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Searching: insurance denials
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Page 3 of 46
Message Board (2269)
Message Board
Views: 74 | Replies: 3
insurance handle their insurance? They may have less BS to deal with than you would. Good to know though! Good thought. That may be the right road to take. The last time I had a similar situation my car was totaled, the guy was insured, and it was a battle of epic proportions. Talking to their claims
March 23, 2026
Automobiles
Message Board
Views: 417 | Replies: 15
. Getting denials is the worst one, because it does nothing to solve the denial problem. Instead, focus on how to avoid denials. Then if you want to drop, go for it and have happier patients who's insurance still pays out benefits. As a former claim review consultant - send me everything and I can
September 18, 2025
Claims Processing
Message Board
Views: 4198 | Replies: 233
. But to many times employees complain about this and that...and then when they realize how much a new cavitron is with new tips and calling a repair guy in and then getting denials from insurance- they understand that business is not that easy. NO FD and no CDA? Even better. When patients cancel
September 01, 2025
Staff Management Issues
Message Board
Views: 217 | Replies: 10
Long story made short. Patient was seen back in March. We followed up with claims. Got denials. Followed up over and over and turns out they have HMO insurance. We are not in network with hmo. Nothing was covered obviously. Patient is pissed, called us and told us they were gonna report us
January 25, 2026
Claims Processing
Message Board
Views: 204120 | Replies: 100183
it to everyone on campus evidently......I walked up to her in the cafeteria and I asked her.....How was I?.....was I any good?.....there are sum real nutty people out there in... Someone has not paid attention or is in denial. Did you not hear his voice on countless occasions, or read his posts
April 19, 2026
Politics
Message Board
Views: 208 | Replies: 4
Dentists love dentistry. They tolerate insurance. That is the relationship. Most practices do not wake up excited to 'optimize reimbursement,' yet insurance quietly decides whether your day feels profitable or like you are running a charity with better lighting. Townies keep circling back
December 15, 2025
Claims Processing
Message Board
Views: 203 | Replies: 7
is based on a completely false claim which ruins the doctors reputation with the pt and to others the pt may inform. At what point is the insurance company liable for these damages? Im guessing most just pass it off and say its not worth the headache, bu if the doctor and practice is young, one could
January 15, 2026
Legal Issues
Message Board
Views: 202 | Replies: 3
to "customer experience". Crap like this infuriates me. The publish rules and then don't follow those rules. This is why you cannot trust insurance reps, they don't know anything. This is also why it is pointless to file non-covered services to insurance, you just waste your time and theirs. Bill the patient
May 06, 2026
Claims Processing
Message Board
Views: 373 | Replies: 10
any openings for their first, 2nd, 3rd, or 4th preference - then apologize but they have to attend to something and don't call them back I am confused about what actually happened. Did he pay twice? The insurance paid and he paid as well? It is confusing, I know. In short, he paid his portion
May 06, 2026
Billing
Message Board
Views: 204120 | Replies: 100183
oil and gas You've been given free access to this story from The Economist as a gift. You can open the link five times within seven days. After that it will expire. The Iran war is roiling commodities far beyond oil This is a classic case of public denial from Tehran versus leaked/claimed progress
March 24, 2026
Politics
Message Board
Views: 402 | Replies: 28
If you have disability insurance do you plan on continuing with it till retirement or do you plan on at sometime discontinuing it? If you never had it what are your reasons? I had it until I had enough in investments and that it made no sense to have it. When I was young and had a young family
April 17, 2026
Disability Insurance
Message Board
Views: 371 | Replies: 23
that they give zero $hits what your states laws might be, esp. if their BS gets no pushback. It's one of the D's, Delay ask chatgpt to give you a template for notes that an insurance proof. it will give you a template that covers everything. Yes, and the "wordier" the better! I'd bet one could make a 5000
April 29, 2026
Dental "Pearls"
Message Board
Views: 206 | Replies: 1
takeaway is simple. High trust plus low visibility equals risk. The smartest response is not fear or denial. It is redesign. If a parent asked you today to watch their child's entire appointment without ever leaving the room, would your current system make that easy or awkward? Chandler dental assistant
April 21, 2026
Legal Issues
Message Board
Views: 101 | Replies: 5
Lately(or maybe not so lately) we've noticed certain insurance companies(Guardian in particular) deny everything. So, large cavities or significantly fractured teeth that are typically slam dunk crowns, Guardian will initially decline. We typically send xrays, photos, and a diagnosis. We
December 19, 2025
Claims Processing
Message Board
Views: 573 | Replies: 26
Happy new years! Just acquired practice and the OM retired with owner. She was not available to train anyone. Who do I hire for dental billing? Title? Who bills insurance and patients in your office? And makes sure everything is current? I need to hire someone but don't know how or where to look
November 23, 2025
Practice Management & Administrative Forum
Message Board
Views: 151 | Replies: 9
Dear Dental Townies, I have a question regarding SRP and downgrading and frequency from PPO insurance plans. For background, I am in-network with most insurance plans through umbrella networks such as Carington and Connection Dental. We almost always send pre-estimates before doing major treatment
January 22, 2026
Claims Processing
Message Board
Views: 1231 | Replies: 45
that has insurance. Just wonder how long we can continue to put up with insurance dictating fees as costs continue to increase? I'm sooooo glad to be on my way out but I feel bad for my son who will be taking over the practice and unfortunately will have to deal with these issues. What codes did you bill
May 04, 2026
Billing
Message Board
Views: 3222 | Replies: 145
office on a virtual platform. If you prefer a live seminar, I'll be announcing dates for the east and west coast locations for 2026. Is insurance verification covered in this series? What is your recommendation on insurance verification? We currently get all info, including calling past offices
May 05, 2026
CE Comments / Suggestions / Events
Message Board
Views: 67 | Replies: 2
wondering: - Do offices handle anything differently when a patient specifically requests a copy? - Do you charge a fee for providing a copy, or only bill the patient if insurance denies coverage? - Do you inform patients upfront that insurance may not cover the x-ray, or only address it if a denial
October 22, 2025
Patient Communication / Education
Message Board
Views: 80 | Replies: 2
trigger a denial evenafterapproval? And how soon is too soon to consult an attorney? How confident are you in your current disability coverage, and what do you wish youd known earlier? Drop your thoughts below Disability Insurance Roulette with Edward O. Comitz
July 31, 2025
Disability Insurance
Message Board
Views: 62612 | Replies: 9426
hauls in about $1/2 mil annually. MN has some of the lowest dental Medicaid fees nationally (2020). If a state's dental Medicaid is only paying out 30% or less of that of private insurance reimbursement, the private sector is almost completely disincentivized to participate w/ dental Medicaid (except
April 30, 2026
Ethical Issues
Message Board
Views: 152 | Replies: 8
of claim denials or paperwork. The better services usually pay for themselves (and then some) through improved collections rates and faster cash flow. Have you thought about what it would look like if your coordinator had uninterrupted time for patients while the behind-the-scenes insurance ran
January 09, 2026
Staff Management Issues
Message Board
Views: 383 | Replies: 24
Deleted because I kept getting unhelpful comments from "some" townies... You can submit them to insurance with a different date if you are willing to commit insurance fraud. It would also indicate to your patients that you are willing to bend or break the rules and then they begin to question your
April 29, 2026
Claims Processing
Message Board
Views: 7625 | Replies: 425
will probably gripe about it and leave. maybe just temp then. just my 2 cents. Yeah, I just dont see it. Interesting...I'm usually on the side of Henrius on clinical matters and many others like insurance influencing treatment planning. After imagining working with Henrius? Thats what triggered me
April 28, 2026
Retired and Soon to be Retired Dentist's Forum
Message Board
Views: 435 | Replies: 8
of New York. The defendants listed include the Delta Dental Plans Association, Delta Dental Insurance Company, DeltaCare USA and more than 40 Delta Dental entities, according to court documents. The lawsuit accused Delta Dental of breach of fiduciary duty and denial of benefits in violation
January 23, 2026
Delta Dental
Message Board
Views: 1315 | Replies: 99
If the patient has insurance, the first visit of exam and xrays is capped at $50. We do whatever is needed and write off the rest. If no insurance, we do $100 off first visit. You need to make this easy for communication on the phone and you do not want an initial financial barrier to entry. So
April 29, 2026
Front Office Discussion
Message Board
Views: 70110 | Replies: 5147
. Or the irony that the biggest PE haters on here have been getting bent over without lube by dental insurance for 3 decades and pretend like they have nothing to do with the state of dentistry these days.... TBH I dont think anyone here thinks PE is good for dentistry or any field. Are you saying because
April 28, 2026
Academy of Dental Management Consultants
Message Board
Views: 58 | Replies: 0
to denial. You're forming emotional attachments to the smear layer. You're whispering to calcium through a slurry of contamination and hope. It's the Adhesion Illusion - a polite fiction sustained by marketing and moisture. No room to question chairside, though... time is money. Every 'universal
October 29, 2025
Bonding Products &Techniques
Message Board
Views: 149 | Replies: 4
Has anyone had this happen? This puts the dentist in a really crappy situation. We got a denial from Delta saying the bone graft we placed 3 weeks after extraction was a non-covered benefit (immediate bone graft is covered) because it is now considered an edentulous site! So what, now we just have
June 26, 2025
Delta Dental
Message Board
Views: 371 | Replies: 29
So I need some input here. I am in the process of acquiring an office and getting credentialed with insurance companies. Of course I am not completely credentialed yet because the process takes quite a while, but I have been working on it for over a month. Me and seller currently have
April 24, 2026
Billing
Message Board
Views: 572 | Replies: 21
I saw a NP who needs SRP 1-3 teeth on the lowers. However, the rest of the mouth needs a 4346. What is the proper way to code this? i am asking both for what insurance companies say we should do, as well as the best and proper way to charge private pay patients. thanks! What is more productive
April 24, 2026
Coding Q&A
Message Board
Views: 101 | Replies: 7
Background - new patient came in and was seen for a new patient preventative visit. However due to some oversight on my FD, the wrong UMR insurance card is on file, UMR is the pt health carrier. Later we found out the pt dental insurance is thru - united concordia . Its a preventative visit so
April 24, 2026
Claims Processing
Message Board
Views: 485 | Replies: 23
that is similar in size and revenue to mine. I have approximately 1700 active patients and will gross close to 1.2M this year (FFS/OON.) I started to pick up the phone to call my insurance guy and then thought twice - I'm sure he'll be happy to up that premium for me, but do I really need that much
March 12, 2026
Dental Liability Insurance
Message Board
Views: 141 | Replies: 3
and dying by the schedule density on Thursday afternoon. Benefits are where the structure really shows its value. Full medical and dental coverage for the clinician and dependents. Malpractice provided. Life insurance, disability options, and a retirement stack that includes a safe harbor 401k
November 12, 2025
Associates Corner
Message Board
Views: 244 | Replies: 8
Thanks in advance for your tips. We occasionally have patients who come in and are diagnosed with 2 quads of SRP but the other two quads would pass with a prophy. How do you bill this out to the insurance and do you collect for the prophy from the patient assuming it would be denied from insurance
April 24, 2026
Coding Q&A
Message Board
Views: 222 | Replies: 7
More Perfect Union made a great video addressing the issue of DSOs and insurance companies Dentists Expose Why Dental Insurance Is A Scam Here's the clean narrative summary of that video based on the full transcript and source material: Why Dental Insurance Feels Like a Scam: Dentists Explain
April 08, 2026
DSOs Dental Group Practice, Multi-location Dental Practices, and Dental Su
Message Board
Views: 364 | Replies: 20
I'm curious to know if anyone has or had experience to not use any of the Clearinghouses and just submitted claims directly to the insurance companies via there portals. Any thoughts on this? Pros/Cons Etc thanks ramzi We do it occasionally if a claim keeps getting kicked back on the Clearinghouse
January 01, 2026
Claims Processing
Message Board
Views: 108 | Replies: 4
Administration Act of 2026, and suddenly your feed is full of hope. Finally, someone is going to fix dental insurance. Finally, the chaos ends. Finally, fairness. Slow down. Let's talk about what this actually is, what it is not, and why your front desk is still going to need coffee tomorrow morning
April 22, 2026
Claims Processing
Message Board
Views: 125 | Replies: 3
We have been using Dental Xchange for years, and last year we added NexHealth for insurance verification. NexHealth seems to be going ok, but maybe not great. Someone told me that Vyne is better for insurance verification than NexHealth, and looking at Vyne's website it appears they may do
March 18, 2026
Software Discussions
Message Board
Views: 324655 | Replies: 34371
it was campaigned against during the last election). It was wildly unpopular and now it's gone. Democracy worked. Marshall Correct. Lots of loopholes as well including income sharing with spouse and kids within a corp. Private insurances that function like a pension and pay out tax free. Don't get
April 23, 2026
Personal Finance
Message Board
Views: 44 | Replies: 2
. The danger is that it will define the problem before the clinician has independently thought through the case. Over time that shifts judgment, confidence, and authority. Insurers will love that. Standardized AI-generated reports make audits easier, denials easier, and preauthorization more automatable
March 16, 2026
Artificial Intelligence
Message Board
Views: 1446 | Replies: 65
in a Pediatric office. Is it possible to set up a GP office that way? Give 'em what they want if at all possible. It can be tricky in GP. Some insurances require preauthorization for SRP. Some patients may not be financially ready for SRP at initial appointment. Then that turns into a nonproductive appointment
February 09, 2026
Front Office Discussion
Message Board
Views: 176 | Replies: 5
Let me tell you something that took me way too long to figure out: insurance companies behave exactly as badly as you let them. Wrong fee schedules. Messy EOBs. Provider directory listings that haven't been updated in over a year despite multiple notifications. We've all been there. Most of us
April 24, 2026
Dental Insurance for Dentists
Message Board
Views: 120 | Replies: 0
Every dentist has had this moment. You present a crown that is clearly indicated. The patient nods. Then they ask, 'What does my insurance cover?' You already know the answer is going to be awkward. Now zoom out. In medicine, there is a story making the rounds about a drug that costs about $47
April 20, 2026
Going Out of Network
Message Board
Views: 232 | Replies: 6
by that insurance? Would we have to send letters to each TPA and the insurance company directly? You want to look at everything globally because you need to know the shared network agreements that each company has in advance. If you opt out or drop something, the insurance company may drop to a lower option
April 02, 2026
Going Out of Network
Message Board
Views: 480 | Replies: 14
services, another 'game-changing' software, but the same old chaos keeps coming back. Large DSOs are finally breaking that cycle. They're not hiring more people or buying another half-baked dashboard. They're turning to artificial intelligence that can actually read, understand, and post insurance
January 29, 2026
Artificial Intelligence
Message Board
Views: 524 | Replies: 36
. The leak happened right where the carpet meets the linoleum and resulted in mold. Per my insurance carrier, I will likely receive a payout to cover new floors in the operatory plus all the carpet in the office that is continuous with where the initial damage occurred. The carpet covers my entire office
April 24, 2026
Landlord / Tenant Occupancy Issues
Message Board
Views: 240 | Replies: 6
We need all Washington dentists, your staff, your patients, and anyone else interested in advocating for these important reforms to sign in PRO. --Sign in PRO for Senate Bill 5351: --Sign in PRO for House Bill 1535: The bills outline three key dental insurance issues: 1)Dental Loss
July 27, 2025
Delta Dental
Message Board
Views: 486 | Replies: 15
Question 2 passed easily in Massachusetts yesterday. It appears dental insurance will need to follow the same rules as medical insurance...spend 83 % of the premium money on patient care. How will the insurance companies do this? Increase patient annual maximums, decrease premiums, increase fee
September 24, 2025
PPOs and HMOs
Message Board
Views: 50 | Replies: 4
and not just hemorrhage money based on asymmetric information which is available to the insurance companies but not to us. (Candidly, I hate that this just adds another ~$1,000/month "middle-man" into the process, which siphons more money away from providers and patients. But I would rather pay a PPO
April 15, 2026
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Page 3 of 46
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May 2026
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