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Searching: insurance denials
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Message Board
Views: 494 | Replies: 14
was numb (it is my new grad hygienist so I'm still working through the kinks on how/why to do these things). We did only 1-3 teeth/quad in all 4 quads so not full quads. I'll scan in the insurance denial letter as it says at this point if we want to fight it further we'd have to request an independent 3rd
May 31, 2018
Hygiene Discussions
Message Board
Views: 804 | Replies: 44
% raise.The reality is they learn about dentistry in a very different way. The CE they take inflates their role and downplays the choices dentists make." 2024, I had three hygienists and took all the insurances under the sun. 2026, I have no hygienists, so my own cleanings, mainly FFS with limited stress
May 22, 2026
Hygiene Discussions
Message Board
Views: 361 | Replies: 22
you might as well hire a dentist for $120/hour, but then I suppose that gets tricky with insurance credentialing. I guess the only way is to lock in for at least 6-12 months to lower the subscription cost. The issue is if you hire and you have a subscription with them for 6-12 months. I have
May 19, 2026
Hygiene Discussions
Message Board
Views: 361 | Replies: 7
their insurance won't pay for. Another area of confusion is when to have the patient back to do their re-evaluation and prophylaxis. With SRP, we have to wait a minimum of 30 days before insurance with pay for the prophylaxis. Any thoughts/suggestions?Any success using this code? Are denials
August 28, 2019
Hygiene Discussions
Message Board
Views: 51 | Replies: 1
Dentistry loves simple rules. Prep the tooth, take the impression, cement the crown, pray the insurance company does not suddenly discover a new exclusion written in invisible ink. Liability is not that simple. One of the most misunderstood ideas in dental practice is the belief that supervision
April 29, 2026
Hygiene Discussions
Message Board
Views: 282 | Replies: 4
Arestin, insurance covers 80% very routinely. Almost never get denials. Patient really buys into it because they hear the charting being called out, they understand what we are doing, why we are doing it, and why they need it now. They can understand WHY they need to be numb and why it cannot
January 12, 2014
Hygiene Discussions
Message Board
Views: 305 | Replies: 19
disruption risk. Ultimately though, I think past attendance patterns and reliability are far more predictive than family status alone. I have 4 full time, and one part time. I much prefer to keep people FT if we can justify it. I don't pay for health insurance so that is not really a consideration
May 06, 2026
Hygiene Discussions
Message Board
Views: 979 | Replies: 27
a problem.This is what is wrong with deferring to INSURANCE coding as proper treatment for your patients. Scaling alone is adequate for plaque and tartar removal. Root planning along with scaling adds NO benefit without removal of sulcular epithelium in conjunction. Scaling and Root Planing is NOT definitive
April 30, 2018
Hygiene Discussions
Message Board
Views: 4347 | Replies: 228
the majority of people just want what their insurance covers, we are struggling. I am trying to see a way out of this without resenting hygienists exploiting the situation. On Facebook there are hygienists lambasting dentists, saying that we're not qualified to do cleanings. Which is utter BS because I
March 09, 2026
Hygiene Discussions
Message Board
Views: 2197 | Replies: 165
that I know in Canada are required to also work in clinical practice. I would say this could be a viable option. I guess demographics could come into play. My area demographics lean more toward dental denial...e.g my baby took my enamel Out of my 14 patients a day ( assisted hygiene) 2 may be good
July 04, 2025
Hygiene Discussions
Message Board
Views: 2824 | Replies: 132
deadlines or unclear directions continued denial of requests for time off without an appropriate or valid reason threats, humiliation, and other verbal abuse excessive performance monitoring overly harsh or unjust criticism Criticism or monitoring isnt always bullying. For example, objective
July 01, 2021
Hygiene Discussions
Message Board
Views: 4060 | Replies: 187
patients, we will use 1-3 code more often, but it's not common either. Insurance covers 80% very routinely. Almost never get denials. Patient really buys into it because they hear the charting being called out, they understand what we are doing, why we are doing it, and why they need it now
March 08, 2008
Hygiene Discussions
Message Board
Views: 372 | Replies: 18
of at least some insurance networks, and roughly a quarter of general dentists do not participate in PPO plans at all. Delta Dental's Premier network covers about three-quarters of dentists nationwide, while its PPO network includes closer to half. That means many dentists are technically 'out of network
September 14, 2025
Hygiene Discussions
Message Board
Views: 442 | Replies: 22
a 4 chair practice so not a lot of room to grow. I have went through the typical thoughts of dropping some insurances or stop taking new patients with particular insurances ( DELTA) but I enjoy seeing the patients and want to be here when they need treatment, but the fact is I have probably 200
August 03, 2025
Hygiene Discussions
Message Board
Views: 62 | Replies: 3
. Recare's a waste. I schedule a massage almost every 3 to 4 weeks. If I don't show up, they do not care. They charge my credit card for the 1 1/2 hours whether I show up or not. This is common in other industries. The problem is INsurance.
November 22, 2025
Hygiene Discussions
Message Board
Views: 1211 | Replies: 40
This post from an insta-hygienist mirrors a lot of the sentiment expressed by townies that stagnant insurance re-imbursement rates are the problem in the hygiene world but, ultimately the argument doesn't make sense. Increasing insurance reimbursement will not help with the 17K rdh openings
April 18, 2025
Hygiene Discussions
Message Board
Views: 2339 | Replies: 57
who'll blame you/sue you if you miss something. What is his reason for refusal? Money? Have a form of denial of treatment for him to sign? It's funny now I see mostly Medicaid patients there hasn't been a fight about X-Rays. It's thatMedicaid doesn't pay for them
March 12, 2015
Hygiene Discussions
Message Board
Views: 1377 | Replies: 26
, said Dr. Chelsea Fosse, senior health policy analyst at HPI. The next challenge to remain a competitive employer and recruiter will be to offer benefits like health insurance and paid leave, Fosse said during the webinar, which had about 400 attendees. Seventy-one percent of U.S. workers have health
August 11, 2025
Hygiene Discussions
Message Board
Views: 204 | Replies: 12
. then in 2025....paying like 77$. I was pretty confused when I started getting the EOB's in 2025 showing the low ass payments. Yes, this is terrible and disappointing for everyone involved (except insurance execs and investors I'm guessing). The thing which is even crazier to me is the Waiver of Liability (WOL
November 26, 2025
Hygiene Discussions
Message Board
Views: 267 | Replies: 8
years ago for long term stable patients with no perio history. Patients with insurance usually still wanted their 6 month. I'd guess maybe 25% went to a year or 9 months if we suggested it. Maybe 50% if not insured. I always stressed they should call any time if they wanted something checked sooner
June 20, 2025
Hygiene Discussions
Message Board
Views: 33 | Replies: 0
in certain cases, especially aggressive disease. The real question is whether you can deliver high-quality instrumentation in one long visit without fatigue degrading precision. A four-hour marathon that exhausts you and the patient may be inferior to two focused sessions. Precision beats speed. Insurance
February 21, 2026
Hygiene Discussions
Message Board
Views: 205 | Replies: 5
and family meal at McDonald's is $50! A professional cleaning at $200 sounds like a steal. This muddies the waters too much when people have insurance and not all of the services are provided.
September 24, 2025
Hygiene Discussions
Message Board
Views: 369 | Replies: 17
subsidies are gone. It gave a lot of people really crappy dental insurance. We had one fill in hygienist who was horrible. I dont think she can even find fill in work during a hygiene shortage. Thats bad. Agreed and agreed. I know we'll never get back to the good old days when they would cold call
March 03, 2026
Hygiene Discussions
Message Board
Views: 2197 | Replies: 165
staff you have, the more stress you have.More Patients = More Stress 1) has an employee ever said to you the terms office culture, insurance-related challenges? 2) I think you may be AI Wages are never at the top of job satisfaction surveys because I think people lie and it makes them feel better
June 15, 2025
Hygiene Discussions
Message Board
Views: 436 | Replies: 10
Hey All, I think we can all agree that we are in quite the predicament when it comes to making our hygiene departments profitable since we are faced with higher than ever hygienist salaries, higher than ever supply costs, and insurance companies being overly reluctant to give us decent
March 31, 2025
Hygiene Discussions
Message Board
Views: 359 | Replies: 28
We get new patients that sometimes don't have time to give insurance info over the phone even though we call and text to remind them then they show up and now its a verification issue since were running out of time. worse , the patient has HMO or such then they leave the appointment because
November 12, 2019
Hygiene Discussions
Message Board
Views: 340 | Replies: 6
want to make a in-office code not billed to insurance for 'Second half of long cleaning' or something like that. What do you folks do? Jeff I do this A LOT. We call it a 'two part prophy. Situations where it's not SRP (no evidence of bone loss) but there is a lot of debris to clean up. I charge
February 17, 2023
Hygiene Discussions
Message Board
Views: 2730 | Replies: 58
for extras/charging more than the insurance agreed upon fee (despite what someone heard from a delta lawyer about a side contract with patients) are all bad/non-workable ideas. Bottom line is cut it down to 30 minutes, charge exam going forward, or go OON for more options. hate to sound attorney
May 17, 2023
Hygiene Discussions
Message Board
Views: 337 | Replies: 7
agree. I bet quite a few people are still sub-$100. Ok I charge $150 for exam and hygenist prophy . Once a year I take X-rays and charge $245 for exam , 4bw/2 pa or Fmx if needed and cleaning with Hygiene. I rarely get complaints about the fees How can you guys pay a hygenist and charge sub par of $100 MY UCR fee is $124, one of my main insurance fees is $96, the other main ones are $79 and $77
September 15, 2025
Hygiene Discussions
Message Board
Views: 2017 | Replies: 61
that raise! stick it to the mean money grubbing doctor To now We shouldn't be mad at dentists, its all the insurance fault! look at the big picture guys! The next videos will probably be Temps were greedy and asked for crazy wages and now we are getting blamed and taking the brunt of it! But people act
April 30, 2025
Hygiene Discussions
Message Board
Views: 1781 | Replies: 90
discussing this not long ago and the comments were insane. The vast majority of hygienist comments say they are not paid enough. When it's explained that the business takes in less revenue than what is paid out, they say it's the dentist's fault for taking insurance and not charging enough. Lol
January 19, 2026
Hygiene Discussions
Message Board
Views: 4347 | Replies: 228
system, hindering the ability to monitor and address oral health issues effectively. Access to Care:High poverty rates and lack of dental insurance contribute to limited access to oral health services, especially for vulnerable populations. Impact of Natural Disasters:Hurricanes Irma and Maria
June 12, 2025
Hygiene Discussions
Message Board
Views: 4571 | Replies: 169
were 99% PPO practice. we block about 50 min for recalls. when X-rays are taken along with recall then the production is fine but you start doing pro/exam only, most insurances range 80 to 85. and some periodontal maintenance visits are 60 min long and no exam. therefore only D4910 code which
February 08, 2023
Hygiene Discussions
Message Board
Views: 300 | Replies: 7
One area I have always been fuzzy is when it comes to how to fill insurance for this. 29 y.o female BC/BS PPO in network 2 years since last cleaning no flossing pockets 3-5 Generalized BOP how would you treat/bill insurance. sounds perfect for the new gingivitis code. 4346
January 18, 2017
Hygiene Discussions
Message Board
Views: 144 | Replies: 8
What's everyone's opinion on taking 4 BW / 3 PA x-rays every 6 months if insurance allows? We had been doing this for awhile until the hygienist suddenly stopped. I was never informed. Is six months too frequent? My barometer is not that great because I'm very conservative on treatments
November 16, 2022
Hygiene Discussions
Message Board
Views: 2730 | Replies: 58
I need suggestions on best way to stop prophy only appointments. I am dropping a few PPOs every year so I know people will say just go FFS. These $66 prophies are becoming an issue. 1. If contracted with insurance, is there a way to charge my normal fee for a prophy when patients want that extra
April 27, 2023
Hygiene Discussions
Message Board
Views: 355 | Replies: 15
moreWell what she was getting at is that she did not know that in a relatively healthy periodontal patient there is some benefit to routine use of a laserIt cost $40 and she was waiting to see if her insurance would cover itIs this a new standard of care for even healthy mouths?Can any harm be done
July 18, 2023
Hygiene Discussions
Message Board
Views: 3676 | Replies: 192
the wage gouging. The same thing will happen with hygiene if we have a real recession. Noone is going to pay 80$ for a hygienist if their hygiene schedule starts having holes from job loss insurance loss. Noone is gonna hire 100$ temps either. Pendulum always shifts back. Or we could be in a new bull
April 03, 2025
Hygiene Discussions
Message Board
Views: 538 | Replies: 16
Not sure if this is the right category, if not sorry about that. I just like to put it out there to see what are the general thinking about this. I found out about the Hygiene school in my town has been teaching the new Hygienist to report their dentist to the insurance and or board etc
January 13, 2023
Hygiene Discussions
Message Board
Views: 104 | Replies: 2
I'm looking for ideas to help my hygiene stay busy and get busier. I'm in a ruralish town (5000) but draw from neighboring communities that probably amount to 15-20000. Closest City over 50,000 is 3 hours away. I'm in network with 4 insurance and will likely drop one of them this year. I am
July 01, 2023
Hygiene Discussions
Message Board
Views: 231 | Replies: 9
for the finer movements of my job. Has anyone run into this and have any idea of the healing time involved? Do hygienists buy disability insurance for themselves like most dentists do?tell us more about the cause of the accident. dougI did buy long-term disability, but I think it takes a bit to kick
February 26, 2016
Hygiene Discussions
Message Board
Views: 284 | Replies: 18
A temp agency assigned an RDH who approached my manager about having her come back as 1099 and bypass the agency. She does not have her own malpractice insurance. What issues can arise with having her come in as an independent contractor? Thanks! If you're in California, the Tax Bureau will come
July 19, 2025
Hygiene Discussions
Message Board
Views: 3676 | Replies: 192
explaining why the demo can be good but in the real world, they suck. just have the voicemail saying we are accepting new pts. We dont take Medicaid (this will keep you from having like 8 messages/hr asking if you take Medicaid), we file all other insurances. Please leave a message and we will call you
March 17, 2025
Hygiene Discussions
Message Board
Views: 934 | Replies: 37
If new patient comes in and need sc&rp, can you do prophy on first day, then bring back patient week later for sc&rp? Yup!...Why would you do that? What's the rationale? What are you trying to accomplish by this. If it's an insurance patient, good luck getting paid. Pretty much hell
August 06, 2014
Hygiene Discussions
Message Board
Views: 1334 | Replies: 30
demand a new dental terminology code that addresses the extra expense. Then we could charge for this temporary extra mandated expense, submit it to insurance and when they deny it, we will make them the bad guys who dont want to protect the patients but want to protect their profit. Then we could
April 28, 2020
Hygiene Discussions
Message Board
Views: 1450 | Replies: 27
on either a 4 or 6 (more often) month recall. What constitutes perio maintenance, from an insurance perspective and what's procedurally different than a 1110? What's the general consensus on Arrestin? It appears to be a potentially profitable product to use, I just want to make sure it's actually
February 08, 2023
Hygiene Discussions
Message Board
Views: 65 | Replies: 4
Is there a code practices commonly use for follow up/evaluation of perio therapy (ie 6 weeks after... This topic has been discussed in previous threads. I think that the proper code is an exam code, D0171. The problem here is that these never get paid for by insurance and patients bitch about
May 18, 2016
Hygiene Discussions
Message Board
Views: 87 | Replies: 0
Hi anyone and everyone. I am trying to transition out of dentistry because it is not fun anymore with all the insurance hype and the poor economy. I cannot find no one to take over. I do know that most insurances pay for recall exam, cleaning, fluoride and sometimes radiographs. I decided to cut
April 22, 2014
Hygiene Discussions
Message Board
Views: 361 | Replies: 2
, down-coded from adult to child prophy for a 13 year old with full adult dentition. what? What is the standard? It depends on the insurance company a lot. Very often they just have an age limit. Just charge the adult prophy, and then adjust if it is downgraded. I would not put any more thought into it than that. Personally, I agree permanent teeth = adult cleaning, but welcome to the world of insurance.For most insurances 14 is when you code for a...
October 24, 2014
Hygiene Discussions
Message Board
Views: 413 | Replies: 11
month and will use Arrestin on specific sites rather than generally. Then reassess the specific sites at the three month Periodontal Maintenance. Again, not to nickel and dime, but time and treatment that can be billed...should be billed. (The old unbundle for insurance idea). My fear
June 27, 2016
Hygiene Discussions
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