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Searching: insurance denials
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Page 1 of 14
Message Board
Views: 2355 | Replies: 122
of us. I will say I almost never get an insurance denial. Almost never......and virtually every time I agree that with the info sent in it does look like over treatment. The two x-rays were sent for payment of two endos and 3 crowns. There is only the Union Trust no flex plan.I can only review
February 14, 2008
Ethical Issues
Message Board
Views: 1756 | Replies: 107
and celebrated by so many? He was a human with a family not an animal which can be slaughtered without a care in the world. I dont see much of this uproar for countless families devastated by insurance related claim denials that have resulted in premature death.Is it wrong to shoot someone in the back
December 11, 2024
Ethical Issues
Message Board
Views: 1756 | Replies: 107
in support of global atrocities I could easily compare this look alike competition too but it'd be edited. I could likely name 50 instances off the top of my head. If you are at an insurance convention peddling claim denials, are you worse than a rat? How about peddling a new opiate medication
December 10, 2024
Ethical Issues
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: 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: 258 | Replies: 4
not be an issue And what if the signed planned is not what actually happens? Surprise. You know the crap insurance pulls on us. Stuff like no coverage for surgical extractions, denial of a crown because the insurance company says it wasnt needed treatment.
January 03, 2022
Ethical Issues
Message Board
Views: 1141 | Replies: 91
. OR Just write a check for about $2500, get a signed release and be done, but have to live with the fact that I backed down to this slimy car sales person who kept moving the goalposts. Malpractice insurance broker laughed and said there's people out there like this and just do whatever I like. Thanks
April 27, 2026
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
working people have access to health insurance and are paying tax for those who dont work and dont have access to health insurance. Therefore, those that work pay twice. This is an opinion......please elaborate more about who sets the rules. My opinion is I have a right to a portion of your retirement
February 26, 2026
Ethical Issues
Message Board
Views: 12816 | Replies: 1922
. Not interested, insurance will just pass the costs on with higher premiums. Went to the US Attorney General with this problem, too small to be a concern. Took the problem to the US Postmaster General, because billing was being done by use of mail, not concerned. Went to the dental board and they were
February 18, 2008
Ethical Issues
Message Board
Views: 1228 | Replies: 18
. If theres history and theres a frequency, they wont cover it again. This is in NY anyways. If you get the denial letter, you can ask the patients parents to pay for the redo... or, sometimes, I just explain to them that we got the denial and if they dont want to pay out of pocket, then they can always
May 01, 2021
Ethical Issues
Message Board
Views: 641 | Replies: 13
? Not to be a prick but what's the old saying?Snitches get ditches?Let it go. Nothing good can come out of this for you. Karma will come his...Not condoning fraud, but wait until you are an owner. Things will look different to you then.Move on.....UCC is the worst insurance company out there by far
September 07, 2016
Ethical Issues
Message Board
Views: 11553 | Replies: 1394
contracts, IMO, in my office, BCBS and UC due to their shitty reimbursements and notorious, outright denials of s/rps treatments for many of our pts over the years... Enough is enough. Please tell everyone if your sanity and your practice suffered from that action, or they improved. (Everyone else
August 26, 2023
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
a crown. You are working under the assumption that there's unlimited crowns, rct's, implants and such to go around. While technically true, reality is not everyone can afford it even on insurance. Not even getting in to safety or ethics, these dental therapists aren't doing what you think and/or want
February 27, 2026
Ethical Issues
Message Board
Views: 543 | Replies: 8
audit the billings and patient records of the hospital, treatment facility, mental health facility, or health care professional. (c) A hospital, treatment facility, mental health facility, or health care professional that violates Subsection (a) is subject to disciplinary action, including denial
May 27, 2016
Ethical Issues
Message Board
Views: 56 | Replies: 1
Dentistry has no shortage of confusing terminology, but few words cause more head scratching than 'Candor.' Townies say it gets tossed around in two very different ways, and mixing them up can lead to some serious misunderstandings. One version is about leadership and insurance. The other is about
February 05, 2026
Ethical Issues
Message Board
Views: 312 | Replies: 5
SEE PHOTO GOT DENIAL THAT RESTORATIONS WERE NOT MEDICALLY NECESSARY!!!????? That's true . . . she ain't gonna die if she don't get 'em filled! Well one thing is for certain, she needs to quit drinking Mountain Dew while she is wearing her...She has Invisalign in the presence oframpant decay
December 09, 2017
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
to contains a reiteration of frequently made statements but does nothing to rebut any of the factual information I have posted over the last two or three days. Please let me enlighten you. The insurance industry is infamous for claims delays and denials. They watch over billables like a hawk. They can
July 04, 2021
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
they share in common on the test 4. Malpractice insurance rates for DTs in MN are about $100, similar to that of Dental hygiensits and much lower than that of dentists. THese malpratice insurance companies are not stupid 5. 100% of the published studies demonstrate high quality of DT services. If you have
May 01, 2026
Ethical Issues
Message Board
Views: 12816 | Replies: 1922
tissue. I can only approve, if you send data. If I do not approve coverage, it is logical to send adequate data on your next try.Fredone of these is the insurance company.... the other, the dentist who accepts assignment of benefit.can you guess who's who?? So now we are using the logic of trying
February 18, 2008
Ethical Issues
Message Board
Views: 151 | Replies: 6
Hello everyone, I saw a patient last week who has bruxism , severe wear facets , existing deep restorations , ended up doing an occlusal composite on #30 and 18 wear facets , discussed crowns and night guard . Pt in denial saying nobody talked about crowns and occ guard before and he had been
April 29, 2024
Ethical Issues
Message Board
Views: 391 | Replies: 10
makes me uneasy maxing her insurance on one tooth, especially with a collapsed bite and the need to create restorative room. I have a lot of patients like this because I purchased a patch and fill practice. It sounds like you already have a relationship with this person, I had the advantage
March 19, 2019
Ethical Issues
Message Board
Views: 2272 | Replies: 144
supporting the ADA. The ADA is not a champion of private practice. It is a champion of moving the American Dental Industry in a direction that best suits it and the public in that order. That clearly doesnt involve private practice. Its an insurance and code book store. Nothing more, nothing less
March 06, 2023
Ethical Issues
Message Board
Views: 12816 | Replies: 1922
in the world are they going to debate the denial? Likely they could not and the patient would suffer. The insurance company would profit. Elastic ethetics? From whom?In your recent effort you approved coverage for 17 units of crown and bridge and denied 21 units. Who made you have the all powerful vision
February 12, 2008
Ethical Issues
Message Board
Views: 197 | Replies: 5
be restoring the case. Any ideas how to manage this? We're pretty much a fee for service practice except my one insurance company and I never would say I'm in network that's stupid... I would definitely not write off the balance if documentation is on your side. It is a lose-lose if you write off
July 27, 2016
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
. But this doesn't help the patient who still can't afford the $100 urgent care copay. 4.Out-of-Pocket Cost Is a Systemic Issue Prices are largely set by insurance contracts, not providers. Even if a PA charges less in theory, if theyre billing under a physicians NPI
July 15, 2025
Ethical Issues
Message Board
Views: 553 | Replies: 17
I didn't know where to post this, so feel free to move it, but I have noticed this a ton lately. It's about insurance, but specifically the ethics of it. Us dentists like to complain about insurance due to constraints and writeoffs, but I don't think patients care about this. I think we need
March 12, 2022
Ethical Issues
Message Board
Views: 1278 | Replies: 51
process, but I think they need to just not pay and allow us to bill the patient. The denials for crowns/SRP etc isn't as big of an insurance ethical issue as people make it out to be, its more stuff in this thread. Forcing dentists to think about Do I work with the patient on this and help them, or do I NOT lose money. That is not an ethically right position to put any doctor in
May 12, 2022
Ethical Issues
Message Board
Views: 272 | Replies: 1
it filing under your name, yes, I would let the insurance company know. If your name was not on the claim form (and they are not using your name now), I would let those chips fall where they may.
July 20, 2017
Ethical Issues
Message Board
Views: 110 | Replies: 0
Supposedly had the highest RCT billing for a gp. Did she do them or just say she did?If she did them were they done well?Either way what about dentists pulling good ones claiming they cause cancer?
June 06, 2025
Ethical Issues
Message Board
Views: 233 | Replies: 5
. Resolving denial of this government programs failure is an essential first step. Michael W Davis, DDS Santa Fe, NM I'm sure it will get better when Medicare for All is in place. As I'm certain you've already guessed- There are some in the leadership of the ADA, who WANT dental Medicare. I just
July 25, 2020
Ethical Issues
Message Board
Views: 498 | Replies: 15
solution is to ask him if mom can be present with you while you do an exam, or discuss your findings. If he has a problem, and mom isn't aware, she is probably oblivious or in denial, and is going to have a hard time accepting what you have to say. Present the facts. Any drug abuse is a family
December 20, 2014
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
to reimbursement, and the care delivery model was reformed. Five years later, Medicaid has been expanded in the U.S., resulting in enrollment in Medicaid and the Children's Health Insurance Program which has increased by 27% between 2013 and 2020. Second, dentistry has experienced steady consolidation due to large
February 10, 2023
Ethical Issues
Message Board
Views: 11553 | Replies: 1394
in control of your business decisions, including to become free of their abuses (or to reduce the abuses) and run your business in the way you see fit. The advantages that the insurance industry have had to stifle competition have come to an end. ADA lobbied and not long ago succeeded in removing
September 01, 2023
Ethical Issues
Message Board
Views: 2073 | Replies: 64
business practices. Serious question. I hear about these aggressive treaters all the time. How does this even work? I get crown denials Endo treated posterior teeth sometimes lol. How do these guys get insurance to actually pay out? I don't get it. Maybe I'm just a noob lol. This thread
March 12, 2025
Ethical Issues
Message Board
Views: 246 | Replies: 5
3-4 months. The case has already been billed to insurance (we bill these the day we impress). I am planning to re-do it at no charge when she gets back from her trip. The patient didn't question me at all about the billing, but what's the best way to deal with this? Is it ok to not refund
March 13, 2019
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
The evidence is overwhelming, even for adults who need these kinds of services, as evidenced by malpractice insurance for supervising dentists no different than those who do not employ them and therapists paying only $100/yr. Upstream of where you are, there are millions of adults with "basic" dental
March 04, 2026
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
(or more). Insurance companies in Canada will pay the same for a denture made by a dentist or by a denturist. A denturist has no more incentive to go to the underserved area or the poor (ya still haven't defined this) than a dentist. Are denturists flocking to remote communities? Are they focusing
February 13, 2019
Ethical Issues
Message Board
Views: 2272 | Replies: 144
to be a part the ADA clique but I just can not justify spending my 2k/per year. The insurance companies continue to ruin my life and I feel that the ADA hasnt done anything to combat that. It annoys me that I cant go to conventions or be a part of the local society unless I join the ADA. Well, I have
March 07, 2023
Ethical Issues
Message Board
Views: 1321 | Replies: 15
limited exams are free for cash pts including xrays, diagnosis, and prescriptions. I do a lot of occlusal adjustments, application of desensitizer, pulp testing, and denture adjustments for free. My compensation is based on 30% of production for cash and 30% of collection for insurance. Recently I came
January 25, 2017
Ethical Issues
Message Board
Views: 2368 | Replies: 154
is why she was openly ridiculed. Yes, unfair! So, let's remove the bad apples. Let's stop denial of problems. Michael W Davis, DDS Santa Fe, NM Churning is a HUGE issue at many (not all, but I would guess most) FQHCs. My last Medical Director (who was the also the head of the dental department
November 17, 2019
Ethical Issues
Message Board
Views: 460 | Replies: 5
and radiographically obvious Class II lesion Roots of #14 were present and clinically visible; when we inquired when the patient had the extraction done, the patient stated he removed the coronal remnants himself, at home. The insurance history show that the doctor billed the extraction. It angers me
July 24, 2015
Ethical Issues
Message Board
Views: 3485 | Replies: 119
strongly suggest if you aren't a member to compare both your life insurance plans that you currently have to what the ADA offers, as well as disability insurance. The amount of money I saved with these two entities alone is worth my dues (yes the money I saved paid my dues and still put money in my
March 01, 2015
Ethical Issues
Message Board
Views: 1569 | Replies: 47
after the fact. Though they are still somewhat in denial about the nature of this horrible disease, I have convinced them that a bridge is absolutely not the answer (nor really possible for a number of reasons). I am currently playing phone take with the PCP of this patient in order to determine
April 12, 2016
Ethical Issues
Message Board
Views: 5221 | Replies: 170
in Dental Deserts, Twice as Many as in 2000, As Dentists Shun Rural Areas and Low-Income Communities by Wendell Potter who is a former health insurance executive, author of Deadly Spin and Nation on the Take, and founder of Wendell Potter President and CEO at To Be Fair, Inc. 614 S. 4th Sreet, #310
January 04, 2019
Ethical Issues
Message Board
Views: 62612 | Replies: 9426
MN state legislative employee told the audience that the dental therapist legislation was the worst experience of his career. There was nothing rational about it; just dentists, hygienists and public health in a maelstrom of anger and denial. What came out was indeed the sausage that we hear about
October 31, 2019
Ethical Issues
Message Board
Views: 1199 | Replies: 64
Call ICE My front desk just lost her old Lexus. She was rear ended by a man From Mexico who had an expired license and no insurance. The police showed up and just let him drive away with an expired license and no insurance right after he slammed into a car. Ya, the last thing anyone wants is ICE
December 02, 2025
Ethical Issues
Message Board
Views: 12816 | Replies: 1922
complains, and these cases aren't insurance driven. If a dentist wants to sell cosmetics to a patient, and the patient wants it, more power to both parties. But trying to involve an insurance company, which seems to be the bane of so many dentists, seems a little bit wrong. If we as dentist don't
February 22, 2008
Ethical Issues
Message Board
Views: 1046 | Replies: 60
. No, as to the OP, I wouldn't stay in a place like that and I wouldn't hold back on your reason for leaving. You do know that this is insurance fraud, not to mention a bunch of unethical stuff. No doubt there is a whole other level of stuff going on that you probably don't need to be around. No doc
December 13, 2024
Ethical Issues
Message Board
Views: 12816 | Replies: 1922
are notorious at being the ones who are in self important and who are in a state of denial when it comes to reality. Joe Blaes, the God of Dentistry Gordon Christenson. And (our own) Howard Farran. I have never seen their work. Why would I believe they are so great? I have seen work of professors
January 14, 2008
Ethical Issues
Message Board
Views: 2919 | Replies: 46
insurance says denied patient owes 0. Whatever, goodwill. Well the same tooth breaks again. Patient see's EOB, says they just want a patch. I can't charge them. Is there anything legally or ethically stopping me from saying No it needs a crown and not treating it unless they do the crown? This patient
May 12, 2025
Ethical Issues
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