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Searching: insurance denials
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Page 1 of 14
Message Board
Views: 152 | Replies: 3
We are in our second UHC denial is a month. First they denied scaling and root planing with 5 mm pockets and bleeding in a juvenile diabetic. Now they denied a Build up on 15. We are writing an appeal but this is a huge time waster. Do you just inform the patient if insurance denies
November 15, 2016
Front Office Discussion
Message Board
Views: 139 | Replies: 5
We continue to run into this problem and I need help. Humana requires us to get medical denial prior to payment for extractions, nothing new. Get the denial and insurance pays. What's new is that no matter how many times we send a claim to Anthem (majority medical carrier here), they never respond
February 27, 2019
Front Office Discussion
Message Board
Views: 2249 | Replies: 57
, Alternate Treatment, Insurance denial- Frequency, Insurance denial- Unbillable to Pt, etc., If you have been posting UCR, this change will affect your numbers MTD, YTD etc., So say starting Jan 1st or starting on a landmark 'X' date, we started posting PPO instead of UCR.. Drs and management can
January 16, 2017
Front Office Discussion
Message Board
Views: 2707 | Replies: 79
as much as I can at the front desk- insurance verification, posting payments, A/R, collections, appealing insurance denials, and anything else I can. Then hiring someone with less experience to be more of a greeter, answer phones, in charge of keeping schedules full and working recall, making
September 19, 2019
Front Office Discussion
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: 3539 | Replies: 105
We have threads for patients I want to punch in the face, threads griping about assistants and doctors and hygienists alike, and I have been seeing so many ridiculous insurance EOB's coming back with denials and had many interesting phone calls that I felt this thread was appropriate. I tried
July 03, 2014
Front Office Discussion
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: 576 | Replies: 19
I have about 2000 active patients and see a lot of emergencies...some things are simple as floss stuck between teeth, or a small edge on tooth that needs smoothing.. I usually code these as 9110---paliative minor emergency. But of course DD is giving me a lot of denials . How do you all write
May 07, 2025
Front Office Discussion
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: 2176 | Replies: 69
. Most of the time, talking to a real person may be the only way to get your questions answered. Insurance companies are in the delay and denial business. Takes some investigation sometimes. And stubbornness. And stern wording.so you spend your admin days chasing claims? Are you the dentist or one
March 13, 2019
Front Office Discussion
Message Board
Views: 316 | Replies: 12
monitor your outstanding patient balances so you can see if anything is out of alignment there as well as if your team is collecting copayment on DOS or not. -Insurance Aging helps you monitor whether or not denials/appeals are being worked as can also indicate whether or not you have any blockages
July 20, 2023
Front Office Discussion
Message Board
Views: 304 | Replies: 5
procedures are correct and submit claims with proper supporting documentation -save a copy of the transmission report and check report for any -post all insurance checks or EFT payments received that day and deposit Weekly -work denials and appeals Monthly -run an aging claims report/open claims report
November 11, 2022
Front Office Discussion
Message Board
Views: 771 | Replies: 45
the point? You might as well be posting your own insurance payments and working your own denials at that point. Just schedule an extra admin day for you to do that. ;) You should have as many payments coming in as EFTs as you can. Most of them can be enrolled for free. The best way to prevent
February 20, 2024
Front Office Discussion
Message Board
Views: 557 | Replies: 10
Any luck finding a company that is able to verify insurances and enter in breakdowns into the PMS? I have reached out to a few companies and they tend to be pretty pricey. I would like to outsource this task if possible so that way I can ensure that it is being done correctly each time. It seems
January 25, 2026
Front Office Discussion
Message Board
Views: 71 | Replies: 1
We received a "loyalty check" at the end of the year from an insurance company that we had been contracting with for years. We terminated our contract with that company at the end of the year, but we haven't cashed the check yet. Is there any reason why we shouldn't cash that check? In other words
January 30, 2026
Front Office Discussion
Message Board
Views: 381 | Replies: 18
(provider and patient) vs. THEM (insco) boundaries. It's the perfect way to start educating the patient on what they are actually paying for when they make their monthly insurance contribution.I read somewhere you may have less denials when you Pre-D but I'm not sold on that one way or the other but will see if I can find any statistical data to back it up.
November 27, 2017
Front Office Discussion
Message Board
Views: 3539 | Replies: 105
… I wish he could have recorded them.Mark! I have no words for the evil that represents!There is a special place for these silly insurance companies. The situation is getting worse but my wife (14 years of experience and rarely a denial that sticks) contents that a few situations described
July 01, 2015
Front Office Discussion
Message Board
Views: 201 | Replies: 6
but this one is a new insurance company to us. So all i need is a denial from the medical company. but i have no idea how to fill out a medical claim form or where i would get on. I would appreciate the help. thanks Ha. See if you can get the money from the patient, and have them reimbursed
February 10, 2017
Front Office Discussion
Message Board
Views: 762 | Replies: 9
Has anyone outsourced their insurance claims and entering EOBs? What does it cost, and is there a company that you recommend? I don't like being dependent on a single person in my office for billing and collecting money, it seems like it would be smarter to have a professional company that would
July 16, 2022
Front Office Discussion
Message Board
Views: 442 | Replies: 12
I bought an office a few months ago and so far its been a complete crap show in regards to the front desk. All the staff are great and work hard but they never did any insurance verification, breakdowns or even billing through e-claims. My normal day operation is having one assistant start the day
February 05, 2023
Front Office Discussion
Message Board
Views: 395 | Replies: 13
. This is a preauth baby I wouldnt PRE AUTH. Why wait 6 weeks to get a denial. How will that help the patients periodontal condition? Either way, the patient needs SRP. If your guardian fees are, lets say 150/quad, AND you have any concern that insurance wont pay, then just charge the pt the in-network full
July 08, 2022
Front Office Discussion
Message Board
Views: 503 | Replies: 5
This could go in multiple threads but I put it here. I am tired of staff excuses on why statements don't go out on time and why we have outstanding insurance claims. I get the demands with insurance, etc. So I am looking into outsourcing my billing and insurance. Medical offices do this all
September 25, 2019
Front Office Discussion
Message Board
Views: 110 | Replies: 1
the extra time for this so outsourcing insurance billing may be an answer. A billing service has the means to pursue denials that are going to come from lack of compliance to the changes brought about by insurance companies: See announcement below
June 26, 2015
Front Office Discussion
Message Board
Views: 653 | Replies: 23
I am really interested in outsourcing insurance and billing. I read some great things about eAssist. Do eAssist and Dental Support Specialities do the same thing? Have there been any positive or negative experiences with either? First, lets start with transparency here. I have known the founders
February 04, 2021
Front Office Discussion
Message Board
Views: 962 | Replies: 10
a long time To resolve such as extensive corrections or appeals on denials may also go by wayside. You can imagine a claim for $20 needs a two hour phone call and back-and-forth with the insurance the specialist may not choose to work on that. However your patient expects payment from insurance
June 23, 2021
Front Office Discussion
Message Board
Views: 443 | Replies: 20
I bought a dental office last month and it's kind of like a start up. I don't know the fees for cash patients. How do I find fees? I'm in the process of credentialing with few insurances and I accept medicaid. Thank you Cash fees are fees you feel are adequate for your time and skill. Ppo fees
August 23, 2020
Front Office Discussion
Message Board
Views: 484 | Replies: 10
on prep date, you may have to call insurance company and advise them of the seat date.Build ups are not always covered on prep date either. Hope this helps. Thanks Rhona!Here are my thoughts. 1. We submit electronically with Renaissance LLC and use NEA fast attach. 2. Somewhere I have narratives
July 31, 2014
Front Office Discussion
Message Board
Views: 1579 | Replies: 29
do they do? Do they both do EOBs, collections, insurance verification, recalls, etc? Or do you have one person responsible for individual duties? How do you divide it up? What reports are you asking for on a daily, weekly and monthly basis? I'm feeling defeated and betrayed that they did this to me
April 03, 2026
Front Office Discussion
Message Board
Views: 1473 | Replies: 38
Has anyone had success with outsourcing insurance verification and has the juice been worth the squeeze? For our small 3 op practice, I would estimate at least 2 hours a day is spent on insurance verification. For the size of your practice, I wouldn't recommend outsourcing. I would recommend one
July 28, 2025
Front Office Discussion
Message Board
Views: 427 | Replies: 18
are screwed. If you are out-of-network, then I simply send a note to the insurance carrier advising them that their contract is with their policy holder and not with you. YOUR bill has been paid in full, if they want a refund they must collect it from their ploicy holder and NOT from you. This has NEVER
October 07, 2015
Front Office Discussion
Message Board
Views: 2176 | Replies: 69
. This also goes hand in hand with AR. The nice thing is your wife will be more diligent in looking at every claim and the reasons for denial or approval and each insurance company really processes claims.Whitecliff, every day I reconfirm what a bonehead I have been for not fully utilizing our
March 29, 2019
Front Office Discussion
Message Board
Views: 1151 | Replies: 56
receptionist. Hang in there people, the technology will probably be ready in 5 years. Wow this is a very timely post. My front office person just asked me to do some research on an AI company that can get insurance breakdowns. While I understand where you are coming from with the nuances of talking
April 07, 2026
Front Office Discussion
Message Board
Views: 911 | Replies: 22
it with the prep will guarantee denial just because they're rejecting a buildup on what they assume is the date of insert. Exceptions are made with CEREC users with a narrative showing the prep and seat date happened on the same date. Delta frequently wants the insert date for payment as well
April 10, 2017
Front Office Discussion
Message Board
Views: 479 | Replies: 24
is aware of all backlogged items in the office and constantly working on fine tuning and completing those tasks (AR, insurance credentialing, licensing, etc...) If she is doing claims, answering phones, going over treatment plans, calling insurance companies for benefit breakdowns, checkin and check out
April 16, 2026
Front Office Discussion
Message Board
Views: 965 | Replies: 29
I am a GP and I'm researching a possibility of using third-party companies to submit claims to medical insurance. I would love to hear the opinions of those here who actually do it . How reliably do you get paid for things like comprehensive exams, night guards , extractions, bone grafts ? I don't
October 18, 2018
Front Office Discussion
Message Board
Views: 1026 | Replies: 43
week, I followed up with a denial back in MAY for a crown and we got in touch with insurance and they are gettin back to us. NOONE will follow up with your money...like YOU- the owner does. You might have an excellent front- but at the end of the day, YOU have to follow up as things do get missed
August 04, 2024
Front Office Discussion
Message Board
Views: 44 | Replies: 2
this. I've checked on my local dental society webpage, but there was nothing there. Hey there, your front desk is right, give them some cookie points! The Type 2 NPI is for the billing entity. Your business. It's not new. It helps separate the doctor from the business in the eyes of insurance companies
March 17, 2026
Front Office Discussion
Message Board
Views: 224 | Replies: 7
their appointments. That should keep less of them from calling in and tying up your phone lines. Consider outsourcing some part or all aspects of dental insurance. From verifications to filing claims to insurance AR follow up and working on claim denials. Lastly, you can always tap into a dedicated
April 29, 2021
Front Office Discussion
Message Board
Views: 1446 | Replies: 65
disagree with this. This sounds like you're treating the insurance not the patient. So what if the debridement triggers the deductible and is not a covered service. That's the patient's dental benefits. If they need it, then they need it. A prophy means the patient has healthy tissue with an absence
February 11, 2026
Front Office Discussion
Message Board
Views: 159 | Replies: 10
Didn't want to hijack the other thread; How is everyone doing the NP scheduling that participates with insurance. We currently go through hygiene first most of the time, and book 90 minutes. The problem is on a lot of them they are coming in with no insurance verified and several are leaving due
February 04, 2026
Front Office Discussion
Message Board
Views: 5194 | Replies: 56
For those of you who took breakaway, do you wait on insurance verification until the day patient is seen or do it beforehand? In my start up, we do it before hand because I wanted to be hard headed but I'm starting to get super frustrated with the amount of time each one takes and then people
January 05, 2023
Front Office Discussion
Message Board
Views: 966 | Replies: 56
What are people paying for a good front desk person. Doing the basic,send some insurance some times,answer phones,check in and out and confirm It's a high schooler 12/hr job honestly. Had a front desk that quit during the 'nobody wants to work' era of 2021-2022 tell me that, so I took her advice. I
March 20, 2026
Front Office Discussion
Message Board
Views: 298 | Replies: 3
Hi all, I have a quick question. I just opened my very first office from ground up. So all these hiring employees and business aspect of dentistry is very new. Having said that.... I have one receptionist right now.... She has this slightly obsessive need to verify insurance a couple days
July 19, 2022
Front Office Discussion
Message Board
Views: 57 | Replies: 4
hello; I have been doing all insurance work as I look for front desk help - I'm a victim of staff not wanting to come back after covid shutdown! Anyways - How long does Aetna typically take to pay a secondary insurance claim? Also, how long does delta take to pay as a secondary? There is no set
September 23, 2020
Front Office Discussion
Message Board
Views: 210 | Replies: 2
Hi everyone. I was wondering how everyone else is working with this because as insurance allows for such a low fee and the Invisalign lab bill alone is almost $2k. It's almost not even profitable with this. Thoughts? And don't say Clear Correct....that is not an option for me anymore. :) Thanks
October 15, 2019
Front Office Discussion
Message Board
Views: 131 | Replies: 2
I wanted to find outhow often it isrecommend tocheckinsurance eligibility. We always check patient eligibilityduring their first visit in the newcalendar year. But how often thereafter do yourecheck once they have already been checked? Only on future recalls? If they haven't been seen in over 3...
January 19, 2019
Front Office Discussion
Message Board
Views: 86 | Replies: 1
I'm told that most insurances are not providing coverage for the modified full mouth series (7-8 films). So, we have been submitting these as 4 bwx + 3-4 single films and getting some coverage. I discovered today that MetLife covered the prophy, exam and 3bwx but then applied the other films
November 06, 2017
Front Office Discussion
Message Board
Views: 144 | Replies: 5
to about 7.5 w/ the efts. delta and metlife even tell you which ones that aren't going to pay and why. if they need more info, an x-ray, tooth number, maybe it's a wrong birthday or subscriber id.... easy to fix and get paid quickly....Stock market is up and the insurance companies have their money in play. Not wanting to give it up!Thanks so much!
December 01, 2016
Front Office Discussion
Message Board
Views: 90 | Replies: 3
. We have 1 dentist and 3 hygienists and only one front desk person and it is becoming way too much to handle. The Dr doesn't want to increase overhead and doesn't want to hire an additional front desk person and insurance coordinator. We also need a person who coordinates treatment plans and co
March 10, 2016
Front Office Discussion
Message Board
Views: 162 | Replies: 1
I make payments on the co-payment? Or “Can’t you just write it off because $375.00 is a lot of money?” Sound familiar? Educating patients to the limitations of their “dental insurance” is the bane of the dental practice and a constant source of stress and frustration
August 11, 2015
Front Office Discussion
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Page 1 of 14
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