Dental Benefits and Practice Management (eBook)

A Guide for Successful Practices

Michael M. Okuji (Autor)

eBook Download: PDF

2015 | 1. Auflage
216 Seiten
Wiley-Blackwell (Verlag)
978-1-118-98035-4 (ISBN)

Infos

Dental Benefits and Practice Management: A Guide for Successful Practices is a practical tool that helps you manage your office in tune with the realities of modern dental practice.

• Written by both dentists and insurance industry professionals
• Practical explanations to effectively and legally process claims
• Describes the changes in dental practice management to make your practice patient centered
• Competitive strategies for dentists and organizations

Michael Okuji, DDS, MPH, MBA, is the Dental Director at Delta Dental of Colorado. Prior to working for Delta Dental, Dr. Okuji maintained a solo private dental practice for 35 years in San Francisco. He was also an Assistant Clinical Professor at the University of Southern California, Ostrow School of Dentistry and a Group Practice Director at the UCLA School of Dentistry. He lectures on insurance issues and practice management. Dr. Okuji is the author of the book Dental Practice: Get in the Game.

Inhalt

Title Page 5
Copyright Page 6
Contents 9
List of contributors 11
Preface 13
Acknowledgments 17
Part I History of Dental Insurance 19
Chapter 1 Why dental benefits? 21
Introduction 21
The coming of health insurance 22
Private health insurance 23
Moral hazard 24
Health insurance: The Blues 27
Federal health benefits 28
Dental benefits 30
Dental service company 30
What is dental insurance? 31
Antitrust 36
Conclusion 37
Further reading 38
Chapter 2 Dental benefits: Get it done 39
Introduction 39
Dental benefits 40
Participating provider agreement 42
Dental claim form (American Dental Association) 45
CDT code 50
Exclusion and limitation 56
Electronic claim submission 57
Code Maintenance Committee 58
Nondentist provider 60
Diagnosis code 61
Conclusion 62
Chapter 3 Dental benefits: Get it right 65
Introduction 65
Get it right 65
Participating provider agreement 66
Dentist and dental plan design 71
Dental plan contract 72
Dental claim process 72
Electronic services 77
Claim filing tips 79
Desktop procedures 84
Conclusion 85
Part II Dental Claim System 87
Chapter 4 Patient-centered practice 89
Introduction 89
Key to transform the health-care system 90
Transformation: Impact on dentistry 92
Transformation: Evidence in health care and dentistry 94
Oral health-care delivery model 101
Organizational structure: Opportunity 103
Patient-centered care: Competitive advantage 105
Conclusion 107
References 108
Chapter 5 Streamlined dental practice 111
Introduction 111
Private practice 112
Airline analytics 118
Sarrell Dental Center 119
Quality 122
Social determinant of health 123
Conclusion 126
Chapter 6 Patient Protection and Affordable Care Act 127
Introduction 127
Health-care insurance marketplace 128
ACA 130
Key provisions 132
ACA essential health benefits 133
Medicaid expansion 133
ACA funding 134
Drivers of health-care reform 134
ACA quality and outcome 135
ACA themes 136
Actuarial value 136
ACA dental benefit 137
Impact on dentistry 137
Cost of care 139
ACA implication for dentists 140
Conclusion 142
References 143
Part III Competitive Strategies 145
Chapter 7 Ethics and ethical behavior 147
Introduction 147
What is a profession? 147
Situational ethics 150
Dentist as expert 152
Owner versus employee 156
Dental board 158
Value of treatment alternatives 158
Social media and ethical behavior 160
Future of dental ethics 162
Conclusion 163
Reference 163
Chapter 8 Stay out of trouble 165
Introduction 165
Fraud, waste, and abuse 166
Bad behavior 168
Who’s looking? 174
Fraud, waste, and abuse in your office 177
Conclusion 184
References 185
Chapter 9 Analysis to action 187
Introduction 187
Premise 187
Competition 188
Information 189
Small private practice 189
Group practice 192
Group practice system 197
Safety Net System (SNS) 202
Organized dentistry 204
Quality 205
Teledentistry 206
Integrator: Organized dentistry 206
Integrator: IPA 208
Integrator: IT company 209
Conclusion 210
Index 213
EULA 218

Produkt-Details

• Erscheint lt. Verlag: 28.10.2015
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete
• Themenwelt: Medizin / Pharmazie ► Zahnmedizin ► Praxismanagement
• Schlagworte: Berufspraxis i. d. Zahnmedizin • Dental Professional Practice • dentistry • Zahnmedizin
• ISBN-10: 1-118-98035-2 / 1118980352
• ISBN-13: 978-1-118-98035-4 / 9781118980354