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Pediatric Dental Services

MDCP is committed to simplifying Pediatric Dental Billing for you by effectively navigating such challenges of pediatric dentistry billing and coding as:

  • Whether there is a separate code for difficult prophylaxis
  • Do D1201 and D1203 Topical Fluoride codes cover fluoride rinses and swishes
  • Code used for dental evaluation of a young child
  • How extraction of a supernumerary tooth of a child between eight to nine years should be billed and so on


Med DataCare Pro extends to its clients

We make sure that all claims meet successful reimbursement through accurate handling of such details as mentioned above, sound documentation, error-free claim forms and adherence to standards.

MDCP staff is well trained to:

  • Appropriately assign CDT codes
  • Meet all ADA standards for coding compliance and documentation guidelines
  • Fill out ADA forms accurately
  • Submit claims in compliance with HIPAA

And thus we ensure 99.5% overall accuracy of your billing and coding details while most of our clients obtain 100%.

Excellence in Service and Security

We have managed to bring ease of operations to our Dental clients, through a combination of excellence service, technology and security.

The highlights of our services are:

  • Greater Flexibility for your customized operational and billing and coding needs
  • An Expert Accounts Manager, specializing in Dental reimbursement issues, for fewer errors
  • Accurate and timely reports to track success of reimbursement ratio

Security

Our security measures adequately adhere to all HIPAA regulations.

Service Modules

If you have an in-house billing and coding operation, we can identify and plug in sources of revenue leakage and operational tardiness so that your revenue management cycle is oiled and geared to work smoothly.

If you have a lean operation and don’t want to fatten it up by adding an in-house billing and coding department, our Outsourcing services will handle your entire billing and coding process starting from preparation of claims through claim submission to post-submission follow-ups with payer authorities.

Our services are flexible and if you think your operation, is working fine but you wouldn’t mind experts handling, a part of your process, we can offer you piece meal solutions to meet your exact requirements.

Pediatric dental challenges and how MDCP is geared to meet them

To expand the coverage net of children, Medicaid has introduced a comprehensive plan where reimbursement validity will be assessed based on whether a treatment episode has covered the full lifecycle of dental treatment – EPSDT (Early and Periodic Screening, Diagnosis, and Treatment).

This doesn’t work for the targeted group as it misses the practical point because the families they come from don’t have the habit of visiting dentists for preventive dental measures; they mostly do so for curative treatments, placing themselves out of the Medicaid eligibility ring.

This leads to rejected claims because either the pediatric center doesn’t have relevant documentation or lack knowledge of how to handle documentation and use appropriate CDT codes to make a foolproof claim.  

To address this situation, MDCP:

  • Ensures proper documentation across a treatment lifecycle
  • Determines extent of insurance coverage via eligibility verification
  • Prepares claims by assigning appropriate CDT codes by deciphering medical and or dental information adequately to take coding decisions


Additionally, MDCP ensures that the following technical areas are handled efficiently:

  • Cross-linking of CDT-dental codes with CPT medical and ICD-9 diagnostic codes, when required
  • Checking whether medical procedures (especially when pediatric dentistry services are given from a generic medical setup) and diagnostic codes used are relevant to pediatric dentistry
  • Accurately filling up current ADA and CMS 1500 Claim forms


Our billers and coders are also experienced enough to handle cases where pediatric services are given from generic healthcare setups where a child receives dentistry care as part of a larger or another treatment. When it comes to preparing such claims, one has to contend with lot of pediatric medical information bundled up with information about non-dental medical procedures.

Our billers and coders are efficient enough to navigate through such data, separate non-dental from dental and use the appropriate pediatric codes to make airtight reimbursement claims.