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Seminar Detail

CDT Dental Coding & Reimbursement Update: Identifying Common Practice Mistakes

Thursday, October 17, 2019 at 8:00 AM - 3:30 PM

This event is not currently available for purchase.

For more information: Call (800) 844-8260
Course Description:

Without a thorough understanding of insurance reimbursement, today’s dental office is at a serious disadvantage. In this economy, dental professionals need to ensure that they are getting reimbursed as adequately as they can. Insurance companies use various tactics and strategies that, unless understood, will cause unnecessary delays and rejections during claims processing. Each office has unique insurance problems. All offices have common insurance problems. We will teach you how to be aware of the potential problems and offer possible solutions!

Why this Program is Unique
  • Get your practice up to speed with an experienced dentist who ran a dental insurance company and practiced for 30 years.
  • You will be given a consultant’s perspective on records and billing, so you can do your own audits, increase your income, and decrease your risk.
  • You will obtain helpful, realistic, and practical risk management and practice management tips.
  • You will be given the information you need to file claims correctly and challenge denials with appropriate documentation and narrative.
  • You will understand how insurance companies evaluate your claims.
Most Offices Can Immediately Increase Income with the Information in this Seminar
  • Overcome a down economy with LEGAL ways to maximize billing.
  • Implement proven strategies to improve patient collections.
  • Bill properly for general practice, periodontal, and oral surgery services.
  • Help prevent rejections.
  • Identify what insurance companies look for other than fraud.
  • Assess the claims process from the insurance company’s perspective.
  • Examine the pros and cons of accepting Medicaid.
  • Analyze dental contract language and determine how to best educate the entire dental practice, including the staff, doctor, and patients.
  • Formulate the best narratives and documentation.

  1. Identify what you need to be aware of to maximize billing.
  2. Examine the intricacies of the dental insurance world.
  3. Discuss how your office is being watched and how to avoid billing fraud.

The Dental Contract
  • Insurance carrier rights
  • Trends in today’s contracts
    • Changes in benefit frequency
    • Oral-systemic disease link
    • Avoiding dental fraud
    • PPO participation
Practice Management
  • Fees
  • Patient communication and managing the patient
  • What consultants look for – common practice mistakes
  • The importance of self-auditing records
  • Risk management tips
Avoid Dental Fraud
  • Avoiding “red flags”
  • Suspicious claims
  • Fee discounts
  • Over-utilization
  • Accepting Medicaid: Should you/shouldn’t you?
  • Examples of legal action
The Complete Claim Form
  • How to look at claims like a claims reviewer
  • Correct X-ray, photograph, and narrative submission
Insurance Strategies
  • Learn how the insurance company thinks
  • Learn to correctly resubmit claims for appeal
  • The truth about insurance company stall tactics – Are they real?
  • Effect of the HIPAA laws on coding
  • Effective communication skills
  • Discover how to use the EOB to your advantage
Effective Coding and Billing
  • Tips you can use to keep your practice afloat in a down economy
  • Identify the biggest loss of income for your office and how to correct it
  • CDT – the latest additions and revisions
  • Documentation needed to support claims
  • Correct use and maximization of codes
  • Electronic claim filing
  • Outside financing – Which lender should your practice recommend?
  • The correct claim attachments and narratives – What needs to be included?
  • Important tips to ensure a complete claim – the first time you submit it
Special Areas of Attention
  • Learn to bill periodontal services correctly including the new D4346
  • Fraud: Prevent fraud from occurring in your billing
Target Audience

  • Dentists & Practice Owners
  • Front Office Personnel
  • Office Managers
  • Schedulers
  • Treatment Coordinators
  • Insurance Billing and Collection Personnel
  • Dental Hygienists
  • Dental Assistants
Please bring
  • It is recommended (but not required) that attendees bring current CDT coding books to the seminar
  • CDT coding books may be ordered from the ADA by calling 800-947-4746 or 312-440-2500


Paul Bornstein, DMD, has reviewed thousands of claims, helped draft contracts, and developed fraud detection guidelines as chief dental consultant for a national insurance company. In addition, Dr. Bornstein has over 30 years of dental practice experience. He served as an instructor and assistant professor for Tufts School of Dental Medicine and as a member of the diagnostic department for the Harvard School of Dental Medicine. Dr. Bornstein has acted as an expert for the defense in multiple fraud cases at both the state and federal levels. He has lectured in 47 states including the Yankee Dental Conference, the Greater New York Meeting, and the Big Apple Dental meeting on dental insurance, fraud, and HIPAA. Dr. Bornstein is a published author with articles in Dental Economics and Dental Practice Report and in recent years he has been a contributor for the ADA publication Coding Companion. He is a member of the American Dental Association and the American Association of Dental Consultants. Dr. Bornstein’s seminar is based on his unique experience of being on both sides of the claim form. Participants can expect to receive the most current and accurate information on optimizing insurance reimbursement.

Speaker Disclosures:

Financial: Paul Bornstein is the owner of Dental Office Consultants. He receives a speaking honorarium from PESI, Inc.

Non-financial: Paul Bornstein is a member of the American Dental Association; and the American Association of Dental Consultants.
Credits listed below are for full attendance at the live event only. After attendance has been verified, pre-registered attendees will receive an email from PESI Customer Service with the subject line, “Evaluation and Certificate” within one week. This email will contain a link to complete the seminar evaluation and allow attendees to print, email or download a certificate of completion if in full attendance. For those in partial attendance (arrived late or left early), a letter of attendance is available through that link and an adjusted certificate of completion reflecting partial credit will be issued within 30 days (if your board allows). Please see “live seminar schedule” for full attendance start and end times. NOTE: Boards do not allow credit for breaks or lunch.

If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, or questions on home study credit availability, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

The planning committee and staff who controlled the content of this activity have no relevant financial relationships to disclose. For speaker disclosures, please see speaker bios.

PESI, Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare, PESI Rehab and Psychotherapy Networker.

This program has the prior approval of the American Academy of Professional Coders (AAPC) for 6.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by the AAPC of the program content or the program sponsor. AAPC approval good thru 12/31/2019.

BOC LogoThis activity is offered for 6.0 credit hours.

Dental Hygienists
PESI, Inc. is designated as a nationally approved sponsor by the Academy of General Dentistry, which is recognized by many state dental or hygienist boards. Please check your state rules and regulations to determine if this course meets your state criteria. This activity consists of 6.0 clock hours of continuing education instruction.

Other Professions
This activity qualifies for 360 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific requirements.

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