Christine Taxin

The #1 authority on medical/dental
​cross coding in dentistry today.
She’s helped thousands of dental
practices increase their case
acceptance and profitability
​through medical reimbursement.
Founder and president of Links2Success, a practice management consulting company to the dental and medical fields. With over 25 years’ experience as a practice management professional she now provides private practice consulting services, delivers continuing education seminars for dental and medical professionals and serves as an adjunct professor at the New York University (NYU) Dental School and Resident Programs for Maimonides Hospital.

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See Christine in action in the following samples of her speaking engagements, interviews and articles.
VIDEO
PODCASTS featuring Christine
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The Passionate Dentist with Dr. B
Dentistry’s Ideal Practices with Jayme Amos
ARTICLES
Increase Profits Without Raising Fees
By Christine Taxin
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Increase Profits Without Raising Fees
By Christine Taxin

Billing is the process of submitting and following up on claims to insurance companies in order to receive payment for services rendered by a provider at your dental practice. That definition may seem obvious, but your dental office may be losing revenue daily due to lax billing practices. The problem: haphazard and imprecise dental and medical diagnostic coding for your services.
 
The Impact of Billing and Coding Problems on Your Business
 
Dental billing and coding problems can cost you thousands in lost revenue. But it’s lost revenue that you can easily recapture—with a better understanding of the latest billing and coding methods.
 
“The difference between profitable, growing dental practices and those who barely break even: expertise in dental billing and coding.”  — Expert industry consultant and trainer, Christine Taxin of Links2Success
 
Your Disadvantage: Dealing with Insurance Company Experts
 
One thing is certain–insurance companies train their teams to be experts in dental diagnostic codes and treatment codes, so that they don’t pay you any more than absolutely necessary. If your office has fallen behind on the latest dental coding and billing best practices, using the same codes constantly because they are all you know, you are leaving money on the table.
 
Due to lack of billing and coding skill:
  • You’re using inadequate diagnostic codes, not coding and billing for the complexity or extent of the examination. You may not be using the most up-to-date codes from ICD9 — and ICD10 is coming soon.
  • You’re getting paid slowly because when documentation isn’t in order and properly coded, claims are denied.
  • You’re wasting staff resources. Your office must resubmit documents, using valuable staff time and slowing down your receivables.
  • You’re not collecting proper co-pays and deductibles.
  • You’re getting paid less than you should for procedures you perform.
  • You may be missing out on payments for certain billing codes entirely, in some cases.
  • You’re missing out on payments for medically necessary dental work.
 

What you need to do
 
Get Expert Training
 
Optimize your billing practices with professional training. Get your billing paid more quickly with properly submitted documentation. Save staff time by eliminating re-submissions, and get paid your full fee for every procedure. Just think, you could use those funds you’ve been missing to grow your business!  Don’t be at the mercy of insurance companies. Make sure all your procedures are billed optimally so that no code is left to chance. Training can be tailored to the needs of your dental office to include billing patient’s medical insurance.
 
A great training should offer consulting on:
  • New Dental Claim Form
  • New Health Claim Form
  • Documentation
  • Diagnostic Codes
  • Insurance Rules
  • Learn How to Bill Dental Procedures to Medical Insurance
  • Learn the Secrets for Success in Dental Billing
  • Get Your Questions Answered about Dental Billing and Coding
 
You should also…
 
Get a Professional Chart Audit  Why should you have a professional chart audit? Have you been underbilling patients insurance at your dental practice? That’s what an audit will tell you. Without proper training in insurance billing and coding, chances are that you have been missing out on fees that you are entitled to receive. You can mine your recent billing for missing revenue: Let an expert find missing or incorrect codes and identify recurring error patterns. Schedule a professional audit to find out about underbilled procedures to help you recover lost revenue. Your audit should more than pay for itself. Advantages of a professional dental chart audit:

  • Ensure that the CDT codes your practice reports are reflected in the services documented
  • Verify that your practice is following CDT guidelines along with Medicaid (if applicable), state, and federal rules and regulations
  • Ensure that your practice is receiving proper reimbursement for services provided
  • Determine whether your dentists and staff are applying the principles of documentation for compliance
  • Evaluate documentation for risk management exposure not specific to the documentation guidelines. (Insurance companies conduct their own audits and reviews of your billing to their insured. When they find incorrect documentation or overpayments, they will seek to collect from you.)
  • Identify any missed or absent documentation and possible unbilled charges
 
Dental Office Staff: Ask for an Expert Coding Class from (Or sign up on your own)
 
According to the BLS (Bureau of Labor Statistics), health care is the largest US industry, making this career a sound choice. You can make your current job easier–and obtain valuable skills to advance your career–with up-to-date knowledge of codes, both dental and medical (cross-billing for medically necessary dental procedures). Larger dental practices may pay towards class tuition for team members to be at the cutting edge of coding knowledge. If your practice won’t pay your tuition, consider taking the class anyway for your own professional development.​
A DENTAL GUIDE TO CROSS-CODING FOR ​ORAL CANCER SCREENING
Published by Christine Taxin
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​A DENTAL GUIDE TO CROSS-CODING FOR ORAL CANCER SCREENING
Published by Christine Taxin
 
Dental professionals are a patient’s primary source of screening within the oral cavity; thus attention must be paid to the most common oral malignancy:
 
SQUAMOUS CELL CARCINOMA
 
Historically such malignancies were attributed only to patients with a history of extensive alcohol and tobacco use. However, other risk factors such as human papilloma virus (HPV) and medication use are shifting the profession’s perception of who may be at risk for oral cancer. According to experts,  “the dentist must consider all patients at risk and act accordingly in the history-taking and examination phases of the dental visit” (Kondori I, Mottin RW, Laskin DM, 2011). Due to the newfound understanding of oral cancer risk, the dental professional should take seriously the options for insurance coverage from both the dental and medical insurer for the patient’s exam.
 
Historically dental professionals relied solely on health history and visual exams to detect abnormalities in the oral cavity. While within acceptable limits, the variance in training and experience of the practitioner is enough to leave the patient questioning reliability. What is more, recent evidence suggests high rates of clinical misdiagnosis by general oral health practitioners (Kondori I, Mottin RW, Laskin DM, 2011). Thus, studies suggest that augmenting the traditional approach with technology can in fact assist the practitioner in “One of the most difficult decisions a clinician may face—when to refer a lesion for further investigation and biopsy” (Denise M. Laronde, P. M. Williams, T. G. Hislop, Catherine Pohl, Samson Ng., Chris Bajdik, Lewei Zhang, Calum MacAulay, Miriam P. Rosin , 2013).
 
It would stand to reason that implementing the most comprehensive exam available would provide the most accurate and timeliest detection of oral cancer. This should be enough to garner the use of a targeted risk factor checklist including (but not limited to) information on the patient’s history of tobacco use, alcohol consumption, exposure to HPV, and recreational drug use; as well as the use of a chemiluminescent device to augment the risk assessment visual exam. However, many patients are bound
 
financially to what will and will not be covered by their insurance plans. So to further the argument for use of oral cancer screening devices mentioned above, it is worth noting that both dental and medical insurance codes can and should be utilized during the process.
 
Cross-coding for Oral Cancer Screening
 
Nearly 41,000 Americans will be diagnosed with oral cancer in 2014. The survival rate of this cancer, when found in late stages is at best grim. However, equipped with new evidence regarding risk factors for the disease as well as innovative tools to add to an office armament like oral cancer screening devices and comprehensive health history forms, patients can be confident their dental team can alert them in the case malignancies are suspected.
 
If something is found, the patient’s dental insurance should be billed first, utilizing appropriate CDT codes.
 
Dental Codes
 
CDT D0480 for adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions, not to include cytology or biopsy procedures
CDT D7285: code for biopsy of oral tissue (hard)
CDT D7286: code for biopsy of oral tissue (soft)
CDT D7287: code for exfoliative cytological sample collection
CDT D7288: code for brush biopsy- transepithelial sample collection (ADA, 2013)
 
Medical Codes
 
If the patient’s dental plan does not cover the procedure, a medical claim can be used. The International Classification of Disease codes (ICD) are required each time a claim is submitted to describe what abnormalities have been detected. The most common in the case of oral cancer screening would be:
 
ICD V76.42: Screening for malignant neoplasms; oral cavity
The other set of medical codes used are called Current Procedural Terminology (CPT) codes. These codes can be used to cover things like the exam, screening devices, radiographs and other procedural tools. In this case the CPT code for the use of an oral cancer-testing device is:
 
82397: Chemiluminescent assay
There are complexities within both dental and medical billing. Classes, consulting and training are recommended for practitioners new to one or both systems.
 
The Bottom Line
 
As a patient’s first line of defense, dental screening for oral cancer is a necessary part of the dental practitioner’s job. With the advances in diagnostic and screening technology and the safe-guard of cross-billing, there is no reason patients should not be offered a comprehensive oral cancer screening utilizing the latest technology as part of their regular dental visit.
 
For a consult on all types of billing, including that discussed here, dental professionals should contact consultant Christine Taxin at Links2Success.biz.
 

Resources:  ADA, CDT 2014: Dental Prodedure Codes, 2013
 
Denise M. Laronde, P. M. Williams, T. G. Hislop, Catherine Pohl, Samson Ng., Chris Bajdik, Lewei Zhang, Calum MacAulay, Miriam P. Rosin. (2013). Influence of fluorescence on screening decisions for oral mucosal lesions in community dental practices. Journal of Oral Pathology & Medicine.
 
Kondori I, Mottin RW, Laskin DM. (2011, Jul-Aug). Accuracy of dentists in the clinical diagnosis of oral lesions. Quintessence Int., 42(7):575-7.
3D Imaging For Better Patient Care
Why 3D imaging provides a better option for patient care and how changes in Dental Insurance Reimbursement make it a good investment for the future.
By Terri Lively
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​3D Imaging For Better Patient Care
Why 3D imaging provides a better option for patient care and how changes in Dental Insurance Reimbursement make it a good investment for the future.
By Terri Lively
 
Christine Taxin, adjunct professor of New York University College of Dentistry, understands how the ADA guidelines on dental radiography affect reimbursement. The dental industry is moving from the routine file-and-pay insurance reimbursements to a model more like medical physicians, where dentists must document the need for certain diagnostics and other procedures. With a changing standard, Taxin has a unique take on dentists’ need to adjust their strategy.
 
Dentists are concerned with the ROI of the products in which they invest. Many look toward insurance reimbursement as a way to help. What is your take on this?
CT : Insurance companies do not always cover the service. Even though there are so many codes in the dental world at this point for cone beam imaging, they are not covered procedures under most plans. Having a code doesn’t mean that an insurance company is going to cover it. Medical is different, but in dental that’s how it is.

The reason you needed to take the 3D scan becomes the answer for billing. That reason is always about why the person needs a treatment. If you have that, then it will be covered.
 
What effects have guidelines from institutions such as the ADA had on insurance billing and reimbursement?
CT : The meaning of X-rays changed two or three years ago to Diagnostic X-rays. However, people that read the CPT or X-rays have not changed how they use them, however. They just look at the insurance program to see if it’s time to take another set of X-rays, and then they take a set of full mouth.

​But the insurance companies are not looking at radiology as an “insurance said you could have this” payout. They are looking to see what the reason was for the X-rays. Doctors using 3D modality need to know the diagnostic codes because that’s the difference between billing it and billing it and getting paid.
 
What do you see as future trends in insurance coding for dental?
CT : The big trend is that there are some plans already that allow you to treat patients that are orally systemically ill, diabetic, pregnant girls, etc., which can access additional dental benefits because of the diagnosis. Doctors need to take patients’ medical history much more seriously if you want to access wellness benefits for patients that have oral systemic conditions because 90% of the dental insurances have some form of wellness benefits.
 
How important is education when using a 3D cone beam system and how does it benefit the practice?
CT : Extremely important. This is taking your dental fix-it shop and moves you into diagnosing why you need to fix it. You aren’t fixing something broken without knowing why it’s broken. These 3D systems are the Diagnostic tool. That’s where the surgeries and the treatments come from, not just what you see visually.

Look at it this way; a car mechanic is going to diagnose your car. Why aren’t we diagnosing our people? Right now, we diagnose what’s broken to fix it, but we aren’t looking beyond that tooth. We never really diagnose patients beyond that. Now, however, we are being asked to collaborate with the medical world to get the patients healthier.

What Can You Gain By Implementing Advanced
​Medical Billing Techniques In Your Dental Practice

The benefits of medical/dental cross coding are numerous. Understanding of medical insurance is the key to getting paid!

You should leverage medical billing to increase case acceptance AND get reimbursed for these treatments:
  • Sleep Apnea
  • CT Scans
  • TMD/TMJ
  • Periodontal Procedures
  • Oral Surgery
  • Implants
  • Bone Grafts
  • Extractions

Why Bill Medical

✔︎ Case acceptance skyrockets when out-of-pocket goes down.
✔︎ Expand your ability to propose treatment.

See if Christine will be speaking in your area.