Imagn Billing Case Success Story

Medical Billing For Orthodontic Treatment.

The Orthodontic Case Overview

What follows are the details for this Imagn Billing case success story about medical billing for orthodontic treatment.  Read on to learn how a dental practice in Washington state successfully billed for orthodontic treatment. The practice completed this service March 11, 2020, and submitted the case to our Imagn Billing team November 5, 2020. On March 25, 2021, the insurer, Tricare West – HealthNet Federal Services, initially denied the claim. The Imagn team appealed the insurer’s decision on August 3, 2021.  Then, on September 15, 2021, the medical claim was paid at 100% of allowable

The Case Details

An 18-year-old male patient presented for an evaluation foA. HPI (history of present illness) patient has had increase in malocclusion with more hypoplasia. The oral physician notes that due to the medical conditions, orthodontics is required to prepare for the additional facial surgery.

Proving Medical Necessity

As noted in the providers SOAP note:
  • History of recurring pain and malocclusion
  • Facial Bipartition Surgery
  • Midface hypoplasia

Billing Medical Insurance

The practice collected all required documentation and clinical SOAP notes .  (Course on SOAP notes is available free by Devdent.) The pre-authorization on medical billing for orthodontic treatment was completed and approved.

Allowable was $5,267.68. Total collected from patient and insurance $5,267.68.  $0 applied to deduct, $0.00 applied to co-insurance.  Dental insurance paid $0.00.  Patient portion $0.00.

The medical insurance paid 100% of the orthodontic treatment.  This patient’s parents were ecstatic that the provider obtained these medical benefits. Otherwise, the funds would have had to come out of their pocket.  Instead, medical billing for orthodontic treatment paid 100% of the services provided.

At Devdent, we are passionate about guiding dental and orthodontal practices on how to be paid for the great services they provide.  We offer access to live, on-site, and online educational courses on correct submission of dental and orthodontic treatment claims to medical insurance when appropriate.  And we’ll let you in on a little secret:  it is almost always appropriate. 

Imagn Billing offers software, forms, other tools and personal support to complete the claims properly and timely.  The end result is that your practice increases case acceptance so you can get paid for the work you do.  Talk to one of our experts to learn more.

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Imagn Medical Billing Service

Due to the complex nature of medical insurance billing, most dental offices are not equipped with the knowledge to properly credential national payers, submit successful claims, or handle aging and appeals. Imagn Medical Billing Service performs the proper credentialing and billing for you, which results in fewer denials and time well saved as you rely on expert help.

One-Time Credential Fee

$795/per dentist

The key to more successful payments

Our experts complete the process so you can start billing medical insurance. Each dentist billing medical insurance needs to be credentialed.

Pay Per Case

Verification of Benefit

$35 per vob

We get your patient’s insurance information so you can set proper expectations with the patient regarding the specific coverage available and any out of pocket fees. This is the most critical step in all of medical billing.

Per Authorization

$40 per auth

All procedures require pre-authorization in order for your practice to get paid. Gaining appropriate authorization can be challenging, let our experts get the job done for you.

Claim Submission

8% of successful claim

You don’t have time to sit on hold. Let us sit on hold and handle the claim submission work for you  We also handle the aging and appeals so you can focus on your practice.

Choose Your Software

Imagn Software is your one stop solution with both medical billing and dental sleep medicine capabilities with world-class support

What most dentist don’t know is that medical billing can increase your case acceptance rate and ensure your patients get the care they need.

Imagn Software

$195 /month

No contract and your satisfaction guaranteed.

Our goal is to give you the best experience. But if you are not satisfied then we will give you a full refund for your software access fee within 30 days of purchase.

Add Imagn Sleep Software

$100 /month

Our software provides everything you need

to give your patient’s the sleep care they deserve.

Patients can no longer afford to have dentists ignore the responsibility of providing care for sleep disorders. Two out of every three Americans report poor sleep; the ability to breathe well is the most important factor in determining a person’s sleep quality. 

Imagn Software Set-up Fee

$399 one-time fee

No contract and your satisfaction guaranteed.

Our goal is to give you the best experience. But if you are not satisfied then we will give you a full refund for your software access fee within 30 days of purchase.

Choose Your Monthly Devdent Support Program

In order for you to succeed, we offer a unique range of customer support solutions including coaching, online resources, implementation programming, and so much more. We keep an eye on the ever changing industry trends so you can focus on your practice

Medical Billing Support

$200 /month

The program to get and keep your staff trained.

Dental Sleep Medicine Support

$200 /month

The program to implement Dental Sleep Medicine into your practice.

Bundle

$345 /month

Get both of the Medical Billing and Dental Sleep Medicine Support programs at a discount.

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