Medical and Dental Eligibility Verification
We review patient coverage, plan benefits, payer requirements and available coordination-of-benefits information to help determine the appropriate billing pathway before claim submission.
Oral and Maxillofacial Surgery Billing Services
Dastify Solutions helps oral and maxillofacial surgeons manage complex medical and dental claims through specialized coding, authorization tracking, denial management and revenue cycle support.
Our Oral and Maxillofacial Surgery Billing Services
Medical-Dental Crossover Billing
We support claims that may qualify for medical coverage under applicable payer policies. Our team reviews diagnosis information, procedure coding, supporting records and payer-specific submission requirements without assuming medical reimbursement eligibility.
Surgical Coding and Claim Submission
We review available clinical documentation and billing data to support appropriate ICD-10-CM, CPT, HCPCS and CDT code selection. Claims are checked against applicable payer requirements before submission.
Prior Authorization Management
Our team tracks authorization requests, approved services, effective dates and payer responses. We flag missing information and approaching deadlines so the practice can address issues before scheduled procedures or claim submission.
Payment Posting and Reconciliation
We post payments, contractual adjustments and patient responsibility using available remittance information. Unpaid or underpaid balances are identified for further review against the applicable contract and payer explanation.
Denial Management and A/R Recovery
We investigate denials involving eligibility, authorization, coding, documentation, coordination of benefits and timely filing. Our team supports corrections, resubmissions and eligible appeals while following outstanding balances through resolution or appropriate escalation.
Specialized Billing for Oral and Maxillofacial Procedures
Different OMS procedures require distinct coding, documentation and payer reviews. Our billing support covers:
Maxillofacial Trauma and Fracture Repair
Injury diagnoses, operative records, surgical procedures and applicable medical payer requirements.
Orthognathic and Corrective Jaw Surgery
Medical-necessity documentation, authorization requirements and procedure-specific claim review.
Oral Pathology and Cyst Removal
Diagnosis and pathology documentation, procedure coding and payer coverage requirements.
Temporomandibular Joint (TMJ) Procedures
Plan exclusions, medical-necessity criteria, authorization rules and supporting clinical records
Reconstructive Oral and Maxillofacial Surgery
Surgical documentation, applicable medical coverage criteria and claim follow-up.
Dental Extractions and Related Surgery
Appropriate medical or dental claim routing based on the patient's coverage and the circumstances of treatment.
Coverage is determined by the applicable benefit plan and payer policy. Surgical classification alone does not establish medical reimbursement eligibility.
Medical-Dental Crossover Billing Without the Guesswork
Medical and dental claims follow different coverage rules, coding requirements and submission processes. For OMS practices, identifying the appropriate payer pathway is essential to preparing accurate claims. Dastify Solutions supports crossover billing by reviewing patient benefits, coordinating available medical and dental coverage information, checking applicable procedure and diagnosis codes, and identifying documentation or authorization requirements before submission. Our team also manages payer responses and follow-up when claims require corrections, additional information or further review.
How Our OMS Billing Process Works
- 01
Review Your Medical and Dental Billing Today
We look at how your claims are split between medical and dental plans, your payer mix, enrollment, open claims and authorization tracking.
- 02
Set Crossover and Authorization Checks
We agree which procedures (for example, trauma repair or orthognathic surgery) get a medical-coverage review, how authorizations are tracked, and who handles escalations.
- 03
Work Claims on the Right Plan
Our team prepares each claim for the medical or dental payer that applies, posts payments and follows up on denials and requests for records.
- 04
Report on Both Sides
Scheduled reports show unpaid medical and dental claims, denial trends and aging balances, so recurring problems get fixed.
Why Choose Dastify Solutions for OMS Billing?
Medical and Dental Billing Coordination
We help manage claim routing and payer requirements across medical and dental coverage to address billing issues before submission.
Dedicated Revenue Cycle Support
Our team manages assigned billing tasks with defined responsibilities, escalation procedures and ongoing payer follow-up.
Visibility Into Outstanding Revenue
Receive scheduled reporting on unpaid claims, denial trends, payment activity and accounts requiring attention.
Experienced Billing and Coding Professionals
Our billing team supports specialty claim preparation, payer communication, denial investigation and revenue cycle reporting.
HIPAA-Compliant Billing Workflows
We maintain administrative, technical and physical safeguards for handling protected health information and establish applicable Business Associate Agreements.
Secure and Structured Onboarding
We review your billing software, access requirements and data-handling procedures before establishing an agreed workflow for your practice.
Get Specialized Support for Your OMS Billing
Your surgical team should have a billing process that accounts for complex procedures, medical-dental coverage differences and payer-specific requirements. Tell us about your practice, current billing challenges and the services you want to outsource. We'll discuss the appropriate scope and next steps for your organization.
Frequently Asked Questions
What is oral and maxillofacial surgery billing?
Oral and maxillofacial surgery billing involves preparing and submitting claims for surgical services affecting the mouth, jaws, face and related structures. Depending on the procedure and coverage, claims may involve medical insurance, dental insurance or applicable public programs.
Can oral surgery procedures be billed to medical insurance?
Some procedures may qualify for medical coverage when the clinical circumstances and payer requirements support it. Coverage depends on the patient's benefits, medical necessity, documentation and the insurer's policies. Not every surgical dental procedure is eligible for medical reimbursement.
Does Medicare cover oral and maxillofacial surgery?
Original Medicare covers certain medically necessary oral and maxillofacial surgical services. Routine dental services are generally excluded, although limited dental services may be covered when they meet Medicare's clinical-linkage requirements. Coverage depends on the specific service and applicable CMS rules.
Which coding systems are used in OMS billing?
OMS billing may involve ICD-10-CM diagnosis codes, CPT and HCPCS procedure codes, and CDT dental procedure codes. The applicable coding system depends on the service, payer and claim submission requirements.
Can Dastify Solutions manage existing OMS claim denials?
Yes. We can review assigned denied claims, investigate administrative causes, identify correction or appeal opportunities and follow up with payers. Recoverability depends on payer rules, filing deadlines, documentation and the circumstances of each claim.