Unlocking Claim Confusion: The Key is Proper Documentation - On Demand Access

Proper documentation is a critical key to efficient claim processing. Submissions that are complete, accurate and include the right supporting diagnostics are processed faster and reduce the need for resubmissions, which both delay adjudication and increase staff and patient frustration. This webinar will review key sections of the ADA claim form, current CDT codes that tend to be problematic, and appropriate diagnostics and narratives as well as discuss the administration of an alternate benefit provision.

Learning Objectives

At the conclusion of this program, participants should be able to:

  1. Describe what constitutes a clean claim submission.  
  2. Assign appropriate coding and identify diagnostic attachments to aid in claim processing. 
  3. Explain how the administration of an alternate benefit provision impacts the allowable benefits of the OMS and patient. 


An Internet-based CDE/CME Activity
Original Release Date: April 17, 2024
Expiration Date: April 17, 2027
Estimated time to complete this educational activity: 1.5 hours
Method of participation: Self-Study

Stewart R. Balikov, DDS

Stewart R. Balikov, DDS, earned his dental degree at the University of Southern California School of Dentistry. He serves as the National Dental Director and Director of Dental Special Investigations for Elevance Health, having previously held the position of National Dental Director of Utilization Management for Aetna. Dr. Balikov is a Certified Dental Consultant and a past president of the American Association of Dental Consultants. He also is an Accredited Health Care Fraud Investigator through the National Health Care Anti-Fraud Association and a Certified Quality Assurance Consultant through the California Association of Dental Plans.

Disclosures: No relevant financial relationships were disclosed.

Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.

ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.5 continuing education credit(s).

AGD - Accepted Program Provider
FAGD/MAGD Credit
11/1/22-12/31/26
Provider ID# 214680

The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Association of Oral and Maxillofacial Surgeons designates this internet-based enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Key:

Complete
Failed
Available
Locked
Faculty and Planner Disclosure
Pre-Quiz
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Unlocking Claim Confusion: The Key is Proper Documentation
Open to view video.
Open to view video.
Post-Quiz
5 Questions  |  Unlimited attempts  |  4/5 points to pass
5 Questions  |  Unlimited attempts  |  4/5 points to pass
Evaluation
11 Questions
Certificate
1.50 CDE/CME credits  |  Certificate available
1.50 CDE/CME credits  |  Certificate available