The Dental Billing Podcast

Got questions? Send Ericka a Text!

Are you leaving money on the table while your patients remain undertreated? After analyzing over 300 dental practices across the country, I discovered a shocking truth: the average dental practice with a full-time hygienist treats only 17% of the periodontal disease they diagnose. That means 83% of diagnosed disease goes completely untreated—a staggering gap between diagnosis and care.
This episode dives deep into the "hidden opportunity" within your hygiene department by exploring D4346: scaling in the presence of generalized moderate to severe gingival inflammation. This often-misunderstood code bridges the critical gap between a standard prophy (D1110) and scaling and root planing (D4341/D4342). For patients showing clear signs of gingivitis without bone loss—bleeding on probing, inflamed tissue, pseudopockets, and plaque that doesn't respond to routine cleaning—continuing to perform prophies isn't prevention; it's undertreatment.
I walk you through a comprehensive, step-by-step process for properly implementing D4346 in your practice, from accurate diagnosis and bulletproof documentation to effective patient education and ethical billing. We cover common challenges including insurance downgrades, particularly when carriers like Delta may pay less for D4346 than for a prophy, and how to handle these situations without compromising ethics or revenue. The key message: this code is based on diagnosis, not difficulty or time spent, and represents therapeutic care designed to heal tissue, not maintain it.
Whether you're a dental biller, office manager, hygienist, or dentist, this episode provides practical guidance for transforming your approach to gingivitis treatment. The benefits extend beyond proper coding—you'll deliver better care, improve patient outcomes, and optimize practice revenue. Pull a few charts this week and see how many of your "prophy patients" actually qualify for D4346. The results might surprise you.

Want to learn Dental Coding and Billing? Join here:
https://tr.ee/efzYrY7mp-
Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.
Email Ericka:
[email protected]
Schedule a call with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Perio performance formula:
(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)

Got questions? Send Ericka a Text!

Have you ever wanted to learn dental billing?
In this week's episode, we share our first session in our new group coaching program The Dental Billing Lab. This group training is designed for individuals with little to no experience in dental billing.
Got questions?
Email Ericka: [email protected]
See you in this episode, friends!!!

Want to learn Dental Coding and Billing? Join here:
https://tr.ee/efzYrY7mp-
Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.
Email Ericka:
[email protected]
Schedule a call with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Perio performance formula:
(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)

Got questions? Send Ericka a Text!

I've had the opportunity to sit down and have a deep and enlightening conversation with Jennifer Lyman, a devoted dental hygienist with a heart for recognizing signs of sleep apnea in children. It was fascinating to hear about her journey and how her experiences have shaped her practice and fueled her passion for educating others about sleep apnea, a potentially fatal condition that we should all be aware of.
We also got to talk about the beneficial effects of myofunctional therapy in dealing with sleep apnea and other oral health issues. Jennifer shed light on the signs and symptoms we should look out for in both children and adults, along with the connections between sleep apnea and conditions like ADHD. She emphasized the criticality of referral to sleep centers and the potential hazards of ignoring what may seem as trivial as snoring.
Towards the end, we tackled the complexities surrounding medical billing in dental sleep medicine and explored the essentials needed to successfully implement oral appliance therapy or myofunctional therapy. Jennifer underlined the importance of a dedicated team and the value of continual coaching and training. We also discussed how to navigate insurance coverage and ensure a smooth billing process for patients. For those eager to learn more, Jennifer shared her contact information. After listening to this enriching conversation, I'm sure you'll appreciate the crucial role oral health plays in our overall well-being.

Want to learn Dental Coding and Billing? Join here:
https://tr.ee/efzYrY7mp-
Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.
Email Ericka:
[email protected]
Schedule a call with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Perio performance formula:
(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)

Got questions? Send Ericka a Text!

Tired of bureaucratic inefficiencies and missed technological opportunities? Join us as we analyze the healthcare workforce, dissecting the tough reality of supply and demand in medical residencies, with a special focus on the rising field of pediatric dentistry. We'll reflect on personal encounters with government red tape and ponder how the tech boom of the 90s could have spurred a much-needed modernization of government systems. We'll even speculate on how influential figures like Bill Gates and Elon Musk could have further propelled these advancements.
Thinking about launching your dental career in an underserved area? Discover strategic insights on how to capitalize on dental care shortages by using data to pinpoint opportunities, and learn how buying out retiring dentists can set the stage for a prosperous practice. We also debate whether specialization in high-demand services like endodontics requires extensive schooling or if ambition and a good attitude can suffice. Expect candid discussions on the importance of self-care and reassessing your career path to ensure it brings you joy, much like evaluating the health of your personal relationships.
As technology continues to transform industries, we'll highlight why it's crucial to keep your skills sharp, whatever your field of expertise. From the evolution of dental billing practices and the indispensable role of consultants to the need for continuous education in today's rapidly changing world, our conversation covers it all. Enjoy a light-hearted wrap-up as we share personal family anecdotes that remind us of the importance of gratitude and the fun quirks of familial bonds. Prepare for an engaging episode that combines professional insights with personal charm.

Want to learn Dental Coding and Billing? Join here:
https://tr.ee/efzYrY7mp-
Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.
Email Ericka:
[email protected]
Schedule a call with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Perio performance formula:
(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)

Got questions? Send Ericka a Text!

Dental billing has undergone a dramatic transformation since the carefree days of the late 1990s. What was once a straightforward process—send a claim, get paid, move on—has evolved into a complex system demanding meticulous attention to detail and strict compliance measures. The reason? Insurance companies have woken up to the staggering $12.5 billion lost annually to dental fraud, and they're scrutinizing claims like never before.
You don't need to be committing actual fraud to get caught in this web. Cutting corners, skipping steps, and clinging to outdated "backyard billing" habits can quickly put a target on your practice. Are you submitting claims without checking clinical notes? Skipping attachments to get claims out faster? Using coding loopholes that worked a decade ago? These practices aren't just inefficient—they're potentially putting your practice at risk for denials, audits, and recoupment demands.
True billing expertise isn't defined by years of experience but by commitment to compliance and continuous education. It means verifying clinical documentation matches what you're billing, understanding dental necessity requirements, staying current with coding changes, and implementing robust follow-up systems. It means knowing when to push back when insurance companies request additional information despite receiving sufficient evidence the first time. Most importantly, it means understanding your state's prompt pay laws and holding insurance companies accountable when they attempt to delay payment beyond legal timeframes.
The transition from backyard billing to compliant billing isn't complicated, but it requires intentionality. Start by implementing daily report monitoring, creating standardized billing protocols, and ensuring your team understands compliance requirements. The reward? Fewer denials, faster reimbursements, and significantly less stress from chasing payments that should have been received the first time. Remember: the goal isn't just getting claims paid—it's getting them done right.

Want to learn Dental Coding and Billing? Join here:
https://tr.ee/efzYrY7mp-
Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.
Email Ericka:
[email protected]
Schedule a call with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Perio performance formula:
(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)