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Searching: insurance denials
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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: 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: 2080 | Replies: 69
1996 levels 2. Insurance claim denials are even more creative than thought possible 3. Near elimination of indemnity 4. Cutting special deals with DSOs, not for private practice 5. DSOs are not responsible to the same level as private practice 6. DSOs skirt state laws 7. There is no such thing
May 05, 2015
American Dental Association
Message Board
Views: 119 | Replies: 2
The Dental Insurance Casino: How ERISA Is Changing the Game Insurance companies don't just chase profit. They manage risk. And that's changing everything in dental benefits. Editorial by Bob Dee 4/2/2026 I wrote the first version of this a couple of years ago, but never published it. Now we have
April 03, 2026
American Dental Association
Message Board
Views: 182 | Replies: 19
they are protecting DSOs. Solo dentists need a separate lobbying group if that's where the ADA interests lie. I like that you brought up anti competitive and illegal. The biggest example of anticompetitive and illegal regarding dentistry is how dental insurance acts. The McCarran-Ferguson Act is quite
April 12, 2026
American Dental Association
Message Board
Views: 1469 | Replies: 79
of outside expertise are the problem. They made decisions that opened the door for insurance companies, DSOs, and private equity to gain power while membership collapsed and trust eroded. Walking away from the ADA only hands more power to the same forces hurting private practice. If the ADA falls
December 08, 2025
American Dental Association
Message Board
Views: 267 | Replies: 4
Hi, I've had some exchanges with people on my local board, but remain confused why organized dentistry isn't pushing for higher reimbursement for dentistry, improvements in excluding denials, etc. Is it a collusion issue? Is it a conflict of interest, persons on the dental board are part
March 09, 2019
American Dental Association
Message Board
Views: 3308 | Replies: 440
products. Six possible dental insurance reform issues were targeted: assignment of benefits, disallow clause prohibitions, non-covered services, prior authorization, retroactive denials, and virtual credit card-payments. Dentistry would need to educate state attorneys general, state insurance
September 20, 2023
American Dental Association
Message Board
Views: 682 | Replies: 12
Hi All, What is the cost with the ADA Disability insurance? Anyone willing to share their coverage and monthly premium? I am not a member but would consider if it saves the money... How much annual coverage is recommended? Thank you! Do you really need that much insurance? How old are you? I
October 21, 2024
American Dental Association
Message Board
Views: 775 | Replies: 44
, numbers of procedures, and value per procedure lower each year, what has the ADA done? What have they done to protect members from insurance abuse? How about those nasty letters to patients about how their dentist lies to them? What about wrongful down codes and denials? How about practicing dentistry
May 04, 2016
American Dental Association
Message Board
Views: 1366 | Replies: 48
that. That is where we can turn the tide against insurance and get higher fees. If anyone wants to know more and how, I can explain. They are very clearly in bed with the major insurance companies. I don't feel like they are actively fighting to stop bundling of procedures, or to get companies to at least have
December 30, 2025
American Dental Association
Message Board
Views: 1469 | Replies: 79
not just profit dental schools with their very opaque cost structure. It also helps private equity get cheap labor, cheap as in forcing people to do things they should not be doing. It helps insurance companies by flooding the market with more and more in network dentists. I am a PPO doc myself
December 31, 2025
American Dental Association
Message Board
Views: 454 | Replies: 8
The only reason I am a ADA member is for their disability insurance. I just got a notice that the have transitioned away from Great West to Protective. Does anyone know anything about this? It says it is own occ on the website. I just wonder why they changed on me? I believe this change
May 03, 2022
American Dental Association
Message Board
Views: 301 | Replies: 8
Hello, Ok so I have read several previous threads re staying away from the ADA and not joining just for insurance. But it seamed like each thread was a little disjointed and there would be a little confusion. I currently have have disability insurance with own occ. He is recommending joining
October 05, 2015
American Dental Association
Message Board
Views: 661 | Replies: 23
, finding that dental insurance markets are local, not national in scope. U.S. District Judge Elaine E. Bucklo issued an opinion and order on Monday denying a motion to of some 240,000 dental providers who allege they were underpaid reimbursements by Delta Dental's local member companies. The case targets
September 26, 2025
American Dental Association
Message Board
Views: 78 | Replies: 2
Young dentist here. I am looking for disability insurance. Who do you have your insurance through? Where should I look? Thanks in advance. Been using mass mutual since dental school. I hear Guardian is good too I use Guardian.
June 10, 2024
American Dental Association
Message Board
Views: 124 | Replies: 6
faded. The mainstream profession moved forward with evidence and economics. Membership declines in the ADA came much later and for totally different reasons. Insurance interference, corporate dentistry, student debt, burnout, politics, generational shifts, and the perception that the ADA protects
January 12, 2026
American Dental Association
Message Board
Views: 447 | Replies: 12
? As opposed to sucking constantly? ? Leonardo approves. Can you please provide some context :) Yeah, on issues that should have been addressed about 20 years ago with the insurance companies Posted at the same time as you, just guessing based on the recent self-promotional headlines I've seen
October 16, 2025
American Dental Association
Message Board
Views: 2675 | Replies: 96
some who are really interested in that topic, but that wouldn't even be in the top 10 of concerns of member and non-member dentists. What is number 1? Insurance. And speaking of insurance....each state could follow the lead of Massachusetts on the Dental loss ratio front. But instead, NCOIL gets
October 29, 2025
American Dental Association
Message Board
Views: 3308 | Replies: 440
fixing by insurance companies, allows doctors to choose laboratories that best suit patient needs, and limits insurers from dictating network agreements longer than two years. (This is a federal non-covered procedure bill.) 1- Last time I looked, you hadn't thumbs up on that to show agreement. 2
September 19, 2023
American Dental Association
Message Board
Views: 1353 | Replies: 76
organizations and if you have, what do you feel youve missed. Having been on the board of a state organization with a strong focus on advocacy. I can tell you that non-members havent missed a thing. Theyve reaped all the benefits of our work with the state board, the legislature, and insurance
January 23, 2023
American Dental Association
Message Board
Views: 519 | Replies: 10
. The key to saving the profession is gaining pricing power. VIDEO: You left out some very important parts such as. That is just 2022 and its not a complete list. Also, does not include state lobbying which may have a greater impact. It is in the states where the majority of insurance reform happens
November 21, 2024
American Dental Association
Message Board
Views: 125 | Replies: 3
Question: Where is the ADA when insurance companies start mis-applying the ADA code set and start bundling procedures? For example why do insurance companies get to decide that 4 bitewings and a panorex can be combined and called a full mouth series. Why can an insurance company print on an EOB
February 22, 2014
American Dental Association
Message Board
Views: 3308 | Replies: 440
.......but it shouldn't be too much to ask the ADA to acknowledge that the MENTAL and FINANCIAL welfare of its members is important....you know, the ones that actually provide care to the public. Saying publicly that dental school debt is outrageous, insurance reimbursements have not kept up with increasing costs
September 15, 2023
American Dental Association
Message Board
Views: 151 | Replies: 5
to adhere to anti-trust laws that otherwise prohibit businesses from engaging in anti-competitive activities like colluding and price fixing. We as dentists are not allowed to get together and engage in anti-competitive acts like setting fees and boycotting, but insurance companies are are allowed
March 19, 2017
American Dental Association
Message Board
Views: 1353 | Replies: 76
Pretty much ANY insurance company. I use Cincinnati. 30 consecutive years or 40 total years are eligible for Life Membership. The ADA changed the rules 2019 effective Jan 1 2021. Life members now pay 100% full dues and 100% any mandatory assessments. They are eligible for some absolutely
January 24, 2023
American Dental Association
Message Board
Views: 2675 | Replies: 96
Insurance and DSO favoring policies while this was going on? How much did THEY know? And then there is the CHIEF STRATEGIST and VP of the ADA who has been there for 19 years and the COO who has been there for 10 years. How much did they know of this mess? Is it time to clean house? Those in power do
May 20, 2025
American Dental Association
Message Board
Views: 698 | Replies: 42
single day. Would it be worse you say - well let me introduce you to their HMO plans ( $16 for a wisdom tooth ext as an example ) I would love to hear what 2K a year gets me What is the benefit to dues paying members of hiring ED's that are Dental Insurance CEO's etc? I do not take this as a dig. I am
May 15, 2025
American Dental Association
Message Board
Views: 229 | Replies: 3
Townies, Please enlighten me as to why I should continue paying dues to an organization that in my mind does very little for the dentists... 1. they support corporate dentistry like Aspen 2. they do nothing to curtail insurances from sticking it to the dentists 3. do nothing to reduce the cost
April 22, 2014
American Dental Association
Message Board
Views: 320 | Replies: 9
or an insurance company needs to use them, they must pay a royalty to do so. This is the non-dues revenue that the ADA talks about. I am certain that you could ask the ADA how much money comes from the CDT code.Hmmm. One wonders when they will start demanding licensing fees from ANYONE who uses them? Per
April 06, 2015
American Dental Association
Message Board
Views: 416 | Replies: 12
about how lobbying by insurance companies and other groups are destroying dentistry. Because that will be productive. And most of all, believe in your heart that you are a... I don't know if it is worth it from a tangible money ROI, but I have chosen to be a part of organized dentistry. I don't
April 11, 2018
American Dental Association
Message Board
Views: 1134 | Replies: 29
insurance companies to run the ADA. That's why you have had "corporate" dentistry invade because they are "helping" the ADA and so policy recommendations and "key" focused initiatives are suddenly corporate friendly. I wish I disagreed. But I think you are spot on. Ouch... but the truth hurts. Not sure
October 31, 2025
American Dental Association
Message Board
Views: 354 | Replies: 31
chain practices provide a lower level of care? I am asking because I am not aware. I think it is best if we provide evidence rather than rhetoric. Please understand, I don’t have an opinion on this matter. I am just soliciting feedback.How about the way insurance companies indirectly try
February 16, 2016
American Dental Association
Message Board
Views: 175 | Replies: 3
the electronic billing monopoly (itrans and CDAnet ). Basically forces dentists to join the association to deal with insurance billing.Grand total:$6365 CAN (approximately $4681 USD)Any state or province higher than this? In Ontario the fees I pay to be able to work Yearly Fees payable to RCDSO
December 11, 2023
American Dental Association
Message Board
Views: 1489 | Replies: 56
) will not come from these PhD's it will come from the insurance companies who control the ADA behind the scenes. Agree, PhDs rarely get anything done. BUT, this guys are just puppets for Delta. By reading the notations you can tell they're just quoting Delta data. My concern is that insurance companies
September 05, 2023
American Dental Association
Message Board
Views: 48 | Replies: 0
Requirements for ADA term life insurance: Active and current ADA member Working a minimum # hours as a dentist Obviously none of us are working now, so is the term life insurance void? Also wonder if there is some exclusion for pandemics? I reached out to Great West but haven't received a response? Maybe they are backed up or maybe they know I won't like the answer. Anyone know how this works?
April 09, 2020
American Dental Association
Message Board
Views: 1662 | Replies: 63
be no dentistry. You want to keep doing dentistry at rates from 15-20 yrs ago, go for it but that's on you. How do you suggest we start? Just name one thing... We can start doing immediately. 1) start dropping insurances 2) drop more insurances 3) go FFS/OON I really think we need an underground
January 24, 2024
American Dental Association
Message Board
Views: 4696 | Replies: 297
I get what you're saying. My point is that the Sherman Act (of 1890) is not what needs to be changed. It's the McCarron-Ferguson Act of 1945 that exempts much of the insurance companies from the Sherman Act. And a resolution was introduced this year to change that exemption. Support
February 13, 2014
American Dental Association
Message Board
Views: 7517 | Replies: 250
bit of sympathy. Did you not WILFULLY know what you were getting yourself into when you signed up for the less than wonderful insurance plan that left you in the lurch? I'm guessing when you signed up for that insurance plan, you never imagined things turning out as they did. And that's fine
May 06, 2017
American Dental Association
Message Board
Views: 3284 | Replies: 85
Rule etc, all would have cost the dental office much more if the ADA had not stepped in. The ADA saves each dentist thousands of dollars each year. There is so much more. The ADA has the second largest healthcare provider PAC in Washington DC. As far as insurance, you cannot beat the ADA Great
March 04, 2019
American Dental Association
Message Board
Views: 399 | Replies: 11
I recently renewed my membership to the ADA. I REALLY don't know why? Maybe cheap Life insurance thru Great West Life? How about you? I was an active member for many years. Served on the board of the local affiliate association all the way to President. So, I answered the call to get involved
February 01, 2017
American Dental Association
Message Board
Views: 129 | Replies: 2
demonstrate value to membership. As a practicing dentist, I 100% see value in an organization like the ADA which is willing to take on abuses of the insurance industry. This has really only happened in very recent history... and not w/out kicking some dinosaurs in the butt. Numbers of recent grads
October 04, 2023
American Dental Association
Message Board
Views: 382 | Replies: 13
they are only affective at the state level. Any plan that is self funded, i.e. the dental insurance company processes the claims, but ultimately sends the bill to the employer, are covered under federal ERISA law. This bill will provide a way around the non-covered services at the federal level. YEP
August 30, 2023
American Dental Association
Message Board
Views: 4696 | Replies: 297
to an even weaker membership. This in turn will lead to a weaker response to ever-increasing outside intrusion. LOOK AT MEDICINE!!! They have already blazed this trail. Is this the way we want dentistry to proceed? Giving up now during a time of unprecedented government and insurance intrusion
December 15, 2013
American Dental Association
Message Board
Views: 3284 | Replies: 85
The only thing I seem toget out of my ADA membership is the reduced insurance rates. Am I missing something? Has anyone found a good alternative to the insurance offered through the ADA? I don't think you actually get reduced rates. I was contemplating joining, so I went to the ADA
September 05, 2018
American Dental Association
Message Board
Views: 3308 | Replies: 440
+ insurance reforms. However, I havent see or read anything of substance from the ADA. Interesting take, however I respectfully disagree. What isreally strangeabout this thread is that it is NOT dominated by people discussing thebiggest threat to dentistry period: The scary reality that dental students
September 19, 2023
American Dental Association
Message Board
Views: 4696 | Replies: 297
of Prosthodontics One representative from the Academy of General Dentistry One representative from each of the following third-party payer organizations America’s Health Insurance Plans Blue Cross and Blue Shield Association Centers for Medicare
December 19, 2013
American Dental Association
Message Board
Views: 760 | Replies: 25
wasn't a member, I would have to travel for CE and it would cost way more than my dues. Where do u practice? What if there is a local CE group with decent CE classes and more affordable annual fee, would u drop ADA? LOL I pay for ADA dues because my health insurance is cheaper (less than 400
January 18, 2018
American Dental Association
Message Board
Views: 4696 | Replies: 297
some CE 3. combat rising insurance company intrustion. 4. maybe some public education against Dr. Oz and his anti-xray rants or that dam article saying that root canals cause cancer. 5. Keep all these new dental schools from opening and class sizes from increasing. there are enough dentists
December 16, 2013
American Dental Association
Message Board
Views: 33 | Replies: 1
Does anyone have their health insurance through ODA? Im looking into it now and Im wondering if any of you have it. Which program do you have and are you pleased with the coverages? .
November 13, 2023
American Dental Association
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