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Delivery-date: Fri, 23 Mar 2018 15:46:39 -0500
From: Amanda Cantelmi <amandac@webhstech.com>
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Date: Fri, 23 Mar 2018 16:45:54 -0400
Subject: Re: Past Claims for Covatto
Message-Id: <AD95C3C2-57E1-42F4-880D-D1A396CF111E@webhstech.com>
References: <CAGJ=7XHK5=3b2KR=NA=YvL6NHhA3F7qOWrL69HCF+z1YrBJxYA@mail.gmail.com> <D16EC168-C83B-434B-8DD0-842AAFB6D5AB@smbdu.com> <CAGJ=7XFfHov2Tb=SqJBhQp+wqGkuLsRvZFyCtzknkMevsvmE-Q@mail.gmail.com> <BD85D07A-E245-4E62-9AC2-C03CF82CE8C2@smbdu.com>
In-Reply-To: <BD85D07A-E245-4E62-9AC2-C03CF82CE8C2@smbdu.com>
To: "Chris Farrugia, DDS" <info@smbdu.com>


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That's why you're the expert!!!  You should offer a Medical Mainland Boot Ca=
mp in Pensacola.  I want to get to the point where this makes as much sense t=
o me as it does to you.  Actually, that's not accurate, because it does make=
 complete sense to me; it's the knowledge of how a claim should be coded and=
 the fail proof establishment of medical necessity (including proper support=
ing docs), that I want to perfect. =20

My weakness (and the weakness of Dave and Geoff), is that I don't have the b=
ackground knowledge of dentistry, so the terms and procedures in and of them=
selves are a foreign language.  Perhaps learning that is not as important as=
 it will be to  focus on mastering 1) the global policies for the payers we'=
ll be seeing 2) the typical procedures we'll be billing for (and their respe=
ctive sequence of events and corresponding codes) =20

In all seriousness, I do think I could benefit from more intense and focused=
 training, and perhaps Geoff, too.  With our partnership, we obviously want t=
o rely on you heavily for the training (or how to train) new clients, but I f=
eel like it would be beneficial to have "expert" level knowledge as we get f=
urther into this and take on new clients.

Do you have any suggestions for any further training from you?  I am current=
ly studying the manual and examining the additional claims and case studies.=
 =20

Best Regards,=20
Amanda

> On Mar 23, 2018, at 2:38 PM, Chris Farrugia, DDS <info@smbdu.com> wrote:
>=20
> Ooops=81c. CT to verify surgical outcome (on the island: implant alignment=
) for that case I sent=81c.
> <76380.jpg>
>> On Mar 23, 2018, at 12:49 PM, Amanda Cantelmi <amandac@webhstech.com> wro=
te:
>>=20
>> Geoff and I had the same reaction seeing all the dental language and not m=
edical.  So that is good, we are identifying what's wrong.  Now we've just g=
ot to get to the point where we know the medical counterparts, or at least b=
e able to get the dentists to that point.=20
>>=20
>> Thanks so much for your input,
>>=20
>> Amanda
>>=20
>>> On Fri, Mar 23, 2018 at 12:48 PM, Chris Farrugia, DDS <info@smbdu.com> w=
rote:
>>> These are a mess. The notes are all dental (Island of dentistry)=81c. cl=
assic case of wanting to stay on the island AND be paid by medical insurance=
.
>>>=20
>>> Some policies exclude the reconstruction codes 21248 and 21249 because t=
he surgical codes include endosseous implants. They generally will cover gra=
fting (21210 and 21215)=81c..  unless it is in conjunction with the reconstr=
uctive code. In these cases we only file for the grafting and allocate our f=
ees accordingly. Also, these preauths are also not being submitted with LMNs=
=81c CODE doesn=81ft do that.
>>>=20
>>>=20
>>>> On Mar 23, 2018, at 9:47 AM, Amanda Cantelmi <amandac@webhstech.com> wr=
ote:
>>>>=20
>>>> Hi Dr. Farrugia,
>>>>=20
>>>> We received information from Dr. Covatto for 2 past claims (2016) that w=
ere not paid.  They have nothing to do with Sleep Medicine and the 1500 form=
s are not included, but based on the denials, in addition to not being famil=
iar with the payer's global policy; they did not establish medical necessity=
.
>>>>=20
>>>> Geoff and I thought you may want to take a look and give feedback as to=
 what could have been done differently.
>>>>=20
>>>> Thanks!
>>>> Amanda
>>>>=20
>>>> --=20
>>>> Amanda Cantelmi
>>>> Executive Assistant=20
>>>>=20
>>>> Healthcare Support Technologies
>>>>=20
>>>>=20
>>>=20
>>>=20
>>>=20
>>>=20
>>=20
>>=20
>>=20
>> --=20
>> Amanda Cantelmi
>> Executive Assistant=20
>>=20
>> Healthcare Support Technologies
>=20

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<html><head><meta http-equiv=3D"content-type" content=3D"text/html; charset=3D=
utf-8"></head><body dir=3D"auto"><div>That's why you're the expert!!! &nbsp;=
You should offer a Medical Mainland Boot Camp in Pensacola. &nbsp;I want to g=
et to the point where this makes as much sense to me as it does to you. &nbs=
p;Actually, that's not accurate, because it does make complete sense to me; i=
t's the knowledge of how a claim should be coded and the fail proof establis=
hment of medical necessity (including proper supporting docs), that I want t=
o perfect. &nbsp;</div><div><br></div><div>My weakness (and the weakness of D=
ave and Geoff), is that I don't have the background knowledge of dentistry, s=
o the terms and procedures in and of themselves are a foreign language. &nbs=
p;Perhaps learning that is not as important as it will be to &nbsp;focus on m=
astering 1) the global policies for the payers we'll be seeing 2) the typica=
l procedures we'll be billing for (and their respective sequence of events a=
nd corresponding codes) &nbsp;</div><div><br></div><div>In all seriousness, I=
 do think I could benefit from more intense and focused training, and perhap=
s Geoff, too. &nbsp;With our partnership, we obviously want to rely on you h=
eavily for the training (or how to train) new clients, but I feel like it wo=
uld be beneficial to have "expert" level knowledge as we get further into th=
is and take on new clients.</div><div><br></div><div>Do you have any suggest=
ions for any further training from you? &nbsp;I am currently studying the ma=
nual and examining the additional claims and case studies. &nbsp;</div><div>=
<br><div>Best Regards,&nbsp;<div>Amanda</div></div></div><div><br>On Mar 23,=
 2018, at 2:38 PM, Chris Farrugia, DDS &lt;<a href=3D"mailto:info@smbdu.com"=
>info@smbdu.com</a>&gt; wrote:<br><br></div><blockquote type=3D"cite"><div><=
meta http-equiv=3D"Content-Type" content=3D"text/html charset=3Dwindows-1252=
">Ooops=E2=80=A6. CT to verify surgical outcome (on the island: implant alig=
nment) for that case I sent=E2=80=A6.<div>&lt;76380.jpg&gt;<br><div><div>On M=
ar 23, 2018, at 12:49 PM, Amanda Cantelmi &lt;<a href=3D"mailto:amandac@webh=
stech.com">amandac@webhstech.com</a>&gt; wrote:</div><br class=3D"Apple-inte=
rchange-newline"><blockquote type=3D"cite"><div style=3D"font-family: Helvet=
ica; font-size: 12px; font-style: normal; font-variant: normal; font-weight:=
 normal; letter-spacing: normal; line-height: normal; orphans: auto; text-al=
ign: start; text-indent: 0px; text-transform: none; white-space: normal; wid=
ows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><div dir=3D"l=
tr">Geoff and I had the same reaction seeing all the dental language and not=
 medical.&nbsp; So that is good, we are identifying what's wrong.&nbsp; Now w=
e've just got to get to the point where we know the medical counterparts, or=
 at least be able to get the dentists to that point.&nbsp;<div><br></div><di=
v>Thanks so much for your input,</div><div><br><div>Amanda</div></div></div>=
<div class=3D"gmail_extra"><br><div class=3D"gmail_quote">On Fri, Mar 23, 20=
18 at 12:48 PM, Chris Farrugia, DDS<span class=3D"Apple-converted-space">&nb=
sp;</span><span dir=3D"ltr">&lt;<a href=3D"mailto:info@smbdu.com" target=3D"=
_blank">info@smbdu.com</a>&gt;</span><span class=3D"Apple-converted-space">&=
nbsp;</span>wrote:<br><blockquote class=3D"gmail_quote" style=3D"margin: 0px=
 0px 0px 0.8ex; border-left-width: 1px; border-left-color: rgb(204, 204, 204=
); border-left-style: solid; padding-left: 1ex;"><div style=3D"word-wrap: br=
eak-word;">These are a mess. The notes are all dental (Island of dentistry)=E2=
=80=A6. classic case of wanting to stay on the island AND be paid by medical=
 insurance.<div><br><div>Some policies exclude the reconstruction codes 2124=
8 and 21249 because the surgical codes include endosseous implants. They gen=
erally will cover grafting (21210 and 21215)=E2=80=A6.. &nbsp;unless it is i=
n conjunction with the reconstructive code. In these cases we only file for t=
he grafting and allocate our fees accordingly. Also, these preauths are also=
 not being submitted with LMNs=E2=80=A6 CODE doesn=E2=80=99t do that.</div><=
div><div class=3D"h5"><div><br></div><div><br><div><div>On Mar 23, 2018, at 9=
:47 AM, Amanda Cantelmi &lt;<a href=3D"mailto:amandac@webhstech.com" target=3D=
"_blank">amandac@webhstech.com</a>&gt; wrote:</div><br class=3D"m_-616339739=
2399347079Apple-interchange-newline"><blockquote type=3D"cite"><div dir=3D"l=
tr">Hi Dr. Farrugia,<div><br></div><div>We received information from Dr. Cov=
atto for 2 past claims (2016) that were not paid.&nbsp; They have nothing to=
 do with Sleep Medicine and the 1500 forms are not included, but based on th=
e denials, in addition to not being familiar with the payer's global policy;=
 they did not establish medical necessity.</div><div><br></div><div>Geoff an=
d I thought you may want to take a look and give feedback as to what could h=
ave been done differently.</div><div><br></div><div>Thanks!</div><div>Amanda=
<br clear=3D"all"><div><br></div>--<span class=3D"Apple-converted-space">&nb=
sp;</span><br><div class=3D"m_-6163397392399347079gmail_signature" data-smar=
tmail=3D"gmail_signature"><div dir=3D"ltr"><div dir=3D"ltr"><font face=3D"ga=
ramond, serif" size=3D"4" color=3D"#38761d"><b>Amanda Cantelmi</b></font><di=
v><font face=3D"garamond, serif" size=3D"2" color=3D"#38761d"><b>Executive A=
ssistant&nbsp;</b></font></div><div><font face=3D"garamond, serif" size=3D"2=
" color=3D"#ff00ff"><br></font></div><div><font face=3D"garamond, serif" col=
or=3D"#a64d79" size=3D"4"><b>Healthcare Support Technologies</b></font></div=
><div><br></div><div><br></div></div></div></div></div></div></blockquote></=
div></div></div></div></div></div><br><div style=3D"word-wrap: break-word;">=
<blockquote type=3D"cite"></blockquote></div><br><div style=3D"word-wrap: br=
eak-word;"><div><blockquote type=3D"cite"></blockquote></div><br></div><br><=
/blockquote></div><br><br clear=3D"all"><div><br></div>--<span class=3D"Appl=
e-converted-space">&nbsp;</span><br><div class=3D"gmail_signature" data-smar=
tmail=3D"gmail_signature"><div dir=3D"ltr"><div dir=3D"ltr"><font face=3D"ga=
ramond, serif" size=3D"4" color=3D"#38761d"><b>Amanda Cantelmi</b></font><di=
v><font face=3D"garamond, serif" size=3D"2" color=3D"#38761d"><b>Executive A=
ssistant&nbsp;</b></font></div><div><font face=3D"garamond, serif" size=3D"2=
" color=3D"#ff00ff"><br></font></div><div><font face=3D"garamond, serif" col=
or=3D"#a64d79" size=3D"4"><b>Healthcare Support Technologies</b></font></div=
></div></div></div></div></div></blockquote></div><br></div></div></blockquo=
te></body></html>=

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