
a of big, bad insurance company.
It’s a box of chocolates we will be
sending you at the holidays for
your valued business and friendly
cooperation.