Search Results

Searching: insurance denials
Results: 1,094
Displaying 1-50 of 1094
1 2 3 4 5
Page 1 of 22
Message Board
Views: 510 | Replies: 27
George's comments it dawned on me that my neighbor might have the same content insurance I have and has already received a claim check from her insurance. She only showed me the bill, but not a denial from her insurance company. Is it possible she is trying to double dip by receiving an insurance
July 30, 2015
Legal Issues
Message Board
Views: 1313 | Replies: 32
! HahaIn todays world of insurance with waiting periods, downcoding, and denials--, anyone that would prep PRIOR to extraction without confirming really solidly what the coverage is in some way or fashion is playing with fire and being foolhardy. Because this is the mess you get. I'm not going to do
February 28, 2017
Legal Issues
Message Board
Views: 203 | Replies: 7
is based on a completely false claim which ruins the doctors reputation with the pt and to others the pt may inform. At what point is the insurance company liable for these damages? Im guessing most just pass it off and say its not worth the headache, bu if the doctor and practice is young, one could
January 15, 2026
Legal Issues
Message Board
Views: 206 | Replies: 1
takeaway is simple. High trust plus low visibility equals risk. The smartest response is not fear or denial. It is redesign. If a parent asked you today to watch their child's entire appointment without ever leaving the room, would your current system make that easy or awkward? Chandler dental assistant
April 21, 2026
Legal Issues
Message Board
Views: 2340 | Replies: 48
center if informed by the patient or OS. Or conversely state that the diagnostic image is not a covered benefit and the patient is responsible for the charges. Their letter indicates that a pano does fall within acceptable images that the plan covers. The OS challenged the denial and the insurance
December 01, 2014
Legal Issues
Message Board
Views: 143 | Replies: 5
building and have the same insurance company for malpractice and the building insurance (property damage, but also slip/fall, etc). In my situation, I was able to do an umbrella policy that kicks in if either policy max was exceeded. I think this was cheaper than raising the limits
March 22, 2026
Legal Issues
Message Board
Views: 483 | Replies: 10
providers to your patients? But that wasn't bad enough, it seems. The ADA also objected to Delta Including unsolicited and unsupported medical opinions from insurance company dentists who were not involved in the treatment in its denials of payment. Think about that - a company dentist who
September 04, 2017
Legal Issues
Message Board
Views: 1619 | Replies: 54
little difference. Moral of the story? A more powerful statement will be a cancellation of the contract with the insurance than a letter to a congressman.I'd be curious if this bill could potentially end the BS of dentist profiling (utilization, denial and coding stats) because the data could
March 13, 2015
Legal Issues
Message Board
Views: 410 | Replies: 8
Hi, Im a new grad. This has concerned me since I started working in this dental office. Basically the office accepts all insurances including Medicaid. When doing crown cases for Medicaid, the office only pre-D full cast metal crown, then once it has approved, the office tells pt that the insurance
October 15, 2022
Legal Issues
Message Board
Views: 299 | Replies: 6
disputes may be resolved through compromise solutions, not involving attorneys and malpractice insurance companies. Patients and doctors may be positioned to avoid the mental and emotional trauma of civil litigation. Mediation concluded in a month or two contrasts sharply with typical lawsuit settlements
February 08, 2026
Legal Issues
Message Board
Views: 19734 | Replies: 1359
they want you to jump through is absurd. Full treatment plans and probing attached for every single unit crown. Still getting denials. Does that apply to partials also? Yes. We got one crown approved. About 50 denied so far as well. 100% denials here as well. So far We are still trying. Any idea why
January 08, 2025
Legal Issues
Message Board
Views: 937 | Replies: 41
association ". For someone to get outted to this level must mean that it was pretty bad. I wonder if the insurance companies set off any alarms. Or perhaps all the denials motivated the pts to call the board. I am taking a guess here: every single patient that came through his door- he treated
February 10, 2026
Legal Issues
Message Board
Views: 3734 | Replies: 100
out on patients & taxpayers, through the dysfunctional Medicaid program. It rarely works in situations w/ conventional dental insurance, because patients have skin in the game (a co-payment). Once the corporate Medicaid provider or small business cheat has round-housed, every possible child
November 29, 2014
Legal Issues
Message Board
Views: 265 | Replies: 10
I need some input on a pt going through a divorce. I see both her ex-husband and her as pts in my practice. Per their agreement, she was supposed to be under his insurance through the end of 2025 but we checked delta in December and it said she was terminated. We informed pt prior to completing any
February 28, 2026
Legal Issues
Message Board
Views: 1060 | Replies: 23
this. flagrent denial of existence of judicial system?? Makes you wonder why some even bother going to dental school if they would go to such extremes for money. Seems like such a waste of time, money and others health. That is greed , not crazy.. to methodical. Patel also called another dentist
December 21, 2017
Legal Issues
Message Board
Views: 1876 | Replies: 71
of pts who have copays on preventative who don't fuss. I don't see that becoming an issue. At least not in my area where offices collect copays. I like pts with insurance, they get more work done and feel happy when they find an office willing to do a little work to accurately estimate copays
December 06, 2018
Legal Issues
Message Board
Views: 797 | Replies: 28
and not the patient. This is the way that offices can improve themselves, acknowledge the problem is the first step to fixing the problem. Just writing it off as a PITA patient is a form of denial. Brad, Thank god for great new patient flow... However, the jury is out on HIPAA damage violations
June 01, 2014
Legal Issues
Message Board
Views: 16242 | Replies: 259
. Sanchez was aware the Medicaid Program does reimburse the cost of root canals and bridge work but chose not to inform the patients of this or told them that those were not covered and instead required them to pay cash. During this same time period, Sanchez billed a private insurance carrier
February 20, 2017
Legal Issues
Message Board
Views: 159 | Replies: 7
for Aetna is demanding a refund, $2000.00, stating that the insurance is an ERISA program which supersedes State lawand therefore since he was not covered I have to refund the monies. Also patient has canceled phone number and turns out his home address is false. We do have his Medicare info. etc. I
January 23, 2017
Legal Issues
Message Board
Views: 1753 | Replies: 38
Wisconsin dentist is charged with breaking teeth so he could crown them. Officials: Grafton dentist damaged patients' teeth on purpose so he could bill insurance. Meanwhile I'm out here losing sleep over whether I used too much bonding agent for my class II and how bad the bitewing is gonna
December 19, 2020
Legal Issues
Message Board
Views: 1031 | Replies: 43
In Evergreen, Alabama a longtime local dentist, Dr. Douglas P. O'Connor, has been arrested and charged with second-degree arson and first-degree insurance fraud linked to an explosion at his own dental practice. The Alabama State Fire Marshal's Office and the state Attorney General's Office spent
February 04, 2026
Legal Issues
Message Board
Views: 945 | Replies: 19
- and as a result will hurt the access to care to existing underserved communities. 3M people in Ohio are on medicaid, and rising due to covid19 high unemployment. Thats almost 1 in 3 people in Ohio who have medicaid insurance. I know few dentists who are in the process of suing Dentaquest this year
November 12, 2020
Legal Issues
Message Board
Views: 826 | Replies: 29
Just had an assistant tell me about a needlestick yesterday. I contacted our Workers Comp insurance and set up a claim, and sent the employee to a local urgent care (that's on the list from the Workers Comp company) for testing. How can I get the patient tested? Can I ask her to use her medical
August 15, 2019
Legal Issues
Message Board
Views: 3151 | Replies: 91
unlikely Marshall will receive such a sentence..... if he pleads guilty, maybe he gets a reduced sentence of 23 years ?? dentist must now prove innocence. I fail to see how filing a claim for a pa and a limited eval are fraud. If you did those things you bill for them. If insurance deny's them
January 05, 2014
Legal Issues
Message Board
Views: 527 | Replies: 4
Didnt know how to post a poll but how many of you dont carry malpractice insurance? Levels of insurance? Umbrella policy? Are you at substantial risk still if you are a LLC which is supposed to limit liability? Seems to me that all the extra insurance policies I am sold are a lot of fluff
March 24, 2021
Legal Issues
Message Board
Views: 1027 | Replies: 34
for insurance reasons. False! They were told insurance was not involved due to lack of coverage and they acknowledged that status in writing by offering a discount of ten percent for no insurance. To make the unethical behavior even worse than a misleading quote, they had the gall to apply
March 23, 2019
Legal Issues
Message Board
Views: 1452 | Replies: 24
I'm looking to purchase this practice in New York. The seller has gone out of network for the last three years however based on demographic it appears to me that he routinely waves copay. Now my question s Is routinely waiving copay considered insurance fraud in New York and if so what
October 30, 2017
Legal Issues
Message Board
Views: 300 | Replies: 7
it for them. We've run into this as well. Sad situation. One particular case we had the family was in denial and said nothing was wrong. I contacted the patients internist directly and they got them in for a follow up and helped them get help. We had an old guy a few years back, he kept mailing us checks
September 06, 2021
Legal Issues
Message Board
Views: 52 | Replies: 0
I am an associate working at a multi doctor practice owned by a dentist who does not have a dental license in this state. I have been noticing his fraudelent billings recently. Billing services that were not provided. As an associate dentist, I get paid fixed daily rate and I don't have any access...
October 21, 2016
Legal Issues
Message Board
Views: 480 | Replies: 12
Opening office soon, what is considered legit and what is not? 1. Giving patient referral gift cards 2. Discounts for treatments--some forums say this is insurance fraud b/c you are essentially indirectly charging insurances more Thank you! Actually more like directly charging the insurance
July 15, 2015
Legal Issues
Message Board
Views: 1919 | Replies: 66
"this too shall pass".... If you need someone to talk to, give me a call, (914) 629-3808. I'm a nobody, but I will listen..... Thank you I really appreciate the sentiment. I heavily edited my above post to add more info about the handling of the incident by my liability insurance. This is general
January 26, 2026
Legal Issues
Message Board
Views: 34 | Replies: 1
I own a building and use it for my own office. I plan to sublease 2 of 4 operatories for five days a week. They will share the waiting room, reception, lab, sterilization, lab, restrooms, and parking. Am I able to have them add me to their professional liability and business insurance
January 22, 2025
Legal Issues
Message Board
Views: 190 | Replies: 5
those patients. The owner has another location that is being kept open. Is it up to the owner to finish my cases at the open location or at least offer to do so or to make other arrangements? Should I contact my malpractice insurance? As an IC, you have very little liability as I understand
March 10, 2026
Legal Issues
Message Board
Views: 303 | Replies: 16
that if the patient has Medicaid, that choice is taken away from them. Medicaid wont even allow that you charge the patients unless you receive a denial for the treatment. Metal rpd are much more comfortable and long lasting than flexbase anyway. Do not make a flexible and bill the patient
February 04, 2019
Legal Issues
Message Board
Views: 19734 | Replies: 1359
come first serve. The federal health minister must be in denial about dentists lack of support for the CDCP. Fair concern but why would this federal plan acts as a gateway for other PPO's? My biggest concern on that front has been how few private insurance providers there are in Canada
March 14, 2024
Legal Issues
Message Board
Views: 2385 | Replies: 30
Does TDIC actually protect you and your practice better than other property and professional liablility insurance companies?<br/> <br/>If you ask Randall Ruminson, DDS (LLUSD 2003) and James Chaffin, DDS (LLUSD 2004) they would say absolutely not and there are others who would agree
December 12, 2017
Legal Issues
Message Board
Views: 113 | Replies: 1
I worked in a private practice, and at that time I paid for my mal-practice insurance (occurance ) Couple of years back, the owner sold her practice to a DSO and they told us that we had to be on their insurance policy ( claims made) Now I am quitting the DSO job What do I need to do? Some
September 08, 2021
Legal Issues
Message Board
Views: 195 | Replies: 5
Hows it going, I work in a dental office in Boston area that has general PPO mix of government plans/private insurances. In an attempt to increase efficiency, the office is adopting block scheduling for doctors and hygiene. It was proposed to block by insurance. Is it legal to block new patient
February 28, 2024
Legal Issues
Message Board
Views: 238 | Replies: 11
We had a patient come in a while ago maybe 18 months or so. PT isout of networkwith Aetna which I've since come to find out is an employer funded plan so it's not exactly an insurance. We call Aetna get the details PT has benefits and the plan pay X dollars etc. We do the work get paid (it's
November 29, 2018
Legal Issues
Message Board
Views: 380 | Replies: 5
to satisfy the insurance company that it is a legitimate claim. I could see involving a lawyer if you went through the medical steps and were denied, but until the medical part of it is complete I can't imagine any competent lawyer advising much except following the rules the insurance company laid out
March 11, 2017
Legal Issues
Message Board
Views: 60 | Replies: 0
There's far too little regulatory oversight relating to dental insurance. Here's a report aimed directly at the public. Independent dentists are well-positioned to give patients advice. Even on a one-on-one basis, we can impact a positive difference for the public welfare. Michael W Davis, DDS Santa Fe, NM
July 27, 2016
Legal Issues
Message Board
Views: 946 | Replies: 20
Patient files a complaint to the insurance company regarding the services provided. Got the letter from the insurance company asking for patient's records, charts, consent forms, xrays and and any comments that I might have. How to proceed? How serious is it? Never happened before. Should I
December 18, 2015
Legal Issues
Message Board
Views: 110 | Replies: 3
being processed. On the application it asked a new question, Are you on the OIG exclusion list? my answer was yes which triggered a denial of renewal response. I have written to the OIG 5 times in the past years with no response. So It looks like I will be prevented form practicing on Monday and I
February 26, 2020
Legal Issues
Message Board
Views: 141 | Replies: 1
Ok so here is the situation. A child patient was seen and paid for the treatment up front $675. Then the insurance was billed. The insurance is in the name of the mother and the child is a dependent on that insurance. The father called and asked if the insurance has paid so that they can get
October 02, 2015
Legal Issues
Message Board
Views: 232 | Replies: 1
I am disabled and now my disability insurance company wants to deny some of my expenses. I need a disability Insurance attorney. Would someone recommend a good attorney to represent me? I refer my clients to a law firm in Florida that works nationally but they only do certain cases. Feel free to call me to discuss and if it is the right fit, I'd be happy to refer you to them.
May 07, 2014
Legal Issues
Message Board
Views: 1098 | Replies: 25
were flying left and right. I told her that I will not charge her insurance and she is welcome to see another dentist to have relines done. One week later I mailed her a letter dismissing her from my practice. Patient complained to the State board and I received a request for copies of dental
August 23, 2021
Legal Issues
Message Board
Views: 1257 | Replies: 31
Dental Insurance Industry Celebrates Negotiation Victory over American Dental Association By: Michael W. Davis, DDS 2-4-2024 This gets into many angles. Is the ADA truly working for you? How nasty is the dental insurance industry? Why are DLRs important, and how can
March 05, 2024
Legal Issues
Message Board
Views: 182 | Replies: 2
So i have a really good friend that has mentioned some questionable things about his group practice. He works in a group practice with three or four docs, all owned by one guy. It's a real big ppo office, and all of the work is being filed to the insurance companies under one npi number. It's
January 16, 2019
Legal Issues
Message Board
Views: 221 | Replies: 19
If I provide insurance it will change next year as it always does and be pain in the neck. Was thinking I can get a group plan and pay 50% of their portion if they want it. Some of the staff may not need it and wonder why they don't get a raise. I could just give raises and call it a day
December 13, 2018
Legal Issues
Message Board
Views: 1425 | Replies: 60
million. In October 2024 he was arrested and subsequently indicted (on November 21, 2025) on 110 charges: practicing dentistry and medicine without a license, theft by deception, insurance-fraud conspiracy, drug possession, commercial gambling, and violating the state's racketeering (RICO) laws
January 23, 2026
Legal Issues
Displaying 1-50 of 1094
1 2 3 4 5
Page 1 of 22
Dentaltown Magazine
May 2026
Dentaltown Magazine May 2026 Read Current Issue Read Archived Issues
Sponsors
Townie Perks
Townie® Poll
What’s actually driving most of your new patient flow right now?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Pods & Blogs Classifieds Dental News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
The Dentaltown Team, Farran Media Support
Phone: +1-480-445-9710
Email: support@dentaltown.com
©2026 Dentaltown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450