When it comes to healthcare, patients usually think or assume that medical billing and dental billing work the same way and, for that matter, are the same thing. After all, both the billings involve insurance claims and payments for the care services provided by healthcare providers. However, it’s not like that at all. Though there are a few similarities between medical and dental billing, there are a number of differences as well that patients, healthcare providers, and billers must understand. In this blog, we will discuss the answer to the question “Is dental billing the same as medical billing” in detail. Moreover, we will explain the similarities and differences between the two types of billing. So let’s start:
What is Medical Billing?
Medical billing is the process of submitting and following up on claims with health insurance companies to reimburse payment for services provided by healthcare providers. Medical billing involves proper and accurate documentation of patient diagnoses, treatments, and procedures, as well as knowledge of insurance policies and regulations.
Medical billing is often done either by professional medical billers or healthcare providers. Moreover, it’s the responsibility of the person who is performing medical billing to communicate effectively with both patients and insurance companies to ensure that all necessary information is provided and that payments are reimbursed on time.
What Is Dental Billing?
Pretty much like medical billing, dental billing is the process that involves the submission of claims to the insurance company to get payment for the dental care services provided to a patient. In dental practice management, dental billing is a very key component, and it requires a comprehensive understanding of dental codes, insurance policies, and billing regulations.
A dental biller usually takes care of the dental billing and coding which involves preparing and submitting insurance claims, handling dental coding, and managing claim denials.
Is Dental Billing The Same As Medical Billing?
Medical Billing vs Dental Billing: Similarities
1- Insurance Verification:
Both medical and dental billing involves verifying insurance coverage and eligibility for patients. The patient’s eligibility and insurance verification involve checking the patient’s insurance information, such as policy number, group number, and deductibles.
2- Claim Submission:
In both medical and dental billing, the insurance claim is submitted to the insurance company or payer for payment reimbursement. The claim generally includes the patient’s insurance information, diagnosis, and procedure codes, along with the provider’s information.
3- Reimbursement:
The reimbursement process for both medical and dental billing is also the same. Both the billing involves receiving payment from insurance companies for the care services provided to patients. Moreover, the reimbursement amount is typically decided based on the coverage included in the patient’s insurance plan.
4- Compliance:
In both medical and dental billing, it’s a must to comply with the regulations and requirements set by various government programs, such as Medicare and Medicaid. This includes following coding and documentation guidelines, as well as complying with other medical regulations.
Medical Billing vs Dental Billing: Differences
1- Coding:
One of the key differences between medical and dental billing is the medical codes used. Codes that are used in medical billing are very different from those used in dental billing. Medical billing uses Current Procedural Terminology (CPT) codes and International Classification of Diseases (ICD) codes, while dental billing uses Current Dental Terminology (CDT) codes.
2- Coverage:
The second biggest difference between medical and dental billing is the different levels of coverage. While medical billing covers insurance related to illnesses, injuries, and conditions that affect the body, dental billing only covers insurance for oral health and dental treatments.
3- The Person Responsible for Billing:
In medical billing, all the billing work is managed by medical billing specialists, who are trained to code and submit medical claims. However, in some cases, the healthcare provider can also handle the billing work.
Dental billing is usually handled by dental billers or dental office managers, who are trained and have specialized knowledge of complicated dental procedures and codes.
4- Insurance Requirements:
Just like insurance coverage, medical and dental billing also differ when it comes to insurance requirements. Usually, the insurance plans by various healthcare insurance providers cover the cost of medical treatments and other healthcare procedures. On the other hand, dental insurance plans cover the cost of dental treatment and other oral health-related procedures.
5- Procedures:
Another thing that makes dental billing different from medical billing is the way they are billed. The medical billing process involves patient visits and tests, and they are also billed separately.
However, in the dental billing process, the dental treatment is generally completed in a single visit and is therefore billed as a single service.
Conclusion:
In the end, we reached the conclusion that while dental billing and medical billing are similar in some aspects but they are not exactly the same. Dental billing typically involves less complexity than medical billing, and it has different codes, guidelines, and regulations.
In addition, dental procedures are subject to different coverage limitations and exclusions than medical procedures. Even in terms of the types of procedures and the documentation required, both billings are quite different from each other.
