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Searching: insurance denials
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Message Board
Views: 134 | Replies: 2
familiar to anyone who's dealt with insurance bureaucracy: low reimbursements, rising denials, and endless prior authorization hurdles. The Kaiser Family Foundation reports tens of millions of prior-auth requests each year under MA, and the number keeps climbing. For patients with complex health needs
October 18, 2025
Medicaid and Welfare Issues
Message Board
Views: 671 | Replies: 14
.' That means technical denials. Missing tooth numbers. Wrong provider ID. Incomplete narratives. A radiograph taken but not attached. Dentists have lived this movie. Your fix is not heroism, it is systems. Use templates for narratives. Standardize attachments. Audit your own claims monthly. Find the three
April 29, 2026
Medicaid and Welfare Issues
Message Board
Views: 4452 | Replies: 220
the insurance. Insurance denied and along with the denial they sent a form saying we had to sign the form for any appeal to proceed. The form stated that I would give up my right to bill the patient if the claim was denied again. When we called and told them we had never seen this form before, we were
January 14, 2015
Medicaid and Welfare Issues
Message Board
Views: 246 | Replies: 9
of pocket for it (legal to charge in New York after getting a denial from medicaid) or you can get an extraction or just do nothing. If they think now they need a root canal or an endo consult because the insurance said so and they can get an approval after that, I would say I disagree
October 24, 2023
Medicaid and Welfare Issues
Message Board
Views: 466 | Replies: 10
and get a denial before we can accept any cash or we have them sign a waiver that they are bypassing their insurance and paying for treatment and do not expect to be reimbursed.Medicaid in AR does not cover S&RP and I have many patients who pay out of pocket for this service. Just make sure you
March 17, 2015
Medicaid and Welfare Issues
Message Board
Views: 491 | Replies: 18
I am just venting here. Why do Medicaid patients always ask about implants. They ask in a confidence as if they have million dollar dental insurance. I don't find that with PPO or self pay patient. I mean they do ask about implants but they always ask about other options and they always ask if it's
September 07, 2023
Medicaid and Welfare Issues
Message Board
Views: 135 | Replies: 1
Care Facilities are unable to take X-rays due to medical conditions; they cannot keep their head still or bite down sufficiently to take x-rays. California has cut the pay of Medicaid providers to treat periodontal disease in nursing homes by more than 50%, resulting in a denial of access to oral
January 26, 2021
Medicaid and Welfare Issues
Message Board
Views: 46 | Replies: 3
after the ACA expanded insurance coverage, emergency-department use for dental problems remained common, especially among people living in rural areas. Rural residents were more likely to rely on ER care because they face more barriers to seeing a dentist, including fewer providers, longer travel
March 19, 2026
Medicaid and Welfare Issues
Message Board
Views: 129 | Replies: 0
Hello to all those who accept Dentical in California, If Dentical denies a procedure, let's say Scaling/Root Planning, and we as clinicians see the need for it, can we perform the procedure given that the patient is willing to pay for it out of pocket? Am I violating any Insurance Agreement by doing so? Please advise. Thank you.
February 15, 2022
Medicaid and Welfare Issues
Message Board
Views: 105 | Replies: 2
an enemy, which is effective because dentists have a long memory and dental insurance has never apologized for the annual maximum. The other side leans on the classic trio of choice, innovation, and lower premiums. The attention trap is that everyone argues about one hot slice, adult dental
March 27, 2026
Medicaid and Welfare Issues
Message Board
Views: 393 | Replies: 31
insurance. Among dentists not currently in the program, 93 % said the cuts would deter them from becoming Medi-Cal providers in the future, while only 1 % said they would consider joining and 6 % were unsure. CDA President Robert Hanlon warned that reduced participation could shrink the provider
April 09, 2026
Medicaid and Welfare Issues
Message Board
Views: 328 | Replies: 8
with MCNA on the govt plan was a joke (and an expensive one). It's a lot of BS with a lot red tape, BS denials.... The only regret I have is not dropping it sooner -- would have worked less and suffered less overhead. On the upside, MCNA has a decent management portal so that your claims can be denied quicker. At least they are efficient with their denials.
April 03, 2014
Medicaid and Welfare Issues
Message Board
Views: 77 | Replies: 0
Content removed
September 06, 2024
Medicaid and Welfare Issues
Message Board
Views: 393 | Replies: 9
. They deny to cover the procedure. With the denial form you can then advise the patient that Medicaid will not cover the procedure at which point they elect to pay for it out of pocket. they therefore fill out a form stating that they are electing to pay out of pocket for a procedure that is not covered
April 20, 2017
Medicaid and Welfare Issues
Message Board
Views: 284 | Replies: 1
radiograph and just checked teeth. They have teeth already been extracted before they had this insurance. Wife has her radiograph taken in May in different office where she had extraction and a root canal treatment done when she did not have any insurance. That proves that she is telling the truth
September 12, 2016
Medicaid and Welfare Issues
Message Board
Views: 132 | Replies: 6
Any one have an insurance inspection? Couple things we were told that I want to follow up on. Any information is appreciated. -We were told we must specifically ask about alcohol and substance abuse and nicotine on our medical history form, the form must be signed by both Dr and patient. -Our
January 20, 2018
Medicaid and Welfare Issues
Message Board
Views: 38 | Replies: 0
acquisition cost. The other recurring theme was ownership versus control. On paper, many practices look simple. A dentist owns the entity. A management company handles the business side. Everyone stays in their lane. In real life, the lines blur. Who controls scheduling? Who sets insurance participation? Who
April 12, 2026
Medicaid and Welfare Issues
Message Board
Views: 63 | Replies: 0
When Is Insurance Not Really Insurance? When You Need Pricey Dental Care.
May 21, 2018
Medicaid and Welfare Issues
Message Board
Views: 1887 | Replies: 37
.........looks like another troll...well as long as he is not torturing them and has a nice staff lounge should be OK Seriously with regular insurance they would catch any potential irregularities quick like a bunny and send off some inquiring inspectorsHow is the staff lounge? Does it have table tennis
November 07, 2015
Medicaid and Welfare Issues
Message Board
Views: 390 | Replies: 6
Seattle-area dental insurance is like a joke. But few are smiling. Grandy Au, a dentist, right, and Limei Li, a dental assistant, give Jason Wu from Renton a checkup and cleaning at the International Community Health Services on June 11. ICHS provides low-cost dental services. The people
August 23, 2024
Medicaid and Welfare Issues
Message Board
Views: 69 | Replies: 3
Did you know that one in four American adults, roughly 72 million people, have no dental insurance? That's nearly three times the number who lack medical insurance. It's a staggering gap that reminds us how oral health continues to be treated separately from overall health in the U.S. The numbers
October 12, 2025
Medicaid and Welfare Issues
Message Board
Views: 39 | Replies: 0
care; benefit design and insurance coverage reflect that. What's at risk with upcoming Medicaid cuts Ohio and its residents in Appalachian southeast rely more heavily on Medicaid for dental care than much of the rest of the state. New federal cuts (part of the 'One Big Beautiful Bill Act' passed
September 11, 2025
Medicaid and Welfare Issues
Message Board
Views: 225 | Replies: 3
Lets talk what everyone believes are the rules and guidelines for this. As we know most medicaid programs pay 100% of fee their fee schedule. Now, for non-covered treatments such as denied pre-authorizations or cosmetics. What is the way to charge these patients. Veneers, Composite Veneers...
April 23, 2018
Medicaid and Welfare Issues
Message Board
Views: 1211 | Replies: 27
. What BS. Don't mind the tens of thousands the dentist did in write-offs and double that in denials. Those damn greedy dentists... Not being a prick but what dentist doesnt have $80,000? Us DT dentists dont even bother with that kind of pocket change when throwing it for dry cleaning. P.S: Hey
June 18, 2020
Medicaid and Welfare Issues
Message Board
Views: 198 | Replies: 1
Health Insurance Company CEO's Total Compensation in 2014. Physicians for a National Health Program is a single-payer, national health insurance advocacy organization made up of more than 18,000 physicians, medical students and health professionals. The mission of PNHP is to educate physicians
October 27, 2015
Medicaid and Welfare Issues
Message Board
Views: 346 | Replies: 22
be in there at least 30 minutes, and that it just to quickly get them out of pain. We can't refer them because their "insurance" won't pay any specialist enough to make it worth their while. It just doesn't work with the overhead we carry, and the measly reimbursement from Medicaid, and I have my
October 25, 2025
Medicaid and Welfare Issues
Message Board
Views: 46 | Replies: 6
Pediatric patient with prior active Medicaid coverage; now also covered under parent's dental ins. Although the Medicad is the prior effective date AND in the child's name, would private insurance be the primary? Guessing Uncle Sam would rather have private ins go first, from COB standpoint. Yes
June 28, 2022
Medicaid and Welfare Issues
Message Board
Views: 365 | Replies: 9
Over Half of Oregon Dentists Dont Accept Low-Income Patients on Government Insurance. Heres Why. In interviews with state officials, dentists explain how the states convoluted reimbursement systems undermine efforts to increase access to oral health care. Oregon dentists dont like dealing
October 16, 2024
Medicaid and Welfare Issues
Message Board
Views: 32 | Replies: 0
How U.S. Seniors on Medicare Can Bridge the Gap in Dental Insurance.
November 16, 2018
Medicaid and Welfare Issues
Message Board
Views: 501 | Replies: 20
Tolkkinen: A Rochester dental clinic has a waiting list of more than 4,000.Greater Minnesota badly needs more dentists, hygienists and facilities.Dental care is in short supply in greater Minnesota. More than a million Minnesotans are on Medical Assistance, but few clinics accept that insurance
November 27, 2024
Medicaid and Welfare Issues
Message Board
Views: 266 | Replies: 1
Matthew Smith Executive Director at Coalition Against Insurance Frau 1012 14th St., NW, Suite 1105,Washington, D.C. 20005 (202) 393-7330 The Coalition Against Insurance Fraud is Americas only anti-fraud alliance speaking for consumers, insurance companies, government agencies and others. Through its
November 11, 2020
Medicaid and Welfare Issues
Message Board
Views: 1445 | Replies: 30
We got a letter that Dental Dental will be doing an audit in our clinics. We see a lot of state funded dental insurance patients. They came and did the audit and found out that D2722 that they were approving for our patients were due to a clich on their system. Since no lab does resin crowns (D2722
December 24, 2017
Medicaid and Welfare Issues
Message Board
Views: 44 | Replies: 2
is not merely a purchasing issue. It is a compliance issue. A coverage gap is not merely an insurance problem. It is often a disease progression problem. Dentistry sees this constantly. The patient who cannot get the perio maintenance covered waits. The tooth that might have been restorable becomes
March 18, 2026
Medicaid and Welfare Issues
Message Board
Views: 613 | Replies: 12
or is it illegal? Let me know. Thanks. Depends.. doug Depends. I would not mess around with government insurance at all. Find out the correct...Illegal. Treating dentist is treating dentist. Medicaid is illegal.You need to be credentialed with Medicaid for the clinic to get paid for treatment you provide
June 12, 2017
Medicaid and Welfare Issues
Message Board
Views: 166 | Replies: 9
the dental health care crisis is mostly a dental self care crisis. Preventive care and prophys aren't expensive. Most people who have a jobcouldget their teeth cleaned once or twice a year if they valued it, (whether they have insurance or not.) Feeding your kids Skittles and Mountain Dew
July 05, 2017
Medicaid and Welfare Issues
Message Board
Views: 118 | Replies: 0
Hello doctors, I am a GP who practice in Texas. Currently OON on all insurances. Some of my patients recently enrolled in Medicare and decided to go to in network office. I was wondering if I become in network provider for some Medicare programs, am I automatically considered in network on PPO insurances? Or Medicare is different from PPO? Thank you for your clarifications.
March 02, 2023
Medicaid and Welfare Issues
Message Board
Views: 362 | Replies: 5
Georgia Must Correct Dental Care Disparities.. Research conducted by scientists in the Health Analytics Group at Georgia Tech details the extreme oral health care disparities between children eligible for public insurance and those whose families can afford care through other financial means
October 19, 2016
Medicaid and Welfare Issues
Message Board
Views: 352 | Replies: 9
Hi,Everyone,Today I received a letter from Dentaquest insurance saying that A 60 yr old patient complained to them we are trying to take advantage of his insurance.Treatment planned SRP , fillings and dentures.Pt signed treatment plan.Its Molina superior health insurance,With them Fillings dont
July 15, 2023
Medicaid and Welfare Issues
Message Board
Views: 467 | Replies: 14
Hi all, I'm new to this insurance stuff so this may be redundant but I couldn't find any answers to my questions regarding the affordable care act. I recently purchased a practice that is all cash/PPO, but noticed lately some patients have been trying to get dental insurance through
November 24, 2014
Medicaid and Welfare Issues
Message Board
Views: 595 | Replies: 20
How one Anchorage dentist Joshua J. Jeon DDS built nine BTY Dental clinics in Anchorage, Alaska by serving patients others didnt want. in Alaska the dentist drive to you! Whatever your insurance pays, that's what we'll take, and that's that, Tapia said. ...Interesting quote. A dentist
August 14, 2018
Medicaid and Welfare Issues
Message Board
Views: 1531 | Replies: 62
this or mitigate this?Ive spoken with the insurance company and they told me that pediatric dentists deserve a higher fee because they had a residency. That is their only explanation. They declined to increase the fees for GPs.Im considering talking with a state legislator or representative. Could you
March 11, 2023
Medicaid and Welfare Issues
Message Board
Views: 878 | Replies: 34
. Is there still healthy kids? Yes, Healthy Michigan was kind of the same thing for adults. You might have some entitled patients calling their insurance that you denied them of the implants or molar root canals and crowns that they deserve to have. Ironically, they can call for any specialists that take those
October 05, 2023
Medicaid and Welfare Issues
Message Board
Views: 47 | Replies: 0
My rant of the day I don't even know how this plan even exists. This is the most frustrating plan ive had to deal with when it comes to both the insurance company and the patient. I had a conference call with the rep and patient and she would lie right on the phone about the patient's coverage
September 23, 2016
Medicaid and Welfare Issues
Message Board
Views: 229 | Replies: 1
Good-day. Current practice that I will be transitioning takes a small percentage of government based insurance. I do not want any part of gov. based insurance but I understand that some of these patients may have friends/family that sees the practice and therefore, if I discontinue
February 05, 2017
Medicaid and Welfare Issues
Message Board
Views: 204 | Replies: 4
the commonwealth's dentists. Every piece of grass you look behind, theres another thing hiding there. But ultimately, the only thing thats going to improve it ... or the easiest one to start with, is Medicaid. Private insurance reimbursement rates for dental care in Kentucky also rank among the lowest
April 07, 2025
Medicaid and Welfare Issues
Message Board
Views: 600 | Replies: 19
in Skowhegan. Tibbetts and his wife both made the trip to Skowhegan for the free dental clinic. Tibbetts, a state employee for over 40 years, has not had dental insurance for himself and his wife since he retired. If one wants a solution to care for those of limited means, allow
August 19, 2019
Medicaid and Welfare Issues
Message Board
Views: 358 | Replies: 7
patients present with a private primary dental insurance, but secondary medicaid insurance. We turned them away, saying that we are not taking new medicaid patients. If they need treatment, I know that the private ins will only cover so much, and the the medicaid basically pays nothing on secondary
April 01, 2014
Medicaid and Welfare Issues
Message Board
Views: 460 | Replies: 6
dropped coverage with a traditional insurance? Probably send them a letter. It is courteous and professional. You are their dental provider, I dont think a letter is asking much.Have you seen 1800 Medicaid patients in the past 1 or 2 years? Maybe you need to reclassify a bunch of them to get the number
February 11, 2021
Medicaid and Welfare Issues
Message Board
Views: 46 | Replies: 2
Opinion: Let's Put Some Teeth into Veterans' Healthcare Coverage. The active military families have Tricare dental insurance, which is administered by United Concordia, and it is a joke of a shit-show. The reimbursements are ludicrously terrible and United Concordia is notoriously difficult
November 14, 2017
Medicaid and Welfare Issues
Message Board
Views: 149 | Replies: 2
accept Medicaid, largely due to financial unsustainability under previous low reimbursement rates. Advocates describe the increase as foundational but note that approximately $30 million more will be needed before Medicaid rates align closely with commercial insurance levels and support broader
July 28, 2025
Medicaid and Welfare Issues
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