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Searching: insurance denials
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Page 1 of 46
Message Board (2269)
Message Board
Views: 130 | Replies: 5
is okay, but does not show the entire tooth/root. The second x-ray is not even centered. The tooth in question is a no brainer to get paid with good x-rays and photos. Estimate insurance will pay, get better x-rays and photos, and then do the work. Stop asking insurance for permission. The denial isn't
May 05, 2026
Claims Processing
Message Board
Views: 255 | Replies: 12
Add this one to the Why I hate Dental Insurance Companies list..... Recently, we preauthorized a patient for 4 quadrants of scaling and root planing with Delta of Minnesota. We completed treatment and submitted all necessary documents for payment. This claim was denied. Furthermore, the denial
June 26, 2025
Claims Processing
Message Board
Views: 788 | Replies: 28
the basics. Claims went out. Payments came back. Staff posted them manually and hoped nothing slipped through the cracks. That worked when volumes were lower and insurance plans were simpler. Today, it is a different world. More plans, more carve outs, more coordination of benefits, more denials
May 27, 2026
Artificial Intelligence
Message Board
Views: 36 | Replies: 1
Every few months, a new headline shows up that sounds like the opening scene of a sci-fi movie. The government wants AI doctors. Utah lets AI prescribe medicine. Autonomous cardiologists are coming. If you are a practicing dentist reading that between hygiene checks, crown seats, and an insurance
April 07, 2026
Artificial Intelligence
Message Board
Views: 57 | Replies: 1
Canada's Canadian Dental Care Plan is not socialized dentistry. It is not the end of private practice. It is also not 'free dental care.' It is something much more familiar to dentists: a large, government-funded insurance program with copays, eligibility rules, preauthorizations, fee gaps, patient
May 27, 2026
Canada
Message Board
Views: 1156 | Replies: 60
, when you attempted to extract it with forceps and needed to use a handpiece and bill as surgical extraction and you will be less pissed. Even in the OP's insurance Dental Doctor Review denial, there is a section that lays out what they deem is needed to constitute surgical extraction: If the tooth
May 14, 2026
Claims Processing
Message Board
Views: 782 | Replies: 12
I don't completely understand how accurate it is but will it help us diagnose or will it be a tool for insurance to deny claims? Does anyone have information about how this will work? I'm currently looking into overjet as well. Would love some feedback from anyone that has tried it. Software seems
February 19, 2026
Software Discussions
Message Board
Views: 340 | Replies: 15
it is not covered but not for every single procedure you do. Thanks for the info. We're essentially applying this approach to about half a dozen proceduresthe ones we see the highest insurance denials for, such as crowns, buildups, scaling and root planing, and similar treatments. What is Delta going to do
August 08, 2025
Delta Dental
Message Board
Views: 160 | Replies: 1
. Companies like DentalXChange, Stedi, Zentist, Pearl AI, Overjet, Vyne Dental, DentalRobot, Curve Dental, and Stratus AI are all attacking the same giant problem from different angles: insurance verification, predeterminations, claims scrubbing, attachment management, denial prediction, payment posting
May 10, 2026
Claims Processing
Message Board
Views: 122 | Replies: 12
, treatment planning tools, insurance workflows, and patient communication systems. Now Utah has given everyone in healthcare something much bigger to chew on. Utah approved a pilot program allowing an AI system from Doctronic to renew certain existing prescriptions without a physician signing off
May 27, 2026
Artificial Intelligence
Message Board
Views: 1330 | Replies: 55
Alright, let it out. What's one thing in your practice that's been driving you nuts lately maybe it's a system that won't work. Patient situation or team dynamic vent it out here we're all ears. Fickle patients, insurance denials, training staff, clinical decisions, Adult male patients with wives
July 09, 2025
Just Plain Bitching and Moaning
Message Board
Views: 39 | Replies: 1
Should routine adult dental care eventually be treated as an essential health benefit? Or would folding dental into major medical create more problems than solutions? Curious where Townies fall on this one, especially those dealing with Marketplace plans and insurance issues every day. Either way
May 29, 2026
Dentistry In The News
Message Board
Views: 442 | Replies: 20
My wife showed this to me the other day. I'll bitch about work and insurances and she just nods, but I think this was pretty eye opening for her on how big of a racket it is. A while back I looked up delta of colorado. The CEO only made 500k/year. BUT then when I looked deeper it was for 4-5 hours
May 29, 2026
Dental Insurance for Dentists
Message Board
Views: 50 | Replies: 5
. The unique part is that obviously I will be looking to grow my new practice and bring in as many patients as possible, but my current practice is also looking to shed patients and drop insurance plans. So if a handful of patients follow me to my new practice that's a bit of a win-win. My current
May 29, 2026
Patient Communication / Education
Message Board
Views: 17198 | Replies: 1131
observations as someone who has watched lawyers at work on highly technical cases and seen a lot of subtle deflection to important questions: Waymo said 'the Waymo vehicle is always in charge of the dynamic driving task.' That is not a denial that the human is performing some of the driving task. (Being
May 27, 2026
Automobiles
Message Board
Views: 324680 | Replies: 34372
% in marvel from politicians stock buys Trump could bang their wives and they'd find a way to justify it. Actually on second thought, they'd definitely let him Yep, I offer Health insurance, paid holidays, PTO, and retirement plan, thats my limit. You dont offer health insurance? i offer 50% insurance 0
May 28, 2026
Personal Finance
Message Board
Views: 1151 | Replies: 57
case. Guardian denial. They said no noted radiographic bone loss was reason for denial. Any help or direction would be MUCH appreciated. Thanks! I actually agree with the insurance company here-not clinically, but by THEIR definition of what qualifies as 4341/4342. They want to see clear radiographic
September 16, 2025
Claims Processing
Message Board
Views: 945 | Replies: 29
minimal cost to keep it. I will not let mine lapse. Mack I would think it's a very low risk high reward situation. Especially if you do not have to pay for liability insurance, disability insurance, workers comp etc and so on the cost of keeping you license would be so minimal in comparison and I
May 28, 2026
Retirement Planning
Message Board
Views: 62 | Replies: 3
denials, and real-time insurance eligibility verification. Practices using the platform report improved diagnostic confidence, earlier issue detection, better patient education and engagement, higher case acceptance rates, and tangible production gains. It's widely adopted by DSOs and solo practices
February 12, 2026
Artificial Intelligence
Message Board
Views: 523 | Replies: 34
I'm sure this will be a useful scenario for colleagues who will face similar undertaking. I'm selling; the closing is scheduled 4 weeks from now.. The new owner won't be credentialed in time to start billing under her own insurance provider ID. My broker suggests to have the new owner bill under my
May 26, 2026
Practice Sales
Message Board
Views: 94 | Replies: 4
current humana patients, you may have to collect in full all payments for services at the time of service and have the assignment of benefits aka check go directly to the patient. "Ms./Mr. X, your insurance company is not a reliable payer and through their own incompetency has borderline defrauded our
May 21, 2026
Practice Management & Administrative Forum
Message Board
Views: 875 | Replies: 33
....and got a denial. The insurance company is requesting pre-op PA's of all of the teeth, which we do not have. In this SAME FUCKING BATCH OF MAIL, this same insurance company denied 2 anterior PA's for not being medically necessary. Please make this make sense. Cant we create a "call the ADA
March 06, 2026
American Dental Association
Message Board
Views: 397 | Replies: 17
I remember hearing that if, as a practice owner, you deduct disability insurance as a business expense, then you will owe taxes on the insurance money paid out if a claim is made. If you pay the premiums with after-tax income, then the disability insurance payout is untaxed. Is this true? Yes
May 19, 2026
Disability Insurance
Message Board
Views: 134 | Replies: 2
familiar to anyone who's dealt with insurance bureaucracy: low reimbursements, rising denials, and endless prior authorization hurdles. The Kaiser Family Foundation reports tens of millions of prior-auth requests each year under MA, and the number keeps climbing. For patients with complex health needs
October 18, 2025
Medicaid and Welfare Issues
Message Board
Views: 23 | Replies: 0
for it in denials. D0351 - deleted January 2023 and replaced with the current surface scan codes. Worth checking whether your claim templates still reference it. I wrote up the full walkthrough for DrBicuspid this week if you want the longer version, including the Phase 3 fabrication codes (D0396, D6190, D5982
May 15, 2026
General Cad-Cam Topics
Message Board
Views: 563 | Replies: 10
complicated it, and any reason the timeline stretched. If a denial lands six months from now, your only defense is a story that makes sense clinically and chronologically. Be honest with the patient up front. Dental insurance is not a treatment plan, it is a cost-sharing arrangement with rules. If their plan
April 28, 2026
Delta Dental
Message Board
Views: 154 | Replies: 5
question - How best to search with AI? If I ask "use only published literature" will it? I know Principal Dental Insurance has started. You now have to submit x rays for all fillings. Prepare for the denials. I have been taking photos mid procedure for years to prevent denials. I just did this #14...x-ray
April 24, 2026
Artificial Intelligence
Message Board
Views: 66 | Replies: 3
Hi All, Recently heard of a denial for x-rays along with an exam, and the reason for the denial was something like 'submitted codes have been bundled into one procedure and are not eligible for payment.' Are we going to stop getting paid for x-rays? Just exams? Gather whatever data you want? Does
April 15, 2026
Claims Processing
Message Board
Views: 85 | Replies: 4
PSA for every dentist who has ever worked for a DSO. Go look yourself up. Right now. Open Google, search your name plus 'dentist,' then go to the provider directory pages for the three or four insurance carriers you take. I'll wait. Did you find yourself attached to offices you haven't set foot
May 18, 2026
Dental Insurance for Dentists
Message Board
Views: 218 | Replies: 2
, alleging gross negligence, wrongful death, denial of due process, and failure to properly support him during a mental health crisis. The case has already been covered by NRI Pulse in 'While Nothing Can Bring Our Son Back, We Want to Ensure This Never Happens to Another Student,' The Times of India in 'Our
May 17, 2026
Mental Health, Well-Being, and Stress Management
Message Board
Views: 33 | Replies: 1
notes. Verifying insurance. Classifying images. Useful, but limited. The next phase is orchestration. Instead of optimizing isolated steps, AI begins coordinating the entire workflow. Documentation gets validated in real time. Imaging is checked before it causes downstream errors. Eligibility
May 01, 2026
Artificial Intelligence
Message Board
Views: 204170 | Replies: 100198
, be prepared to do a lot of walking. Uphill walking at that. Good exercise! I've done great things too. On my farm in NC. But I sold it. I got too old. Still have chickens. Love my chickens. That statement makes no sense at all, but makes you feel better about your ridiculous denial stance over
May 23, 2026
Politics
Message Board
Views: 1141 | Replies: 19
in practice. Think in branches, not in averages. If it is swallowed and smooth, it is usually a GI observation problem. If it is aspirated or might be aspirated, it is an airway problem. And airway problems do not tolerate denial. The first move is always the same. Stop. Assess airway, breathing
May 22, 2026
Medical Emergencies
Message Board
Views: 132 | Replies: 1
take the tooth out on Monday, bring them back Wednesday, and we can all pretend this is smarter.' That is the joke. It is also the tragedy. Because when you slow down and really look at what happened, the denial usually is not random. It is not even mainly about whether the graft was good dentistry
April 21, 2026
Coding Q&A
Message Board
Views: 889 | Replies: 35
to pay, because it's not free. Tell her you'll gladly refund her money once the insurance company pays for it. Sorry, I will respectfully disagree with this (and I never disagree with what you say, :) ). Explaining insurance issues, payments, EOB's, denials, balances, etc. are not the doctor's job
January 12, 2026
Claims Processing
Message Board
Views: 171 | Replies: 7
this for years. It will be a battle of the AIs. OP , this is a common denial pattern for Cigna. We get duplicate denials after claim payment, denials for missing tooth numbers when their letter has the tooth number in it, and denials for missing attachments. We call; all attachments were there. The list goes
April 08, 2026
Claims Processing
Message Board
Views: 930 | Replies: 57
is wasted. #1 answer was time spent trying to verify insurance benefits. Excited to see the launch of your product! We are working hard. Our benefits eligibility is basically done and quite a few have real time info which means you can confirm plan on the phone and not waste a follow up call to confirm
May 06, 2026
Artificial Intelligence
Message Board
Views: 61 | Replies: 0
, and the final plan. Attach radiographs, photos, CBCT slices when appropriate, and product labels if your system supports it. In today's insurance world, the clinical procedure is only half the work. The other half is telling the story clearly enough that a computer denial engine does not murder
April 25, 2026
Oral & Maxillofacial Surgery
Message Board
Views: 725 | Replies: 30
. You cannot garnish wages or place a lien on the person's primary residence. Interest is capped at the 1 year U. S. Treasury (1.5 - 4 %) and they consider late fees to be part of interest. I have a patient who when we started treatment, had insurance through Delta Denial. By the time we were done
December 23, 2025
Billing
Message Board
Views: 671 | Replies: 14
.' That means technical denials. Missing tooth numbers. Wrong provider ID. Incomplete narratives. A radiograph taken but not attached. Dentists have lived this movie. Your fix is not heroism, it is systems. Use templates for narratives. Standardize attachments. Audit your own claims monthly. Find the three
April 29, 2026
Medicaid and Welfare Issues
Message Board
Views: 55 | Replies: 1
all think? Thanks. - Leo " but to me it seems insurance will deny that claim?" - First want to address this. If insurance denies something, the patient pays. We ALL need to get out of the mentality that a denial means we should not do something. Now a disallow, that is different. You are correct
March 26, 2026
Coding Q&A
Message Board
Views: 75 | Replies: 1
setups (instruments/materials Phone scripts Hygiene protocols Scheduling policies Staff task checklists Process of how to do Insurance claims and billing For example, the other day we had a repeat offender who consistently denied X-rays, so I ended up creating an SOP for handling X-ray/exam denials
April 16, 2026
Practice Management & Administrative Forum
Message Board
Views: 241 | Replies: 10
Has anybody had any success renegotiating fees with an insurance company that they participate with? Curious because I wanna know if I'd be wasting my time to attempt to do this Absolutely-it's something you NEED to do. You should absolutely do it every year. It's not that much work. Some
May 20, 2026
Dental Insurance for Dentists
Message Board
Views: 2443 | Replies: 92
satisfaction but I highly doubt people are happy drilling 3 modl 4 mod 5 do and then fighting insurance denials and dealing with staff problems If you didn't want to be a business owner then dental school, with today's debt load, just isn't worth it. Zooming out a little though, most of what makes
October 02, 2025
Practice Management & Administrative Forum
Message Board
Views: 700 | Replies: 16
My rep introduced me to Dental Advocacy Group, which promises a higher negotiated PPO rate that incorporates several insurance companies such as Guardian, Cigna, Met Life, etc. Does anyone have any experience with them? Feedback appreciated, thanks. what's the catch? Did you ever hear anything from
May 21, 2026
PPOs and HMOs
Message Board
Views: 157 | Replies: 4
by price, insurance networks, prior authorizations, deductibles, and confusion. Europe rations by budgets, queues, government negotiation, and delayed access. Pick your poison. No healthcare system has figured out how to give everyone unlimited access to the best doctors, newest drugs, shortest waits
May 21, 2026
DSOs Dental Group Practice, Multi-location Dental Practices, and Dental Su
Message Board
Views: 44 | Replies: 3
Anyone submitting to medical insurance for sleep apnea appliances? If so, would you mind stating how to do it? Thanks This is far too complicated to explain here. I suggest using a 3rd party to help you. Kent is being quite accurate. You can buy CE courses to learn the ways of billing medical
May 12, 2026
Sleep Apnea / Snoring
Message Board
Views: 617 | Replies: 27
far their official position is that it is our fault. We are supposed to follow up with the patient after a denial and make sure they gave us all The correct Info. If we can't, then we are supposed to use all of the insurance websites and search for the proper number. If you guys could hear the call
April 08, 2026
Claims Processing
Message Board
Views: 173 | Replies: 13
a large following and patients are extremely loyal to him. I do see a decent amount of his patients as they have transitioned to me over the years. Our practice is PPO dominate with Delta at about 45%. It gets complicated because patients that would normally see him and have insurance would then need
May 20, 2026
Delta Dental
Message Board
Views: 2167 | Replies: 161
their energy on decreasing SL burden, fighting the hygiene situation and standing up to insurance. You know, the real reasons why people dont want to own or want to sell. I'm learning so much in this thread Pharmacy and dentistry are very different thank god. A commodity type business vs a personal
May 20, 2026
DSOs Dental Group Practice, Multi-location Dental Practices, and Dental Su
Displaying 1-50 of 2269
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Page 1 of 46
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