These TIPisodes keep getting better and better! Teresa gives us another round of great advice and in this tip, she tackles the new Perio Classifications!
Teresa Duncan, MS is such a wealth of knowledge. Please visit her website and enjoy her awesome resources! For more info from Teresa, see below!
Teresa Duncan: Speaker on insurance and management, Podcaster, Author of a book and contributes to several magazines and the ADA’s publications!
Book : http://odysseymgmt.corecommerce.com/Book/
use code TALE for $3 courtesy (offsets shipping)
This TIPisode has been transcribed for your viewing pleasure:
Michelle Strange: A Tale of Two Hygienists presents this week’s TIPisode: Quick and easy tips to keep you up to date, and presented by the experts in the profession. Now, get ready for your unofficial TIPisode.
Teresa Duncan: Hi. This is Teresa Duncan with the Nobody Told Me That! podcast, and I’m happy to be back on A Tale of Two Hygienists for a quick tip on how to handle insurance in your office even though you’re a hygienist and usually don’t want anything to do with it. Let me see if I can help with that.
Well, I know that you have some new classifications that have come out, well, last year. So I know they’re not necessarily new, but they’re new to a lot of offices. In my classes, I ask if anyone has heard of these or talked to their teams about them, and it’s 50/50. So chances are you’re in an office where they may not have been introduced, and so let’s talk about this for a second.
When you have these new classifications, what we need to do is introduce them to the teams because what they’re going to do is use these classifications when they are writing the narratives for your claims. The claims being for the scaling and root planing, for the 4910s, the stuff that typically we need to send in additional information for. So I’m not asking for you to teach them clinically all of the staging and the grading — and if you’re not sure what I’m talking about, please go back into the archives of A Tale of Two Hygienists podcast because I know that they have talked about this and they’ve had a couple shows on the new classifications.
So you as the hygienist in the office, I’m not asking you to teach a fully clinical course to your teams. But we do need to go over some aspects of it so that, for example, if I’m your insurance coordinator, I would be able to write a good narrative regarding the classifications.
So starting today what I would do if I were you is to take some examples of some of the more severe cases you see. And this could be a month project. You see a lot of stuff in a week, a lot of stuff in a month. So let’s start right now, and for a month have you note down the different cases that you’re seeing. You may even want to take a printout of the classification and next to each one when you see a patient write down their name next to the one that you think it applies to. The reason I want you to do that is when you have a team meeting — which you really should have a team meeting about this when you feel confortable — when you have a team meeting, you’ll be able to pull up patient’s names with the intraoral images, with the radiographs, with the perio readings, and it’ll give everybody an idea of where you classify all of your patients.
And, of course, your doctor and you would have to be on the same page. That’s usually not an issue when I go into offices and talk with them. But again, if you’re not on the same page, then that’s something that I would start with.
With your 4910s, pull out a few names and put those down on the grading scale because we need to know as — if we’re trying to get a 4910 paid, we as admin people need to know where they are on the grading so that we can write that in to any narrative that may be needed. Now, 4910s typically don’t need a lot of narratives, but it could change once the insurance carriers really begin to use the staging and grading criteria, which is probably going to be next year, which is 2020. I’ve been hearing that from multiple carriers that they will start to incorporate that into their coding guidelines, and that means that your admin people are going to be looking to you to help them with these narratives. So get started on that now. I would do that now.
I don’t want you to have to write the narratives because, let’s be honest, that’s not what you went to school for and that’s not what you really want to do. But it would be very helpful if we could get your help in writing the first couple so that we know exactly what you’re looking for and what you’re trying to indicate with your notes.
One other issue I would bring up in your team meeting is where in the notes can I as your insurance coordinator find this information? Do you keep it in the same clinical record? Of course you probably do, but I have come across some offices where they’ll put notes on the perio chart or they’ll have notes in a different area of the software. It is very software dependent, so make sure your admin team knows where they’re looking so that they can find it easily. And really, the goal is to not get bugged about it, right? So that they’re not constantly coming to you for help with this.
So if you’re looking for any handouts to help you with this, of course the perio.org page, the AAP’s page. It’s perio.org. They have a whole microsite on there about the classifications, the staging and the grading. And again I would look back to previous episodes of the A Tale of Two Hygienists episodes because I know Michelle and Andrew have gone over this with a couple different guests and those would be very, very helpful for you. In fact, if you think it’s appropriate, tell your admin team about it. Why not have them listen to some of the same information so you don’t have to repeat yourself.
I hope that it’s been helpful for you to just get a heads up on the team meeting that you’re inevitably going to have.
One other note that I wanted to make is that we are definitely seeing — I’m definitely seeing in my insurance classes — I’m seeing more hygienists and clinical team members come in and taking [sic] these classes. And so if you’re one of those and you’re in my class and you’re thinking, “What am I doing in here,” I hope that I’ve made it fun for you. Please come up and say hi to me. I would love to meet you. I do appreciate when clinical team members come into my classes because I can tell right then and there that that office is not going to have issues with reimbursement when they come together as a team. It always takes two parts of a good narrative to get paid. The person who writes it, makes it clear, and the person who can submit it and send it at the appropriate time.
And when you come with your team to take my insurance classes, I promise it will not bore you. But it will also be a lot of information for you to go home and digest, so I do appreciate if you have made it into my meetings. I’ve heard from several of you, and it’s been really cool to put the dots together.
If you have any questions about insurance or anything that has to do with narratives, hit me up. You’ve got my — my email will be in the show notes. My website, actually, has a lot of free webinars and free articles that are good for both admin and hygienists as well. And hopefully, you will think of me when you have any coding issues. Until the next time, enjoy A Tale of Two Hygienists, and come check me out on my podcast Nobody Told Me that!
Michelle Strange: We hope you enjoyed this week’s TIPisode. Be sure to reach out to our guest experts and let them know how helpful their tips were. Follow A Tale of Two Hygienists on Facebook, Instagram, and head over to ataleoftwohygienists.com and subscribe to our newsletter. You can also email us at firstname.lastname@example.org, and keep listening for more awesome content from your unofficial dental hygiene podcast.