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Searching: insurance denials
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Page 1 of 8
Message Board
Views: 1033 | Replies: 10
to verify no odor, caries, etc) then the patient will likely have a flare up within a short time of new core placement. Not having a CBCT or an opinion from an endodontist on the retreat is leaving you open to denial of an insurance claim for the crown which could happen even with these.
January 09, 2017
Endodontics -- The ENDO Files
Message Board
Views: 851 | Replies: 21
and small endo access. And in most our cases root canals are done due to extensive decay where half of the tooth is gone. We do root canal and crown prep on the same day and it saves us time dealing with insurance BS. P.S. When I started personally supervising all claims/denials I decided to buy Charles
April 14, 2016
Endodontics -- The ENDO Files
Message Board
Views: 96 | Replies: 7
manually adjust this.If that does not work you need to submit an appeal with a narrative. Just call them. We get the automatic denial if we bill PA on save day as RCT. Their system is setup to do this. Because working xrays are part of procedure so guessing same auto denial. So anytime we do limited, PA
January 13, 2020
Endodontics -- The ENDO Files
Message Board
Views: 448 | Replies: 8
and methodically trying to work through a problem. Example: an insurance denied a patient's treatment plan. It did not appear that the reason for denial was customary. It is likely that something went wrong on our end, or in the insurances end...and my goal was to determine that had happened, and if perhaps
October 01, 2017
Endodontics -- The ENDO Files
Message Board
Views: 235 | Replies: 4
a type of internal resorption that can occur rapidly in some cases. That looks like trauma to me. At 60 years old there is very little wear. And at 60 years old they generally would mention trauma if this occurred 6 weeks ago. Unless her husband smacked her and she is in abusive denial or she has
January 08, 2014
Endodontics -- The ENDO Files
Message Board
Views: 159 | Replies: 5
Hello, I am a general dentist in San Francisco and have a close relative who needs a RCT on #31 but doesn't have insurance. What is the best self funded plan that you can recommend so he may get this done? Thank you for your assistance. there is none. try Care credit and have them finance
August 02, 2018
Endodontics -- The ENDO Files
Message Board
Views: 193 | Replies: 1
and therefore complained to insurance company. the patient speaks two languages and we spoke with this patient in her native language and inenglishbefore and during treatment and explained everything to her on multiple occasions, the patient never called us between her appointment to complain of any
April 04, 2017
Endodontics -- The ENDO Files
Message Board
Views: 701 | Replies: 17
is the patient's tolerance to developing a toothache after the prep. What if they travel internationally much of the time for business? What if they are losing insurance benefits in the near future? And then there is the matter of the restoration itself. Less risk with a single crown than a 3 unit
April 15, 2014
Endodontics -- The ENDO Files
Message Board
Views: 2255 | Replies: 37
with plastics, ENTs, hospital administrators, and all of the medical types who want to protect their turf. Most of the ones that I know around here have given up orthognathic surgeries due to insurance hassles. Many limit their practice to 3rds and implants. Now, every new gp doc wants
January 29, 2017
Endodontics -- The ENDO Files
Message Board
Views: 174 | Replies: 2
I did a pulpectomy and some cleaning and shaping with intra canal medication placed during first visit for an abscessed tooth and will finish rct after 2 weeks or so.Is it ok to bill insurance for pulplectomy for first visit and rct for second or will this be considered unbundling ? This happens
November 12, 2018
Endodontics -- The ENDO Files
Message Board
Views: 2290 | Replies: 69
in a radiographic or symptomatic form, and, by then, it’s just another one of those mysterious endo failures. Phrases like “cracked root” and “endo doesn’t work that well” get bruited about.” As dentists, we tend to live in denial. What we don’t see we
February 28, 2014
Endodontics -- The ENDO Files
Message Board
Views: 61 | Replies: 1
I just realized that I do this procedure quite often but am only billing for a sedative restoration and then monitoring the tooth for apical closure and then placing a definitive restoration. I'm sure medicaid is too cheap to cover it, but I am just curious if private insurances do? bump Does Insurance cover apexogenesis?
March 19, 2014
Endodontics -- The ENDO Files
Message Board
Views: 529 | Replies: 18
is not then they simply aren't telling the truth or are in denial. My advice would be to trust less of what patients tell you happened before they came into your office and address what you see and recommend moving forward Ha Karim we basically posted the same thingask the patient what her favorite
June 22, 2016
Endodontics -- The ENDO Files
Message Board
Views: 157 | Replies: 3
TOOTH 13 I JUST DID THIS root canal on no 13 The 2 canals merge at 1/2 or 2/3 of the root. thanks I don't bill by the number of canals. I bill according to anterior, bicuspid or molar. For that tooth I would use 3320.Yes as the code is for a bicuspid, not X canaled...I think in Canada...
October 29, 2018
Endodontics -- The ENDO Files
Message Board
Views: 595 | Replies: 14
for limited and PA.If you think the person won't be back I would probably also be charging for irrigation and a temp fill. I wouldn't assume insurance covers any of it except the limited/pa. If they cover great but the reimbursement is so puny it's barely worth arguing over so collectupfront
July 26, 2017
Endodontics -- The ENDO Files
Message Board
Views: 558 | Replies: 21
Hi all, I was associating at an office a couple years ago and was notified by the office yesterday the insurance company deemed a root canal I completed on #19 was overfilled thus unacceptable. They refuse to pay for the crown, and the office is asking I pay for the root canal in full($730). 1
August 04, 2019
Endodontics -- The ENDO Files
Message Board
Views: 249 | Replies: 3
for general dentist. Frederick Eichmiller DDS Sheila Stover DDS, MS, MPH Interesting way to do a study. Use of insurance database allows to greatly increase the sample size. The methodology seems legit. In my mind it makes me worry what an insurance company could do with these numbers
August 20, 2016
Endodontics -- The ENDO Files
Message Board
Views: 458 | Replies: 7
Just wondering for insurance billing purpose. Filling...I always bill as BU if insurance, never any problem with payment. There's a lot more to this procedure than just an occlusal filling. Some private pay pts I will bill as filling to save them $... I always thought there was a lot LESS
February 05, 2017
Endodontics -- The ENDO Files
Message Board
Views: 422 | Replies: 5
the payment to the INS? The pt would then be responsible for the payment for the apicoectomy or retreatment w/ the specialist? Any advice would be appreciated. I could be wrong on the legality of what you should do with the money the insurance company paid, but what I would think I would do: Refund
June 26, 2017
Endodontics -- The ENDO Files
Message Board
Views: 618 | Replies: 10
treatment. His insurance covers exam at 100% and RCT is covered at 80%. They billed him for 1) Exam (100% covered), 2) RCT (80% covered), 3) CT scan (not covered, around $250), 4) Pulp Vitality test (not covered, around $35 dollars), and treatment of root canal obstruction due to one calcified
October 23, 2017
Endodontics -- The ENDO Files
Message Board
Views: 428 | Replies: 7
I started an endo on tooth #6 and the patient did not return for obturation. I billed for the endo after the first visit and got paid already from the insurance company. Should I contact the insurance company and have the code changed to a pulpectomy? Would the code be D3221? Also, what are my
January 19, 2015
Endodontics -- The ENDO Files
Message Board
Views: 446 | Replies: 6
just put it in his hands and schedule when/if he calls back? We have stressed the importance of completing the treatment as well as documented everything. My thoughts are he will not be back for any reason unless he is hurting. What do you guys do here? Thanks Have you filed on any insurance
July 19, 2014
Endodontics -- The ENDO Files
Message Board
Views: 2351 | Replies: 45
in the tooth. He was refered to an endodontist who diagnosed for retreat #4 . Pt filed a complaint with insurance that the work done was not appropriate and that we need to repay his insurance fees back so that he can get his retreat done with the endodontist. What should I do in this situation. Thanks
October 01, 2015
Endodontics -- The ENDO Files
Message Board
Views: 7330 | Replies: 189
..... I can definitely question the motive here- It may or may not be greed. It could be shame; perhaps the dentist is in denial that he perfed and just stopped the endo at that point. Who knows. However.... .... on no planet does this succeed, even for a short period of time. Come on now
September 01, 2014
Endodontics -- The ENDO Files
Message Board
Views: 905 | Replies: 29
11 yr old. Irreversible pulpits on 18. Specialist isn't and option because pts is state insurance and no specialists in the state take the insurance. Help what do? An 11 y/o with a fully erupted second molar? Cleaning that pulp chamber should be interesting. Maybe use a cavitron
December 30, 2017
Endodontics -- The ENDO Files
Message Board
Views: 287 | Replies: 9
This lady has a lot of problems with her teeth. Upper left first molar started to ache a lot. Irreversible pulpitis. The tooth looks terrible and I am wondering if I should just yank it or fix it. The lady has no money, but insurance covers at 90% of my fee, so I decided to accept that she pays
November 11, 2014
Endodontics -- The ENDO Files
Message Board
Views: 251 | Replies: 1
Referred to ENDO. Will insurance allow billing of pulpotomy, or will it be denied since the RCT was completed. Thanks. Pulpotomy code is usually intended for pedo teeth for most insurances. I use a 9110 code when I do a pulpotomy on a permanent tooth and do not do the...
August 26, 2016
Endodontics -- The ENDO Files
Message Board
Views: 150 | Replies: 1
Does anyone know of any companythat does outsourcing for new drs for insurance I am not a fan of outsourcing. I believe in putting systems into place and training your team to be efficient while being productive. Check out Front Office Rocks for insurance billing. They are a great resource.
July 19, 2016
Endodontics -- The ENDO Files
Message Board
Views: 533 | Replies: 20
fee and the endodontist's fees. Does anyone know anything about this strategy. Is it kosher from an insurance... That's a grey area, that's even harder if insurance is involved. Good luck selling that one. Also, how do you define difficutl? What is difficult for me, may be easy for you
March 20, 2014
Endodontics -- The ENDO Files
Message Board
Views: 539 | Replies: 3
admire those endodontists like DT's Scott Weed who don't routinely do single visit treatments so that a patient is never sent back to the referring dentist until symptoms have resolved. I have elected to participate with PPO insurance, so try to do one visit treatments when possible. I do a fair
November 04, 2015
Endodontics -- The ENDO Files
Message Board
Views: 189 | Replies: 3
that you cant submit the post and core procedure in the future? 5. Any other possibilities? Dont know if there are any courses or resources for proper coding. Frankly its disheartening how insurance carriers like Delta have continually cut their payouts, forcing us to absorb the costs. Our expenses
January 18, 2019
Endodontics -- The ENDO Files
Message Board
Views: 139 | Replies: 3
is, I charged for a BU last year because of how deep the cavity was and how large the previous amalgam filling was on this tooth. I charged this to the insurance. This year when I do the RCT, I am sure insurance will not pay for another BU. Do you guys generally comp that BU when you close. Or do you
February 09, 2016
Endodontics -- The ENDO Files
Message Board
Views: 402 | Replies: 12
insurance, but you will find, more often as time goes on, that insurance will deny payment , saying your treatment was a poor choice. Sometimes that is enough to get the patient to the endodontist. I have seen teeth like this that never changed in 20 years, so you never know. You are protecting yourself
January 11, 2021
Endodontics -- The ENDO Files
Message Board
Views: 351 | Replies: 2
We are looking to upgrade to CBCT for implant placement, and I would love to have it for endo. For those with CBCT, how are you billing it with your endo cases? I have heard $150-$200 for the scan is reasonable for my area. Many of my PPO insurances only cover $650 for a molar. Are you billing
May 31, 2020
Endodontics -- The ENDO Files
Message Board
Views: 312 | Replies: 7
there is another code to use but my front desk staff says that insurance plans never pay it. Can someone please enlighten me on this subject? I want to stop this absurdity. Thanks. gross pulpal debridement dont know code off top of my head you can collect for rct and do it in 2 visits D3221 Pulpal
March 25, 2015
Endodontics -- The ENDO Files
Message Board
Views: 333 | Replies: 6
I know most everyone is digital now so there is not as much hard expense everytime a radiograph is taken but there is still cost, sensor insurance, time, etc. involved in taking PA's during the procedure. I have never billed for these before but the way insurance is beating down our fees I
February 01, 2015
Endodontics -- The ENDO Files
Message Board
Views: 2648 | Replies: 55
own perf is included in the RCT fee. Another example is post removal. Post removal is part of the retreatment process, so there's not a separate fee. The post removal fee is only used when all you're doing is post removal.Thank you, Padawan, for your clarification of the applicable insurance code
November 24, 2015
Endodontics -- The ENDO Files
Message Board
Views: 475 | Replies: 2
I have a patient who needs to wait till next year so that the insurance would cover root canal #19. She is in her 30's. No swelling. Mainly pulpit is and apical periodontitis. Is formocresol pulpotomy a viable option?... Are you nuts? It's not your fault she doesn't have insurance coverage. either
August 04, 2015
Endodontics -- The ENDO Files
Message Board
Views: 522 | Replies: 16
New pt switched dentists because her insurance changed. Had a root canal done on #19 one year ago. The build up was done but the tooth was not crowned. No decay observed on the build up. PT says the tooth does not bother her. What is going on with the distal root? What should be done? Cut
September 17, 2015
Endodontics -- The ENDO Files
Message Board
Views: 376 | Replies: 12
Ok so I don't know where to post this but my assistant of 12 years needed a root canal and I don't do ANY Endo and have really only one specialist that gets all of my referrals. I sent her over there and I was surprised and disappointed that he gave her only a 20 % discount. She has no insurance
May 18, 2017
Endodontics -- The ENDO Files
Message Board
Views: 126 | Replies: 4
Even though pulps are still viable, there is never percussion sensitivity. But these are PAPs. Insurance approve every time we submit for RCTs. Do they really need RCT... No...my answer is no as well. You are defining these as peri-apical dysplasia. That isn't peri-apical pathology coming from
May 16, 2016
Endodontics -- The ENDO Files
Message Board
Views: 1747 | Replies: 60
doubtful that the endodontist threw you under the bus.3) I would have handled it by coding for a retreatment procedure. But nowadays with the way insurance nickel and dime you to death you kind of have to unbundle your fees.4) Yes thats a hefty fee for an anterior Endo.5) $191 co pay, I know its
January 30, 2021
Endodontics -- The ENDO Files
Message Board
Views: 373 | Replies: 11
much sub-bone level, I'll do a RCT, post, buildup and Emax (and take every precaution, so insurance will pay for implant if it fails). But what if the root fragment is loose? A penny for your thoughts :) (for some reason, I can only attach one file to the post - I'll try to get the xray in as well
April 29, 2015
Endodontics -- The ENDO Files
Message Board
Views: 188 | Replies: 3
. Of course the tooth is asymptomatic and the patient cannot understand why they need a retx prior to restoring. Now if they have insurance it is even worse because there is no way to convince the insurance company that the retx is necessary... For lack of a better option when the pt doesn't want to do
January 09, 2017
Endodontics -- The ENDO Files
Message Board
Views: 401 | Replies: 8
, etc. Then, at the second visit, if there is a second visit, I finish the endo and place the core build up, 2950. Thats what Im used to doing. Is there any issue with insurance when coding this way? My current office said I cant bill it out this way legally. News to me. Why? If they think that's
April 07, 2019
Endodontics -- The ENDO Files
Message Board
Views: 2020 | Replies: 122
fails...it had a big PARL...his wife and kids are getting insurance coverage after christmas, so i think it was a practice builder for me...and he's a very loyal guy to me now...and i got some more experience with a tough endo...i'm not advocating doing this, just saying that it's one way to do things
November 24, 2019
Endodontics -- The ENDO Files
Message Board
Views: 1314 | Replies: 39
buried my head in the sand like an ostrich. I kept telling myself I was in a canal...............just living in denial. Eventually the patient came back with problems and we referred to the endo. Tooth was repaired with a guarded prognosis. I moved and didn't see how long the tooth lasted. I
December 09, 2014
Endodontics -- The ENDO Files
Message Board
Views: 709 | Replies: 18
tooth syndrome, however I didn't note any internal wall visible cracks with microscope. Patient is out of insurance benefits for the year. So, I have done what I can do... I told patient I could extract if he wishes. I offered he see endo guy, but I don't want to put my endo guy in a pickle
June 04, 2014
Endodontics -- The ENDO Files
Message Board
Views: 591 | Replies: 13
not covered by his insurance plan ) Thanks! 1: depends on the size of the apex. Giant apex= apexogenesis, manageable size (size of a file) = regular RCT. 2: a good composite restoration should last a long time. If you need to crown/veneer, wait as long as you canFrom the x ray, do you think #9 needs
October 26, 2015
Endodontics -- The ENDO Files
Message Board
Views: 1052 | Replies: 30
the insurance's co-pay.On top of that, I just found out he hasn't paid his co-pay... I think you have been way too nice to this guy. how's that? I took over a practice which sends out bills after the insurance company sends the EOB's, but I plan to eventually phase that out. Glad for the reassurance from you
November 08, 2018
Endodontics -- The ENDO Files
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