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Searching: insurance denials
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Page 2 of 46
Message Board (2269)
Message Board
Views: 1156 | Replies: 60
the pre D is way more work than the extractions. I've never even heard of pre D for extractions. Maybe $150 is low for the hassle of taking out 1 tooth, but you are getting 4 in total. Most of the work is setting up the room, consents, blood pressure, the note, the insurance claim, local anesthetic
May 18, 2026
Claims Processing
Message Board
Views: 508 | Replies: 26
together. 1) set 50% across the board. why are you paying all???? that makes no sense 2) start trying to find ways to cut hours to get people to part time status and dropping their insurance 3) offer hmo or poor paying plans. We pay a fixed amount per employee. It's much easier to do and budget
May 05, 2026
Front Office Discussion
Message Board
Views: 180 | Replies: 9
I am pretty sure that I know the answer, but I'd figure I'd ask. I got a letter from Fortress asking me if I want tail insurance of 1 million/3 million and to respond by 10/2026 for ~$2000 with unlimited and expires when limits are used up. I have claims made policy. I have a new policy from TDC
May 11, 2026
Malpractice Insurance
Message Board
Views: 202 | Replies: 7
in the area expanded aggressively and joined every network that the major employers participate in. I've seen my demographics change over the last five years. Growth in regular insurance and cash patients, but a decline in young families and kids. Hasn't hurt my bottom line, but it has not gone
May 20, 2026
Practice Management & Administrative Forum
Message Board
Views: 55 | Replies: 2
We are edentulating a patient that has 3 solid implants. She wants dentures, but I figure we sleep the implants since they're solidly integrated and could potentially use them down the road. Is there a billable insurance code for this? I figure probably not, but was checking to see if anyone else
May 20, 2026
Implantology
Message Board
Views: 1804 | Replies: 142
I mentioned earlier are for these reasons: immediate patient education, protection from disgruntled patients, shutting down insurance denials, and better yet for your/staff own education in studying what you missed the first go round and what you might do different. Here's my take on this. A lot
August 22, 2025
Ideas To Make Your Practice Grow
Message Board
Views: 114 | Replies: 4
some light on this particular question. Thanks, Mary B. Most insurance policies specifically exclusive cosmetics or electives from reimbursement. Flippers, by their name sake, are more cosmetic in nature than functional. Hence you will find many policies that would not pay them, Delta or many other
March 09, 2026
Dental Insurance for Dentists
Message Board
Views: 142 | Replies: 3
Every few months, a headline screams that AI is breaking health insurance, or cracking dental insurance, or destroying private practice. It makes for great clicks. It also makes for lousy calibration. Dentists are hearing more stories about denials, documentation requests, and automated reviews
February 25, 2026
Artificial Intelligence
Message Board
Views: 559 | Replies: 6
A new law in California bans health insurance companies from using AI to deny care or coverage. This is a major win for patient advocacy and puts decision-making back in the hands of humans, where it belongs. Why it matters: No more automated denials without human review. Patients' care decisions
February 10, 2026
Billing
Message Board
Views: 1151 | Replies: 57
It is vital the patient understand the dentist and patient are partners, not opponents, working together against the challenges and restrictions often presented by insurance companies. The patient must be brought to a point where they recognize what is likely to happen if they do not move forward
March 01, 2026
Claims Processing
Message Board
Views: 2694 | Replies: 84
written to include more generous benefits than newer policies so be sure to read yours carefully before deciding to cancel it . I'm no insurance expert so I'm not in any position to give advice on this. I just like to advocate for dentists to be informed when it comes to stuff like this. I almost
April 10, 2026
Disability Insurance
Message Board
Views: 309 | Replies: 16
for these problem insurance companies that want to waste our time and theirs. Don't wait for the denial to appeal, that is a waste of time. Just send your remark notes with the original claims. No, I am not defending insurance at all. Just recognizing we need our own 'counter-tactics.' Anticipating
February 26, 2026
Claims Processing
Message Board
Views: 304 | Replies: 23
politics, one things that I wish would change is that insurance companies could not take money from one patient check for a prior patient refund. I think that the insurance carrier should be legally responsible for getting that money form the patient, not from taking it from new money owed
May 18, 2026
Claims Processing
Message Board
Views: 204120 | Replies: 100183
all the time. Indisputable photographic evidence of BigFoot and Nessie. The Bermuda Triangle was still a thing. Mark, David: It is getting worse and worse. How long can you hold out with your silly denial? And for what? Funny Bought my wife a Mazda hybrid. Cherry red. Had to drive 3 hours to get her
May 16, 2026
Politics
Message Board
Views: 412 | Replies: 11
paid. So, what do we do? My suggestion: Prepare a few pre-written narratives on the common reasons you take PAs and have them ready to use for these problem insurance companies that want to waste our time and theirs. Don't wait for the denial to appeal, that is a waste of time. Just send your
April 06, 2026
Claims Processing
Message Board
Views: 509 | Replies: 25
another unrelated patients claim on another plan and reduced his insurance payment for the amount they say they want. Now I am stuck. I am not going to get money from the original pt. I am going to have to bill pt 2 the balance that their insurance has failed to pay on their claim. This pisses me off
April 27, 2026
Claims Processing
Message Board
Views: 156 | Replies: 3
is likely your perio chart, a vast majority of offices do not fill out a complete chart, which is a major reason for denial. This is a case that should go in a book of how insurance companies defraud patients and dental practices. Resubmit again with a proper narrative and ask for a human to review this. It likely was an automatic denial, no human laid eyes on this xrays
February 06, 2026
Delta Dental
Message Board
Views: 123 | Replies: 4
We have a patient that requested we submit a pre-determination for a crown on #31. Grossly open lingual margin, recurrent decay, the works in terms of it being medically necessary. Our office submits the pre-d on January 1, 2026 when benefits renew and we just got this as the denial reason
February 18, 2026
Claims Processing
Message Board
Views: 579 | Replies: 23
it. Insurance appeals do not need to be about venting your displeasure with the denial; keep it to the processing policy they used to deny, and refute that. It will help the appeal get processed faster. Please make it your own. Thanks a lot for taking the time to do this! Can I use this to appeal the Pre-D? Yes! Use it for any SRP downgrade. Your hygienists and patients will appreciate it. Good luck, UDent!
March 11, 2026
Coding Q&A
Message Board
Views: 104 | Replies: 5
(D0470) on the day of an exam and subsequently bill for an appliance (like a partial or denture), so long as the initial records are documented as strictly diagnostic rather than procedural. To avoid "unbundling" denials, your clinical notes must show the records were used to evaluate the patient's
March 10, 2026
Coding Q&A
Message Board
Views: 30 | Replies: 1
We made Orthotic appliances for a TMJ patient. We typically only submit these to medical insurance, as we haven't seen Dental cover this yet. For this patient, she actually had dental coverage, but it was very low (only a $250 lifetime maximum). We told her we recommended only sending to medical
May 15, 2026
Claims Processing
Message Board
Views: 930 | Replies: 57
per employee Time Wasted on Insurance Verification and Claims 15-30 minutes per patient 20-40+ hours per week per staff member (often 50% of their workweek ) 27-35% of claim denials caused by verification errors Overall dental claim denial rate: 15% Staff Cost Reality Average full-time front-desk
April 08, 2026
Artificial Intelligence
Message Board
Views: 49 | Replies: 2
now (this part sux). When we send the claim, it sits in queue until 8:45 pm every night when all claims are batch sent by EDS to insurance companies. If we make an error, we can easily reject the claim in EDS as long as it's before 8:45 pm. Now to the part that sux: HS1 increases the monthly price
April 30, 2026
Claims Processing
Message Board
Views: 120 | Replies: 2
, those with higher denial rate, because they are far easier to beat. Travis thanks for taking the time to provide that great information! From the above: Not to mention, even for OON offices, insurance can pull money you owe them from future claims, even from patients not involved with the original
February 17, 2026
Claims Processing
Message Board
Views: 614 | Replies: 14
Hello Townies, I am considering outsourcing billing insurances. I've heard bad things about eAssist. I talked to Dental Claim Support (DCS) and I liked them. Of course I spoke with a salesman so naturally he'll make it sound amazing. I want to ask yall about any personal experience yall may have
March 05, 2026
Billing
Message Board
Views: 82 | Replies: 1
allows it to efficiently compete with large national insurers while still operating through regional organizations. The broader implications could be enormous. If dentists ultimately succeed, the litigation could potentially reshape dental insurance contracting, reimbursement negotiations, and network
May 14, 2026
Delta Dental
Message Board
Views: 882 | Replies: 42
with radiographs to prevent nearly all denials. But if you dont want to stay on the edge of it, knock yourself out. The problem is charging someone for something and then having to credit when insurance pays or vice versa . No one is saying to do creative billing . But it's good to know beforehand patient
April 21, 2026
Ideas To Make Your Practice Grow
Message Board
Views: 178 | Replies: 3
, especially among hygienists and assistants. Recruitment and retention continue to strain practice operations and budgets. Looking ahead to 2026, dentists consistently identify insurance issues as a top concern, including low reimbursement rates, delayed payments, and claim denials. Staffing shortages
January 19, 2026
American Dental Association
Message Board
Views: 204120 | Replies: 100183
policies on models unconnected to reality. An insurance company modified a hurricane loss data set by starting from my team's carefully collected data. Many of those modifications have no documentation and no basis in research. The company appended data taken from a different tabulation of losses
April 30, 2026
Politics
Message Board
Views: 86 | Replies: 1
Dental organizations nationwide and results in insured patients routinely paying higher bills for out-of-network care. The legal claims include breach of fiduciary duty and improper denial of benefits under federal law, and the plaintiff is seeking damages as well as court orders requiring changes
March 12, 2026
Delta Dental
Message Board
Views: 45 | Replies: 3
The revenuewell insurance verification program stinks. For one, it wont give us any data on any out of state Delta plans ( we are in CA) . they often have mistakes as far as flouride being covered when its not. Can anyone recommend anything better Anyone have any recommendations? Thanks ! Check out Practice by Numbers. thanks Sandy, will do
April 20, 2026
Ideas To Make Your Practice Grow
Message Board
Views: 324655 | Replies: 34371
insurance verification service. We were having ongoing issues with improper data being put in our software. Anyway, we get a call from an employee, saying she is starting her own business as this business has gone to AI (she was let go and was soliciting our business for her new company). But ever
April 30, 2026
Personal Finance
Message Board
Views: 3549 | Replies: 163
for a buildup/crown compared to other insurances/previous fees" that yes indeed that is bad. Analyze your fees based off your overhead and costs and don't compare them against other low paying insurances to make them seem worth it. In my opinion, anything below a $1000 for a buildup/crown is unacceptable
May 12, 2026
Just Plain Bitching and Moaning
Message Board
Views: 182 | Replies: 17
I just received a denial from Centene Heath Plans under Medicare. I appealed an inital ruling to cover prevident for a disabled patient who has a high caries rate. She can not use her arms and relys on staff to brush her teeth. I can scan and post the actual denial but here is the quote
September 25, 2025
Fluoride
Message Board
Views: 209 | Replies: 5
Has anyone used it? Overjet is one of those companies that offer the AI xray reading. Im not really interested in that part, what im more interested is theyre saying now they will look at your insurance submissions before you send them in, first with AI, and then if it needs to, to one
January 10, 2026
Billing
Message Board
Views: 7088 | Replies: 171
- but to criticize the process that led the nation's dentists to a predictably bad outcome. Mouhab Rizkallah Unfortunate but predictable. Best short term solution to get long term change is dropping Ins. Take back control of your offices Don't be an employee to the insurance companies you par with As others
April 09, 2026
Delta Dental
Message Board
Views: 101 | Replies: 7
What's the ADA code? Will the insurance pay for it ? The codes are D9938 D9939 for creation and placement (separate codes). Almost no chance insurance will pay anything. In general insurance does not pay for cosmetics or most temporary treatments Why not use D8680? When to Use D8680 dental code
January 14, 2026
Removable Prosthodontics
Message Board
Views: 338 | Replies: 7
in dental and medical practices, including insurance eligibility verification, claim processing, payment posting, denial handling, and appeals. Foji provides specialized AI agents such as: VerifiAI for realtime insurance eligibility checks, ClaimSync for generating and submitting claims, DenialGuard
December 23, 2025
Artificial Intelligence
Message Board
Views: 204120 | Replies: 100183
Flocks take on it REFRESHING! Remember that.... BO and Flock say its only like, ELEVEN.... Coastal Dtards will be screaming at their TVs how unfair this is.... Spot on. Fearless and BRAVE I say.... You are completely in denial. Waiting for you to wake up. Exactly. Most of the world has moved
March 27, 2026
Politics
Message Board
Views: 97 | Replies: 6
I recently bought an office and I'm embarrassed to say I really have no idea when it comes to everything insurance. Words like 'clearinghouse' go right over my head. I have a biller on my team who is competent and seems to really know her stuff. Could anyone kindly point me to a resource
April 12, 2026
Dental Insurance for Dentists
Message Board
Views: 1505 | Replies: 31
for them to cause problems with ill conceived updates is a bit too much of an ask. I'm thinking for switch to Curve as I'm hearing good things about its automation in insurance verification and AR/aging report accuracy. Can someone please speak of their current experience on that? My insurance
March 11, 2026
Curve Hero
Message Board
Views: 5258 | Replies: 155
crown fee. Not to mention that you will likely get a lot of pissed off patients when you get denials and downgrades. You can collect whatever you want as long as you refund it once the insurance check comes in. We send refunds for overpayment all the time. If you revieve an insurance check just
March 26, 2026
Ethical Issues
Message Board
Views: 30 | Replies: 1
authority to promulgate rules and that it did not meet while the language was being altered, raising questions about procedural validity. Drummond criticized the influence of out-of-state, for-profit managed care organizations that favored the rule because it would increase bureaucracy and claims denials
February 26, 2026
PPOs and HMOs
Message Board
Views: 72 | Replies: 2
Which company do you use for Life insurance? I had a plan with protective life as part of ADA membership which I did not renew this year. Now I need to replace my Life insurance policy. You can have your insurance guy shop for you based on pricing and ratings. You just want term. If you have
April 01, 2026
Pediatric Dentistry
Message Board
Views: 573 | Replies: 24
the payment. And just like that, you lost 2 to 3 percent of money you already earned. Welcome to modern dental insurance payments. Let's clean this up, because most of the confusion comes from mixing three completely different things into one conversation. There is your fee schedule. That is what you get
May 09, 2026
Claims Processing
Message Board
Views: 87 | Replies: 4
% annually, and incorporates monthly data from 70+ payers covering 225,000 dentists, 189,000 locations, and 110 million insured patients. I think we all saw this type of thing coming. The insurance companies will start weaponizing AI programs as an excuse to deny claims. Once you get the denial, you
September 20, 2025
Artificial Intelligence
Message Board
Views: 115 | Replies: 3
How long does delta typically take to pay for a conventional fixed bridge. It always goes to review..... Does anyone have the answer on this? Thanks! Within 30 days, if they have everything they need to process it. Every insurance company has to follow the same state rules: Respond to a claim
December 09, 2025
Billing
Message Board
Views: 176 | Replies: 9
they call? And can't answer the phone What if you're on the toliet everytime they call? And can't answer the phone The mute button helps a lot in that situation. Ha, have they earn the polite courtesy of the mute button? I did one of those calls a few years back, and there was a number on the denial letter
January 23, 2026
Dental Insurance for Dentists
Message Board
Views: 204120 | Replies: 100183
this was a 'Biden win for fliers.'" "We CARE about pricing! We care about competition. But if the markets say there needs to be a merger because of health issues with an airline, we HAVE to make sure we make the right choices." "History has judged the denial of the JetBlue-Spirit merger under Biden
May 02, 2026
Politics
Message Board
Views: 54 | Replies: 5
What is the proper way to set up the insurance in the account so it can give a proper estimate. I only accept PPO. Should I choose %PPO on subtype. Any tip will help. Thanks Change software Anyone have input on this ? Thanks! ppo percentage in network with attached fee schedule. Category percentage
April 20, 2026
SoftDent
Displaying 51-100 of 2269
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Page 2 of 46
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May 2026
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