Bill Klaproth (Host): This is Amos on the go. I'm Bill Klaproth and I'm pleased to welcome Leslie Snaggle, founder and CEO of insurance billing experts. For decades, Leslie has helped OMS practices streamline their billing operations and navigate the complexities of dental surgery claims. And she joins us to discuss coding educational courses And the resources Amos offers to help practices strengthen their billing systems.

Leslie, welcome.

Leslie Icenogle: Thank you, bill. I appreciate you having me on this.

Bill Klaproth (Host): Yeah. Excited to talk to you. So thank you again for your time. We appreciate it. So, Leslie, first off, can you explain your background and role in oral and maxillofacial surgery?

Leslie Icenogle: I have actually been in OMS since 1986, so I've had four decades in oral maxillofacial surgery. I've really touched every basis. I have done some clinical, but mainly office management, And the implant coordinating role. Where I really excel is the revenue cycle management, and that's where I found that some of our colleagues were struggling was in the revenue cycle management.

So when you go into OMS, it's, very different because we're navigating both the medical and dental side of billing. And so it's, unique. And so I see the struggles. I see how much work is involved with treating a patient And the reimbursement should, really play out as well.

Bill Klaproth (Host): Absolutely. So you said that your work, focuses on office management, full cycle, revenue management, navigating both the medical and dental sides of OMS billing. I would imagine then as times change, you really have to keep up with that. So what continuing education courses have you attended that you found most beneficial to your role in the practice?

Leslie Icenogle: Thank you for asking because I have found that the Amos coding and billing programs to be the most helpful. I did get my certificate, through another organization in my. professional coding certification, and I found that there was a big void in the oral maxillofacial region for that. So the most valuable.

Education of my career has come through Amos. You get support And that, fine line between medical and dental that's getting thinner and thinner every day. Amos can help you navigate that, that can help advocate. They're at the code maintenance committee meetings to make sure that we have codes that are applicable.

so even though I've tried other educations, really there's none. That can even touch the value of the Amos courses that they offer.

Bill Klaproth (Host): So the most valuable education you said has come from Amos. So keeps bringing you back to attend a course more than once then?

Leslie Icenogle: Guidelines change, coding guidelines change, they evolve. Payer policy shift. we've seen a lot of that with the Medicare Advantage plans, et cetera. And each workshop really brings new material. New press, you know, perspectives from other's and just real-world scenarios basically. and I also really like learning from my colleagues because I remember back, one of the courses where someone from California had mentioned that Delta Dental was starting to require medical.

explanation of benefits or denials for impacted wisdom teeth. And that was the first I heard about it. And then of course it hit our doorstep. And, that was just so nice to be in front of that. And knowing that that was coming and knowing what questions to ask when you're verifying benefits, if that's a requirement or not.

so learning from other's, even if you're seasoned, is important, I believe. And really, you know, when you think about. What coding does, it's the foundation of compliance reimbursement. And the overall practice health. So I'm going to let that one soak in because a lot of times the surgeons, they have so many balls in the air, they're juggling a lot of things.

They're, not only do they have, osha, HIPAA ethics and all the other aspects, maybe team members that aren't as reliable as we'd like for them to be. But when you're thinking about coding, it's sometimes the last thing, thinking about the new technology that's out and a lot of times they're very clinical minded.

But you have to think about the coding as that foundation of your compliance, your reimbursement, and your overall practice health. It can either make you happy or I cannot. You want clean claims to go through the first-time with proper payment. You don't wanna have the headaches of fighting appeals, and that's where I find that the Amos meetings, not only do they keep you current.

because I do have my AAMI certification in coding, so it's not a one and done because things do evolve. So, is proud as I was of that certification. it's just very important to me that we always stay compliant to keep our surgeons, compliant. making sure the documentation, will really, show what they have done in the coatings that were selected.

Bill Klaproth (Host): Always important to stay up on the coating, as you say. And you also mentioned surgeons are juggling a lot of things. They're very, very busy. But coating is really important as you were talking about. So did the surgeons and other colleagues that you work with. Do they attend coding courses as well?

Just to try to stay up on all this to make sure that they are maximizing the coding.

Leslie Icenogle: At first, with my history, I had worked 10 years with a surgical practice that was very, Forefront. We were the first ones to have computers, first one to have implant coordinators. You know, we were very, future driven and, I got a lot of education one-on-one and attended the workshops alone.

Then I went to work for a Navy surgeon, just fresh out of school. And when we registered for the Amos, annual event, he had put himself in And the coding. the courses and at first I was like, really? You know, I had never had a surgeon join me before.

But then I realized, You know, he's fresh outta residency and they really do not teach coding in residency and how much it meant to me that that very first year in his practice, that he focused on making sure that he was coding accurately for what he did. I feel every oral surgeon should stay abreast of it.

I know, again, there's a lot of balls in the air, but it is so important that, and you're signing a electronically or what have you, a claim form that you did this procedure. are you coding accurately? Are you coding for that sinus closure when you, do the upper wisdom tooth and you need to repair that.

You have to code for what you did and document for what you did. And having a surgeon in the coding class to me is just hats off to that surgeon because you're gonna really get that back, twofold. you're gonna stay, legal, so you're gonna have that legal exposure as well as, you know, you're gonna have the financial gains of it.

So I encourage every oral surgeon that's listening to this to, not only send a key personnel. But if it's been a while since you've attended a coding class, please do. I just highly recommend it. Everyone there at Amos, they keep it very real. and like I said, you can learn from other people in the room as well.

Bill Klaproth (Host): Yeah, so, a couple of really important points there. As you mentioned, staying compliant legally very important, And then also financially as well to make sure. You're fiscally responsible there too. So Leslie, you have talked about the importance of Amos And the great education they provide. So give us a little more insight on why you think it's really beneficial for OMSs to attend Amos courses with their staff.

Leslie Icenogle: It's essential that both the oral surgeon And the coding team, be on the same page. they really need to make sure that they're together and aligned. On what's being billed, why is it being billed? What is the documentation required to support it? so there again, the biggest risk for the practice is the legal exposure and financial loss of not staying current.

but you don't want outdated or incorrect coding to lead to denials, refunds. failed audits and allegations of fraud, et cetera. There's so much involved with it. on the financial side, you know, missing updates or misinterpreting the payer challenges leads to those profit leaks. I've seen that happen. So, I've also heard, or else surgeons say since I do stay active in a lot of the implant study groups and, and things, so I get to, really.

Be with a lot of oral surgeons, not just the surgeons I work for. And, I've always said, the investment that you make in your team's education, it's so important that you investate in your team. And I often hear, and you probably have two, what if I invest in this employee and they leave?

And then the answer is simple. What if you don't and they stay, that's gonna be your biggest challenge there. So depending on your state laws, you can make it in writing where if the, some of this course will be reimbursed to the surgeon if you don't stay for three months or six months, or what have you.

but it's just important that they stay aligned And that the team is educated to protect the surgeon And the practice. And basically that revenue cycle. you want quick, prompt payment. You wanna know in advance if there's a medical denial needed. And you know, bill, when you look at that entire revenue cycle management, it starts with the, collecting of the proper information from the patient, verifying that information.

Being able to accurately, calculate a co-insurance amount so that you're, collecting the right amount. It's complicated when you get into coordination of benefits between medical and dental. A lot of times there's, four payers. You got two medical, two dental, or even more. And so you have to be, aligned on, how that process works.

So with that revenue cycle management, it comes down to collecting the right co-insurance amount. Filing the claim to the proper payer right the first-time, whether that be, certain attachments that are needed, or, narratives, et cetera. But I should be able to go into my, surgeon's documentation that should be locked.

By the way, make sure, you know, you're locking your, documentation. You can always amend it later if you have to. the documentation is key And so I can take off that documentation and see, okay, what was that sinus closure bill? the team members need to really. Read the subjective objective assessment and plan so that they can accurately put in the right codes charge for what you did And also select the right, diagnosis code C-P-T-C-D-T-I-C-D tens, You know, all these codes change and evolve and think to Amos who really advocate for, new codes and things for the surgeons.

we just have to stay abreast. I mean, for instance. In 2026, all of the anesthesia codes for the a DA, CDT codes are changing. So it's important that You know that starting January 1st, 2026, that your, anesthesia codes change. So with things changing as rapidly as they are, yes, you need to.

Invest in that key team member as well as, keep them educated, but you also need to educate yourself. It's ultimately your license and your reimbursement. Like again, the health of your practice really depends on if you are doing this properly. and, and it's just a matter of, what makes you happy.

You want fast cash flow, you want patient satisfaction by collecting the. Correct co-insurance amount because a referral based practice, so you wanna make sure that the patient is not only happy with. Your surgery, but also the entire process was that first call. Very welcoming was the, follow-up And the billing, accurate.

So it's, a very important position as far as the revenue cycle management, because like I had mentioned earlier, even though I have been in every, I'm certified in my radiographer and all that good stuff, really where I felt I was doing the best for my surgeon is. Really focusing on accurate coding for his trauma as well as in office procedures.

And the biggest compliment bill that I've ever received was from an oral surgeon that there again, was a startup practice and one day I was leaving and he has five study buddies for his, boards. And when I was leaving that day, he just stopped me and said, Hey, I just wanted to let you know.

That out of the five oral surgeons that, were studying for the boards, I was the only one that made profit the first year. And that's how important your team is. They can make or break you really. And so. He is also the one that did join me at the coding, courses.

So hats off to him. But that's what we're in. I mean, we're not.org, most of us aren't, And we wanna make a profit and enjoy that family work-life balance and, have the financial income that we want to survive. And a team member really can help elevate that by looking for those profit leaks.

Bill Klaproth (Host): thank you for sharing that and This is why coding. Education for the staff is so important. So let's stay on the financial side. You've been talking about revenue cycle management and cashflow. Can you share another example or a story of an OMS practice that saw significant improvement in revenue after investing in coding education for the staff?

Leslie Icenogle: one of the first things that. I feel most team members are not aware of is utilizing, the work RVU and where to put procedures on a claim form. So meaning if I did a trauma case and I have fractures and lacerations and all these repairs, I need to know as a biller, what line to put, what procedure and most practices are like, okay, yeah, I know that I put the.

most expensive, so to speak, You know, the highest, fee that we have on top, but is that really what is the highest You know, worth value? It may not. You can't go by your fees. You need to really check the cms.gov and see, okay, what procedure do I need to put on top in order to get my maximum reimbursement?

Unfortunately those trauma patient's aren't always capable of paying their coinsurance amount. So we really need to utilize that claim, really tell that in complete story in the right, order. So we wanna utilize all the i cd tens that are proper And then. Properly and accurately put 'em in the right position on the claim form that you can learn through the coding workshops.

And then also I have seen, a doctor came to me and said that he was having a real problem being profitable with his trauma call. And I think That is being felt by a lot of oral surgeons around, the United States. And so I just took a couple of his operative notes and reviewed them.

And what was happening was he was looking at the operative note and he was just. Write down some codes that he felt they were and give it to the billing team and they would just bill 'em in that order, et cetera. Well, it really needs to be diagnosed more.

For instance, you know, hit condylar fracture. if you have a bilateral condylar fracture, you wanna make sure that you are charging for the LT for the left side And the RT for the right side. a lot of payers think of the condyle as one bone and not really specifying that you can have a bilateral fracture.

So just learning from the specialist there at Amos, like, Kelly and Patty that totally come in to help when you have a difficult claim like That make sure you charge for what all you do. So now instead of getting reimbursed for one. fracture. he's getting reimbursed for two, he's putting it on his claim form in the proper order, and he can get the most out of that, reimbursement for that trauma case.

So that includes your, common wisdom teeth as well. you wanna make sure and put your wisdom teeth on one line with four units if that payer allows that so that you can maximize the, dollars that are, there for reimbursement.

Bill Klaproth (Host): so a great story. So tha again, thank you for sharing that as well. That's a perfect example. If you code properly, and you stay current with all the codes, how that's gonna. Positively affect your revenue. So great example, Leslie. So I'm sure there's some people listening to this that might be saying to themselves, okay, I've sold, I need to do this.

So for an OMS practice, just beginning to invest, in coding education, what would be the first step then that you would recommend?

Leslie Icenogle: I would definitely recommend that you take the full range of coding courses because I like that certification, so whatever. programs are offered under the AAMIs coding certificate program is what I would recommend. Even though it might feel like you're taking a step backward at first, like, oh my, I've been doing this part for, years.

you can actually learn different things just by starting from the very beginning and getting that certificate. Very rewarding, especially as an allied staff member because, we really like to see those, You know, certifications on our wall and things that we do extra to make sure that our practice is, profitable.

So I would start at the beginning. and definitely for me, when you go to the highest level, that's the one that I attend regularly. Not that my certification expired, but codes change and, things evolve. And do go to the National Association of Dental Plan meetings just because I think it's very interesting to hear the payer's perspective on the reimbursement And what the future is there, but the actual.

Courses that are at the highest level are the ones that I wanna attend on a routine basis regardless. even if I don't feel there's change, Medicare, my goodness, that's a very important course. I mean, you have the Mandatory Filing Act, you have all these different, rules and regulations. You have the no surprise act.

There's the anti Stark law, there's so much involved. That if you're not staying current, you're being left behind You want to really stay ahead of that. Medicare's getting more and more in our field whether we like that or not, and I can see that from not this loss in.

national Association of Dental Plans meeting, but the one prior where Medicare had a pie chart that showed how much more money they would have saved by paying for more dental work than they are now. And they're in our fields. We have to keep up with that regulatory. And, there again, I think A to Z go to all of them at first.

And then, as far as the highest level or the Medicare, do those either annually or semi-annually.

Bill Klaproth (Host): So great advice. Start at the beginning and I love how you said if you're not staying ahead, you are falling behind. So That is really important and a powerful statement. Before we wrap up, Leslie, and thank you so much for your time. If there's one single takeaway you want our listener to remember about the importance of coding education, what would that be?

Leslie Icenogle: OMS billing is very complex and. Education is the key to transforming your billing from a daily struggle into something that you can generally enjoy and excel at. I take pride when I get that payment, you know, and you get that check and you know how much work and education's behind getting it.

You really need to know that. Even though it's complex, you have Amos there to train you, they have resources and there's nothing better than seeing a clean, accurate claim get paid quickly without any appeals or any headaches. and that's when your job becomes really generally rewarding. you can take pride in your expertise and, can invest in your own growth and, allow yourself to enjoy the process.

I mean, basically I love what I do. I think you can probably tell the passion because. It doesn't really feel like work. It feels like I am in this team And we are here to win together. and who doesn't wanna have fun, right? I like to enjoy what I do.

So really, as far as a key takeaway, coding education is key to transforming your billing at any daily struggle and to something you can genuinely enjoy and excel at.

Bill Klaproth (Host): Perform the proper coding, have more fun. I like how you said there's nothing better than, seeing clean, accurate claims get paid quickly without appeals, or maybe more importantly no headaches. that's really important. Leslie, thank you so much for your time. This has really been informative. Thank you so much for, uh, sharing all your knowledge with us today.

We appreciate it. Thanks again.

Leslie Icenogle: Well, thank you Bill, and thank you to the entire Amos, coding committee teams that, have, been there to support us through all these years. Thank you.

Bill Klaproth (Host): Absolutely. And once again, That is Leslie Ice Noggle. And to learn more, you can visit amos.org/coding billing. So if you wanna learn more, amos.org/coding. Billing coding. Billing is all one word put together. And if you enjoyed this podcast, please share it on your social media and make sure you subscribe so you don't miss an episode like this, where we give you all this great information.

I'm Bill Klaproth. This is Amos on the go. Thanks for listening.