Revenue protection starts before services are rendered.

We support the verification and documentation of:

• Dental plan type (PPO, HMO, Medicaid, ERISA)

• Frequencies, limitations, and exclusions

• Network rules and patient financial responsibility

📌 Helps reduce write-offs, surprise balances, and avoidable denials.

Why this matters:
Accurate billing depends on understanding the applicable plan rules governing reimbursement.

If it can’t be defended, it shouldn’t be billed.

Clinical documentation should:

• Align with the procedures submitted for reimbursement

• Support medical necessity where applicable

• Include appropriate diagnosis codes, narratives, images, and required attachments

📌 Supports audit readiness, appeals, and payer review.

Why this matters:
Documentation functions as supporting evidence for reimbursement, not clerical paperwork.

Ethical reimbursement is intentional.

We apply structured guidance to support:

• Accurate CDT, CPT & ICD-10 code selection

• Proper use of narratives and modifiers, when applicable

• Appropriate sequencing of claims, attachments, and submission timing

📌 The same procedure — supported by compliant strategy.

Why this matters:
Insurance reimbursement follows plan rules and documentation standards, not procedure names alone.

Predictable cash flow depends on execution.

The framework emphasizes:

• Clean claims submitted correctly on initial filing

• Tracking of applicable prompt-pay timelines

• Timely response to rejections, requests, and delays

📌 Delays impact reimbursement velocity.

Why this matters:
Unmonitored claims can quietly erode revenue over time.

Transparency supports sustainable profitability.

The ELITE™ Process includes systems for:

• Accurate posting of insurance payments

• Identification of underpayments and processing discrepancies

• Trend analysis to support training and workflow refinement

📌 Ethical profit through visibility and accountability.

Why this matters:
Unreconciled payments cannot be corrected or recovered.