Dental OMFS?? (California)

The filing and enforcement of liens (different states refer to these with different terms) to secure payment for services or goods against a workers' compensation award is complex and filled with special rules - this category is for questions and discussion of this special area of work comp law.

Dental OMFS?? (California)

Postby bzybee on Sun Nov 14, 2010 6:12 pm

Hello! I am new here so please bear with me. :) Question...I currently collect for a dentist. I am having issues with the insurance companies as to what is fee schedule for dental procedures. The insurance companies argue that dental bills are subject to CA OMFS. I disagree. Half of what is billed for are "D" codes and there are no "D" codes in CA OMFS. Other codes that are billed are 70328 and 70330 which are found in the CA OMFS. Issue: CA OMFS allows $ 62.94 for 70328 where as Delta Dental pays $ 269.39. The insurance companies are paying the $ 62.94 instead of $ 269.39. Another issue is that if i submit a bill that has D codes on it, they kick them right back and tell me that the code is invalid. I know it is not invalid, its just not in the CA OMFS. CA OMFS does not have a section of dental anything. My understanding is that Dental OMFS is what Delta Dental pays. Can anyone shed some light to this subject? Any information is appreciated. Thank you!
bzybee
 
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Re: Dental OMFS?? (California)

Postby LienExaminer on Tue Nov 23, 2010 8:10 am

LienExaminer
 
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