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Searching: insurance denials
Results: 36
Message Board
Views: 228 | Replies: 7
the PPOs around. However, I have only been able to locate 1 OMFS locally that takes Delta and haven't been able to find any others that are in any insurance plans. I believe there are a few endodontists in the area that may take a few others, but I am mostly concerned with referring to perio
August 02, 2015
GP / Specialist Communication
Message Board
Views: 768 | Replies: 30
elsewhere. -I am in network with 4 plans, no PPOs. I charged him for a comp exam last year, so I would have had to write off another comp exam. Insurance pays like 45 bucks for an emergency exam/palliative treatment. (In the past year 2 perios in my area went OON, so I am very busy.) -Mutha told me
December 15, 2025
GP / Specialist Communication
Message Board
Views: 188 | Replies: 4
We all know that patients have annual maximums for PPO insurances. It is usually $1500 per year. Is it normal for a general practitioner to request that an OMS office send them a letter outlining how much of the yearly maximum the surgeon has used up for a patient? Save some energy. A quick phone
May 17, 2022
GP / Specialist Communication
Message Board
Views: 463 | Replies: 13
i have a friend, who is a patient, that I referred to an oral surgery group that I have been referring to for over 33 years. The two original partners are retired and now there are many oral surgeons and several locations. My patient asked about insurance coverage for his biopsy and was assured
December 15, 2015
GP / Specialist Communication
Message Board
Views: 94 | Replies: 1
to the pt. 7. Tell patients to look up online or call insurance company, and see if they accept their insurances. It also seems like different specialists have different preference in terms of how GP should refer out to them. When a patient was referred out with a method #7 by my office manager, I felt
February 11, 2018
GP / Specialist Communication
Message Board
Views: 1113 | Replies: 96
nowadays is send a STAFF member with a basket of referral slips to greet my OFFICE MANAGER! Shmoozing GPs to get referrals seems to be a lost art. Is it because Gen Zs are so unskilled at face-to-face communication? Or is everything driven by insurance affiliations now? I have tons of uninsured patients
January 29, 2026
GP / Specialist Communication
Message Board
Views: 1401 | Replies: 45
and exams this past year. The kids have had insurance so he used to bill out for everything. My plan changed this year so we are no longer in network with his office anymore. I take my kids in today and he charges me full price for their cleanings. Also my son needs a couple of fillings so they review
May 08, 2018
GP / Specialist Communication
Message Board
Views: 1029 | Replies: 28
! How was it like starting out as a fresh grad to now ? Specialize, insurance will pay a GP $1000 for the same implant that they will pay $2000 to a perio. That applies to every market in the country. This is completely false and just outright wrong . Who lied to you? Whatever insurance that is, Id
May 11, 2022
GP / Specialist Communication
Message Board
Views: 4484 | Replies: 72
California as far as the states we get the most calls from. Texas has had a huge influx of corporate dentistry money flooding the state and solo dentists are getting squeezed more than any other state we get calls from right now. Insurance negotiations look much different there than they did a couple
March 19, 2019
GP / Specialist Communication
Message Board
Views: 125 | Replies: 1
with the insurances under my tax ID and it was messy. Also as a specialist I prefer adjusted production. I don't want to wait months on end to get paid and its not my job to collect, especially when working in-house.
February 01, 2021
GP / Specialist Communication
Message Board
Views: 257 | Replies: 1
, and slowly increase the number of days to hopefully one day a week. Until the number of days increase, and until insurance checks come in, do you recommend doing daily minimum compensation initially? (That's what I did with my GP associate). Or pay by % of production rather than collection? How
October 15, 2019
GP / Specialist Communication
Message Board
Views: 2101 | Replies: 136
. In the real world, insurance companies and corporate groups control the conversation. So, what happens if the specialist wants to charge 20% to make sure the patient returns to the referring GP? After all this is purely transactional. Just stick to the 10%. Do you drive 100mph when the speed limit
June 25, 2018
GP / Specialist Communication
Message Board
Views: 289 | Replies: 18
impairment, I like to document why [FOR A MULTITUDE OF REASONS both clinical, and legal] and try to find a simpler solution before moving to GA/sedation. BUT the wall is the anesthesiology fee--generally not covered (and even then the ENT work up *can* help with certain insurances). Travelling
October 10, 2025
GP / Specialist Communication
Message Board
Views: 2101 | Replies: 136
to specialists . Example: Pt is missing #4. What is the best treatment ? Implant. Yet we still see large percentage of dentists doing bridge from 3-5. Why? Is it only because of insurance coverage ? Could it be possible large percentage of GP's don't do implant placement? They have very little
June 28, 2018
GP / Specialist Communication
Message Board
Views: 475 | Replies: 7
assume someone here has had this happen... In your follow-up report to the doctor, you say, During the extraction, the crown on the adjacent tooth fractured. The crown needs to be replaced. Please send me the bill for the crown. You may get nothing (the patient's insurance paid), you may get
February 16, 2016
GP / Specialist Communication
Message Board
Views: 242 | Replies: 4
patients from, it seems like communication is a one-way street. I don't have the hard numbers, but the breakdown of what I see in MY office would be something like this: 10% of GPs - excellent communication. Send referral letters, x-rays, sometimes photos, patient contact info, insurance info, etc
April 05, 2017
GP / Specialist Communication
Message Board
Views: 331 | Replies: 6
would let him know there was another orthodontist in the practice who would get most of the starts because she is contracted with the insurance. bump...if you want him gone, get him gone, don't play games and try to let him fade away, it'll just cause more problems....work out your plan BEFORE you
January 22, 2015
GP / Specialist Communication
Message Board
Views: 541 | Replies: 19
The periodontist I refer to call me to let me know while he was extracting a tooth on our mutual patient the crown next to it broke off. He said he takes full responsibility for it because of how he was elevating the tooth. Insurance won't cover it because it is less than 5 years old. It was done
July 13, 2024
GP / Specialist Communication
Message Board
Views: 197 | Replies: 5
leaving you liablity. DAs are in some states and not others.FloridaI am in Kentucky. I am also looking to bring in a CRNA to our office and offer sedation to patients. The CRNA does carry their own liability insurance..... any insight on this? I also was wondering how to charge - I just thought
October 28, 2019
GP / Specialist Communication
Message Board
Views: 1007 | Replies: 24
sculpted more and more by insurance, corporate dentistry and social media. In this age of convenience and the costs of doing business definitely not getting cheaper, many general dentists are finding this to be a good option to help them compete with one stop shops. drteeths, You are absolutely correct
March 25, 2020
GP / Specialist Communication
Message Board
Views: 2101 | Replies: 136
and will only pay me $299, or you leverage/lobby against me. Don't mess with me man... I will refer to Mexico. My point is that this would actually allow dentists to collaborate to possibly push back against corporate/insurance companies. However, dental school sadly trains us to compete and not like
June 26, 2018
GP / Specialist Communication
Message Board
Views: 2073 | Replies: 53
a traveling OS and a brick and mortar OS? Because it sounds like youresaying your traveling OS doesnt do very complicated things. Great discussion. I have been on both sides. First as a traveling perio and now my own practice. Let me throw some numbers in the mix. The insurance company with the snoopy logo
October 12, 2017
GP / Specialist Communication
Message Board
Views: 1346 | Replies: 43
don't like wine), It works both ways. I was referring unconnected patients to a particular dentist because of proximity and trying to help a fellow start up out. But 8 months went by and I saw nothing from them (front desk kept telling me but you don't take their insurance) so I started referring
April 07, 2015
GP / Specialist Communication
Message Board
Views: 407 | Replies: 11
, cause of course they took her insurance, she told me the endo mentioned one of the gp's there could do her crown that same day if she wanted. So thoughtful of him!I like it better the old way, The team model, where I do the easier to moderately difficult stuff and refer everything else
November 16, 2019
GP / Specialist Communication
Message Board
Views: 4484 | Replies: 72
and signifigantly reduce fees. In the late 1980's, the patients had mostly indemnity insurance and HMO's were rare. Today, GP's fight to have more enrollments for less than 30 percent of the HMO provider premiums received in 1988. I think this has impacted a lot of practitioners, both generalists
April 13, 2014
GP / Specialist Communication
Message Board
Views: 584 | Replies: 34
and place the patients welfare over the almighty dollar. Not very objective I know.I cringe every time a patient self refers to a Corp specialist because they take my insurance, because way too many times have they come back with crowns and other post specialty tx restorative work completed, all in house
January 18, 2020
GP / Specialist Communication
Message Board
Views: 841 | Replies: 14
Hello, I have been the owner of this practice for about 1.5 years, it's been around for about 55 years though. Ever since I have been here, I have heard a lot of complaints about the staff at the Periodontists office that I refer to and that the previous doctors referred to. It is his insurance
August 02, 2017
GP / Specialist Communication
Message Board
Views: 362 | Replies: 6
, but his staff is not the greatest.....I swear, anytime you add an MD to someone, they draw the worst front desk people.Thanks, any other...Having a formula for your team is smart, and necessary. May want to add in there if they have dental insurance, how it may change the formula (knowing you have
August 02, 2015
GP / Specialist Communication
Message Board
Views: 672 | Replies: 30
home 70% after taxes drops that to $98,000. If they have the normal $300,000+ in school debt subtract another $30,000 off to a take home of 68,000. Finally combine yearly licenses, membership dues, and any disability insurances you are down to low 60,000s. So yup right back to the 20 year old
May 01, 2022
GP / Specialist Communication
Message Board
Views: 1294 | Replies: 65
office anyway if they haven't been referred by the GP? Well that's silly! It's because they read the OP's article on Facebook and self-referred! Insurance and direct marketing. Although those patients had family in treatment with me and wanted a second opinion. Surprisingly the full court
March 03, 2016
GP / Specialist Communication
Message Board
Views: 336 | Replies: 7
of the patient’s insurance benefits Average Treatment Plan Amount Action items: ? I'd love to hear your input on how to positively influence my KPI? & I'd love
December 02, 2015
GP / Specialist Communication
Message Board
Views: 1294 | Replies: 65
to remember I'm coming from a spoiled position. I have pretty much every specialist within a couple miles of my practice. Most take the same insurance as me, can see the patient ASAP, and offer discounts for my cash patients. I know many docs aren't as fortunate. I think this is something we each have
March 02, 2016
GP / Specialist Communication
Message Board
Views: 459 | Replies: 10
, their insurance runs out in 2 days, etc. We have every patient rate current pain level 0-10. A lot of the emergencies rate 1-3 and have been that way for weeks or months. Often the office calls with someone in their office in pain and we have them sent over. No way to know what is truly going
July 08, 2014
GP / Specialist Communication
Message Board
Views: 1733 | Replies: 38
. I got out the root tip and billed the patient's insurance for extraction. It was denied because the GP already billed for it. Hasn't happened in a couple of years, but I never charged for a tooth I had to call os on. That's cold bloodediT'S ALL ABOUT MONEY
September 17, 2018
GP / Specialist Communication
Message Board
Views: 2520 | Replies: 53
by economics but you bring up great points. Insurance companies refer their patients to doctors and get 30-40% break. So technically they are receiving 30-40% for each procedure we do, how that is not a... You make good points, I can see why you're frustrated. I would love to have a healthy
November 12, 2017
GP / Specialist Communication
Message Board
Views: 1333 | Replies: 54
to gain market share. They come together as members of the National Association of Dental Plans to partner with insurance companies in ways PP can't or refuse. They form business alliances while PP won't even speak to one another. Sad. Things need to change to improve. We have already proven that what
June 28, 2014
GP / Specialist Communication
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