Oral Pathology Puzzler: Do You See What I See?

procedures by third-party payers. Only dentists are permitted to take the survey that will clearly define generally accepted practice standards. My advice would be to drop your altruistic dental hat, and place on your business hat when answering the questions so you don’t play into the hands of third-party payers. Enough said.

Our new Utah Dental Law regulates plans that are written here in Utah, for Utah companies. If it’s a federally run ERISA plan, or a plan written for a company in a different state, our Utah Law does not apply to those patients. Having said that, the UDA, MPMB, and other entities are working diligently to make those entities follow “state laws.” I can honestly state there has never been a more important time to support our dental associations than now. The fight is on, and we need everyone to support the battle that prevents third-party payers from coming between the doctor/patient relationship.

Let me be very clear on one major point: when dentists perform procedures that have codes and descriptions defined in the ADA CDT Code Book, or even worse, have codes, descriptions, and fees associated with them in their dental insurance contracts, and they do not charge their patient for those legitimate services, they are playing into the hands of those third-party payers to bundle, control, or eliminate those codes from their contracts and CDT Code Books. For those of you who have been practicing since the late 1980’s, you know exactly what I’m talking about. For example, medical charges for such things as local anesthetic and palliative treatment. Need I say more?

Third-Party Payers continually look for “frequency” of procedures, and ways to eliminate, or not pay for them, just to increase their profit margins. Through the years they have been able to eliminate the OSHA code, acid-etch and bonding, and others. In the early 2000’s they attempted to eliminate anesthetic, and more recently have gone after build-ups by “bundling” services until we are trained to no longer charge for them. Do you see the pattern? By eliminating their ability to “bundle” distinct dental procedures, dentists, and their teams, can be paid more fairly for the services they provide instead of doing free dentistry on insured patients.

Tracy Thorup, B.S. CEO, My Practice My Business 801-226-4420

_______________________ 1 The American Dental Association, “Introduction to Dental Benefits” (online). Accessed on 15 August 2021. Available at [https://ebusiness.ada.org/assets/docs/2201.PDF?OrderID=339016]. 2 https://ebusiness.ada.org/assets/docs/2201.PDF?OrderID=339016

Which of the following represents the best diagnosis for the radioraphic findings in the anterior mandible? . A. Periapical cemento-osseous dysplasia . B. Periapical granulomas . C. Odontogenic keratocysts . D. Lateral Periodontal Cysts (continued on page 15)

Create more accurate restorations with a faster turnaround time by going digital. Call to find out how to get a FIVE CROWN CREDIT!

Full Contour Zirconia

✓ Quality Zirconia – Katana ✓ Fast turnaround – as little as three days in lab ✓ Special UDA intro offer

Guided Implant Surgery

✓ Package includes: consultation, surgical guide, custom abutment and restoration ✓ Easy all-in-one price

Custom Abutment and Crown

✓ Authentic custom abutments ✓ Full contour zirconia restoration included ✓ Easy all-in-one price