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A Dental Consultant Could Be Your Key To Thriving – SmartBox Dental Ep. #81
What does a dental claims consultant do?
Dental claims consultants act as a mediator between a customer, a dentist and the insurance company to come to an agreement about a claim. For example, a customer could file a claim that a dentist gave them a crown for a tooth that wasnt contractually obligated to receive a crown. A dental claims consultant can work with the insurance company to retrieve the contract, evaluate the claim and either approve or deny the claim.
If they approved the claim, the dentist and client can move on to a court case. If they denied it, the dentist can either face contractual obligations for breaking contract laws, or they may lose the claim to the customer. While the majority of a dental claims consultants duties may be law-related, they can also perform dentistry work within their original office.
What is a dental claims consultant?
A dental claims consultant is a law professional who also has expertise and a history in dentistry. They handle dentistry-related law for client and dentist claims and for insurance companies. They work with clients and other dentists to file claims and improve general dentistry practice. These professionals may provide advice about marketing, human resources, office management, equipment purchases or training in specific dental practices. Some dentists, when aspiring to start their own independent office, may hire dental consultants to help them fortify their business.
Dentists may hire consultants to expand their practice, suggest new software or adhere to newly formed laws. Dental consultants may operate their own offices independently or work as managers, having duties that include hiring staff, advertising and monitoring both patients and the practice.
Dental claims consultant skills
Some skills that dental claims consultants use in their roles include:
Attention to detail
Because dental claims consultants first work as dentists, attention to detail can help them succeed in both dental work and office management. Dental claims consultants review claims between clients and fellow dentists and handle legal documents, claim forms and X-ray photographs. Some claim disputes require detailed analysis of a clients X-rays, making attention to detail a critical skill in a consultants daily business.
Communication skills
Dental claims consultants communicate with many types of people in different positions. They may communicate with dentists about a false claim or with clients to explain the legal implications of what a claim means. They may train dentists, explaining intricate dentistry concepts or help other staff to form a schedule. As possible business owners, dental claims consultants may also undertake management and advertising duties, making written communication skills helpful for their business well-being. Because they write claims reports, dental claims consultants use written communication to convey important information almost daily.
Dentistry knowledge and ability
As consultants, dentistry knowledge is important for teaching others and asserting claims. Dental claims consultants understand contractual agreement laws between clients, dentists and insurance companies, concerning both contract laws and dental application standards. Extensive knowledge of procedures, including any possible displays of malpractice, can help dental claims consultants make accurate decisions concerning each party.
Management abilities
Because dental claims consultants may be able to run their own dentistry office, understanding how to manage a business can help them succeed in their careers. Knowing how to resolve common employee conflicts, create schedules and manage payroll can help them ensure the business is operating efficiently. They may need to take responsibility for other dentists as a practitioner or train dentists for specialized procedures. Being able to lead and confidently teach are both management skills that can help dental consultants have a diverse career path.
Business knowledge
As business owners, dental claims consultants understand finances. They may do bookkeeping, organize documents and manage large amounts of important data, such as client profiles. Basic business knowledge can help dental claims consultants abide by business practice laws and maintain the office properly.
Dental claims consultant work environment
Dental claims consultants work in an office environment, usually in a dentistry office. They may work in a private office as a contractual consultant before acquiring independent work, but they usually first gather experience as consultants within a dentistry office. As claims consultants, most of their duties involve researching and assessing claims between dentists and clients. Clients and dentists may or may not be from the office in which they work, although they receive any claims within the area, depending on the number of available claims consultants nearby.
Claim assessment work involves desk work for both research and remote consultation. Dental claims consultants may meet with clients or dentists to discuss claim details in person. When not performing claims work, dental consultants may care for patients as dentists or manage the office as the business owner.
Dental claims consultant salary and job outlook
If youre considering becoming a dental claims consultant, explore some of the following steps:
1. Earn a bachelors degree
To apply for dental school, first work to obtain a bachelors degree. While your bachelors degree doesnt need to be in a dental-related field, consider taking courses that may help you prepare for law, management and dental work. Some helpful courses for a dental claims consultant include:
2. Take the entrance exam
To enter dental school, take the Dental Admissions Test. This exam assesses your general dentistry skills. In combination with your GPA, dentistry schools use this score to determine whether you qualify. Maintaining a GPA of 3.2 or higher may help increase your chances of recruiters accepting you into the competitive dental program.
3. Get a dental degree
When you pass your Dental Admissions Test, you can earn a Doctorate of Dental Surgery. While you can earn your Doctorate of Dental Medicine, dental claims consultants usually have a Doctorate of Dental Surgery, both to understand medicine and to perform and teach various procedures. In both curricula, you can expect to work within a classroom setting for at least two years before beginning clinical dental work in an office as a student.
4. Become licensed
To practice dentistry, you need to obtain a valid license in your state. Various licenses can approve you to perform different practices, including orthodontics, pediatric and surgery. As a dental claims consultant, acquiring multiple licenses can both extend your range of practice and prepare you to teach others in different methods in the future. Each license takes anywhere from two to four years to obtain.
5. Gain a specialization
Once youve gained all the licenses you need to practice within your state and fields, consider gathering further specialization through one of your licenses. For example, if you want to specialize in surgery, you may be able to create an independent dental claim consulting service exclusively for surgery, as long as you deeply understand the principles in the specialization. Work toward defining the specialization you want to work in and gain knowledge in the field.
6. Consider certification
Once youve become a knowledgeable dentist, you can begin gaining other skills that can allow you to practice as a dental claims consultant. In addition to courses in general accounting, management and business studies, obtaining a certification in business administration can aid during the application process. While starting a business as a dental claims consultant is possible with dentistry knowledge, obtaining a Master of Business Accreditation (MBA) certification or general business certification can help you become a practicing consultant on behalf of your current office.
FAQ
What is a dental consultant?
What does a dental claims processor do?
