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Searching: insurance denials
Results: 251
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Page 1 of 6
Message Board
Views: 97 | Replies: 4
would tell me to get signed treatment plan, informed consent and payment first. Call your malpractice insurance if you want a real answer about liability. How does the case look overall? Do you know the aligner company she used? Thankyou all for your valuable responses. Her bite is open all over
April 23, 2026
Orthodontics
Message Board
Views: 1066 | Replies: 55
, but I think it's across all...You can files a complaint to your state's Insurance Commissioner . And if not , then have a collection Attorney help you collected the money. As long as you provided the service and the patient is happy. Also , politely ask the insurance to send you the contract
October 24, 2016
Orthodontics
Message Board
Views: 417 | Replies: 12
What is the bullet proof narrative for orthodontic treatmentfor insurance purposes? Patientgots crooked teeth....and they is butt ugly. JohnHahaBump Patient is depressed and suicidal due to their obsessive compulsive desire to have straight teeth. Failure to provide Ortho will result
January 20, 2017
Orthodontics
Message Board
Views: 185 | Replies: 3
! I would only code as comprehensive and save yourself and staff any confusion. I have never had an issue with a contracted fee being lower than what I charge, but I am only in-network with Delta Premier. I think most insurance do not give you a ortho limit that you can charge even if you
November 09, 2021
Orthodontics
Message Board
Views: 139 | Replies: 3
On a standard insurance form, there is a box that can be checked for orthodontic tx. When you do a space maintainer, should this box be checked or left blank? Sorry if this seems like a dumb question. I see you got a lot of help; ) Wish I knew but, considering it is a preventive code, I would vote no.Dental Code, not ortho. Is it bilateral or unilateral? D1510 or D1515Thanks...
May 28, 2017
Orthodontics
Message Board
Views: 390 | Replies: 5
I'm pretty sure I'm going to start a Progressive Ortho course in the near future but I'm concerned about insurances not covering because I'm not a specialist. For GPs out there doing Orthodontics - is this a problem? Or do you just charge insurance and usually it's not a problem? Or are you
August 23, 2016
Orthodontics
Message Board
Views: 205 | Replies: 2
For those of you who do Invisalign, when do you submit it to insurance? the day you take impressions and pictures and send it to the lab with the rx or the day you deliver the aligners? does it really matter? thank you! You submit the claim after the first set of aligners have been delivered
February 09, 2016
Orthodontics
Message Board
Views: 189 | Replies: 4
We are a GP and have started doing more Invisalign cases. This is great, however, knowing how insurance typically pays for ortho (1/2 now 1/2 in 6mos, 1/4...) is hurting our A/R! Does anyone have any suggestions how to get a handle on this? We have attempted to ask the patient for payment in full
June 18, 2014
Orthodontics
Message Board
Views: 148 | Replies: 1
I have a patient on whom I am trying to start invisalign. She wants to get pre-appoval from her insurance and I am required to fill out some paperwork. The insurance forms are asking for me to state the treatment mechanics. Does anyone have any experience in what they are asking for? I spoke
March 06, 2014
Orthodontics
Message Board
Views: 541 | Replies: 23
even know where to start, especially if insurance is involved. You read my post all wrong I think you should definitely do it BUT Just like extractions, don't take a weekend class and then try wisdom teeth. Take a weekend class and do some 4mm crowding cases. Take a few more classes and do some 6mm
February 25, 2026
Orthodontics
Message Board
Views: 71 | Replies: 2
Hi, I was wondering what's the requirement in order to be preauthorized for braces in both PPO and Medicaid. Do we need to send them usual 8 photos with x-rays? If so, what are the x-rays that they want? And do we need to write anything such as % overbite, overjet, skeletal and dental...
June 02, 2021
Orthodontics
Message Board
Views: 163 | Replies: 1
We have a patient who has Aetna insurance and they pay $3902 for Ortho. If patient has Invisalign can we charge more? With a lab bill of close to 2K for Invisalign it doesnt make sense to do the case Invisalign is usually 5,000 and up. You can compare with fees around your location
August 27, 2021
Orthodontics
Message Board
Views: 66 | Replies: 3
Posted at 3 am - gotta love waking in a panic over insurance. Thank goodness for DentalTown! If you were going to start your practice again, which insurances would you accept in-network? I'm new to insurance for orthodontics. Which companies pay more to in-network providers (or simply pay nothing
October 28, 2020
Orthodontics
Message Board
Views: 211 | Replies: 2
searched DT, but can't find any good answers. I do participate in some PPO's and looking at the fee schedules, some insurance list nothing, some list a total fee, then some DON'T list a total fee but under D8090 list several other things. Cigna for instance has this D8090 Comprehehsive Orthodontic
March 28, 2017
Orthodontics
Message Board
Views: 95 | Replies: 1
of a patient before paying. Never had that before. Anyone else? Can you elaborate a bit...
August 18, 2017
Orthodontics
Message Board
Views: 484 | Replies: 6
Does insurances required preauthorizations for invisalign? If ortho is covered, does this also apply to invisalign? Does insurance pay the whole amount upfront or does it pay a part of it each month? please enlighten me on ortho insurance please Aligners are simply a method of treatment. It's
January 21, 2015
Orthodontics
Message Board
Views: 113 | Replies: 0
Are clear aligners considered a cosmetic form of braces, and if so are we obligated to offer the treatment at the insurances price for standard wire/brackets braces. I am a participating provider for ppos do I have to follow their fee schedule for d8090,d8040, ect., if I do clear correct? If I do need to follow their fee schedules it may not be worth it to do clear correct. thanks
July 23, 2014
Orthodontics
Message Board
Views: 94 | Replies: 1
Does anyone have recommendations or experience using a service that files and follows up with insurance claims? We are looking for a reputable outside source to assistance a busy orthodontist with 2 offices in San Diego. He's had 3 'experienced people in 2 years doing less than adequate work
April 21, 2014
Orthodontics
Message Board
Views: 159 | Replies: 9
from the parents monthly and dental insurance is quarterly. Who figured out the payment schedule from the start of treatment? We took a thousand dollar deposit and then divided the remaining balance by 18 months. It was an easy case and it took us 1/2 of the time. Front Desk. We have only been
July 29, 2025
Orthodontics
Message Board
Views: 47 | Replies: 1
Hi looking for front desk forms to work up invisalign cases, such as insurance portion, patient payment and agreements. and any other important info. to help me streamline, keep track of calls made to patients Thanks We use ortho banc for ach payment plans if You are general dentists you need
May 12, 2025
Orthodontics
Message Board
Views: 57 | Replies: 0
running beta version right now- will verify dental insurance and import into open dental. other great features, but new insurance verification coming out later this year. we just started using and out staff loves it
May 29, 2024
Orthodontics
Message Board
Views: 230 | Replies: 2
I am GP and just started few invisalign cases at my office. But I encountered some patient with PPO insurances who are interested in invisalign, but I am wondering if most PPO insurance cover invisalign? If not, I think I will quote PPO patients the same fees I charge to FFS patients. Any GP doing
January 23, 2014
Orthodontics
Message Board
Views: 169 | Replies: 9
drift of the 1st molar? peds specialist here put in an LLHA as insurance against space loss ext K/T maybe a little osteoplasty over 20 to promote easy pathway pan q6 months to evaluate i've seen those teeth #20 spontaneously upright Peds1 Thank you sir! I have also seen those bicuspids upright
November 18, 2025
Orthodontics
Message Board
Views: 341 | Replies: 4
. If it is a $400 discount on the fee for the patient, how is that even legal if a patient has insurance? I'm mainly thinking of in-network doctors that have a contracted rate regardless on if insurance is picking up a percentage or not. Its seems like you are buying a coupon! Invisalign, caskets ... what next
August 30, 2024
Orthodontics
Message Board
Views: 140 | Replies: 3
In April of2017I started an Invisalign Full case (D8090) on a patient. We area FFSoffice. The patient took assignment of benefits. We just finished the case this month, approximately a9 monthtreatment. When checking out the patient asked when her insurance would finish reimburse her. She said
January 19, 2018
Orthodontics
Message Board
Views: 165 | Replies: 9
insurance pays the stated ortho benefit? Please, lets not debate whether Phase 1 is necessary as I know there will be lots of opinions as to how to accomplish ortho. Really interested in those who have some wisdom about how to bill the phase I Thanks I don't think they give a damn. If it's
July 31, 2018
Orthodontics
Message Board
Views: 148 | Replies: 1
My practice consists mostly on Medicaid, Dentaquest patients.. sad but true. I see numerous children everyday that need ortho treatment, but these government insurances don't pay general dentists like me to do ortho. So I end up referring these patients to orthodontists. Actually, my front desk
December 08, 2014
Orthodontics
Message Board
Views: 263 | Replies: 2
Hello, I am having a difficult time figuring out how to bill for ortho. One big insurance company in the state of NE (that has a color as part of its name), tells me that they will pay 25% at brackets and banding and then we will need to submit for the EXACT AMOUNT, divided by the number of months
May 02, 2019
Orthodontics
Message Board
Views: 187 | Replies: 4
Just got notified that our patient might quit his job soon and we just got pre auth back. Any idea how this works if I start this while he is eligible will insurance pay out full portion despite of him not being insurance later?? I haven't calle the insurance yet, but I wanted some advice
October 07, 2017
Orthodontics
Message Board
Views: 2562 | Replies: 114
is supposed to be emailing us some info and we are just waiting on that. Once I get this all together, I plan to post the results here so others who may be having similar problems can get easy answers.But at this point it sounds like I should just tell the patient that thier ppo insurance co does
August 06, 2013
Orthodontics
Message Board
Views: 617 | Replies: 15
at the thread titled, best way to restore this? (perio plus diastema issue #24/25). Someone suggested the 2nd radiograph looks as if it's got a fracture. Come on, man. Someone missed 2nd canal on that tooth, on a front tooth. And you are telling me that Insurance companies should pay benefits for endo
May 17, 2019
Orthodontics
Message Board
Views: 808 | Replies: 13
Hi townies, im gonna be starting Invisalign but Im unsure how much to charge patients. How do you set the professional fee?? Are you at all familiar with how insurance reimburses for orthodontics? I was actually going to ask the same question. With Invisaligns monster lab fee. How are you doing
January 25, 2022
Orthodontics
Message Board
Views: 457 | Replies: 3
What is the correct way to code for Invisalign to get maximum reimbursement with in-network insurance companies? We have been coding D8090 only. I am in network with several insurances and end up doing a large write off. For example, our in-network fee for Guardian for a full Invisalign case
October 12, 2016
Orthodontics
Message Board
Views: 275 | Replies: 3
I am about 50 percent in network with insurances. I did a start up from scratch about 2 years ago. I have taken multiple short term ortho courses. I am frustrated because there are a lot of insurances saying thatthey cover the limited ortho code. A lot of the allowable PPO fees are around 2000
November 12, 2015
Orthodontics
Message Board
Views: 396 | Replies: 5
Our practice just started offering Invisalign and I have a few questions regarding billing. Is it recommended to send a pre-authorization? What is the least amount of time frame that an insurance will pay the max of benefits for this procedure? example 4 months, 6 months, 12 months... If you read
January 23, 2018
Orthodontics
Message Board
Views: 234 | Replies: 5
as exposed her upper canines. I used some power chains and brackets to try to erupt them but so far it looks like they are erupting directly over her laterals. I need to refer her to an Orthodontist but none in the area takes her insurance and parents don't have much money. Any ideas??Front
June 12, 2014
Orthodontics
Message Board
Views: 615 | Replies: 16
seems like there's a grey area here. THANKS The only parties concerned if a procedure is comprehensive or limited are the insurance companies and those bound by them. In general, short-term ortho is limited in scope and qualifies as limited orthodontics and would use the limited codes. If in doubt
January 20, 2016
Orthodontics
Message Board
Views: 442 | Replies: 7
for ClearCorrect. If patient is further interested, then we schedule an orthodontic workup - impressions for plaster models, pano, and photos. 2. Ortho workup/records. We then schedule for a final consultation. Write official treatment letter for patient and insurance company. 3. Final consultation
December 21, 2017
Orthodontics
Message Board
Views: 101 | Replies: 1
Hello everyone, I have started a limited ortho case this february on a patient. Pts mom just let us know that they had an insurance active Feb 1st and she would like us to submit the claim to the insurance. We called the insurance- they have a clause of Pre authorization for all cases. How do we go
April 20, 2014
Orthodontics
Message Board
Views: 231 | Replies: 8
, retainer upgrade, etc. But then you also have to do this in a way to follow your insurance contract, as well as avoid state insurance fraud law breaches. I do these kinds of trainings a lot, but it is a lot more than just what additional things can you charge for, so they tend to be an hour or more
November 15, 2023
Orthodontics
Message Board
Views: 46 | Replies: 2
Hello, I have a few patients getting Invisalign treatment. Insurance pays for periodic ortho visit. Can I do tele dentistry to check the patient and bill the insurance for periodic ortho visit with a narrative that tele dentistry was done. Patients don't want to come to the office. Thank you
June 13, 2020
Orthodontics
Message Board
Views: 152 | Replies: 0
How do you bill out your Vivera Retainers to patients and insurance? I always did D8680 upper $150 D8680 lower $150 But now a insurance company is telling me I only can submit D8680 once, is this correct? Thanks!
March 02, 2017
Orthodontics
Message Board
Views: 170 | Replies: 0
Saw commercial for this last nite. :(. Yet another. What I want to know is how the hell is this insurance eligible. Half a tooth is gone, I take a picture with the claim and have the BU denied. Do your ortho at home, no problem? Candid Aligners Orthodontist directed and designed to fit you
October 19, 2018
Orthodontics
Message Board
Views: 425 | Replies: 15
. My assistant spent an hour with insurance as he said he had insurance but we found out he didn't. I decided to quote him $200 which includes Exam, X-ray and removal of the Lingual wire. I felt this was fair as I had never seen him before and not sure if I would need to numb up and how much work I
May 06, 2021
Orthodontics
Message Board
Views: 268 | Replies: 2
that she would like removed. Is there an ADA code for this procedure? Any guidelines for the fee? Thanks! D8695 or D8999. I wouldn't expect any insurance reimbursement and would inform the patient of that. In my office for a rare occasion procedure like this, I'd probably just do a small flat fee
September 05, 2022
Orthodontics
Message Board
Views: 734 | Replies: 34
is not gauged by the ability of practitioners to accept it. Some folks still believe the earth is flat - Does that mean the subject has not been put to rest? There will always be practitioners that endorse the pyramid of denial; however, it is incumbent on them to provide the data to support their claims. I do know Kevin O'Brien. I have followed his writings for...
January 09, 2018
Orthodontics
Message Board
Views: 144 | Replies: 2
and code for this? And is insurance reimbursing any for this? Thanks! D1330 Oral Hygiene Instructions Don't expect insurance to pay.It's a GV if it treating altered passive eruption. It's esthetic CL if it's flap and osseous surgery. It's an out of pocket procedure 99% of the time.
February 17, 2015
Orthodontics
Message Board
Views: 864 | Replies: 31
of the French social security ( the patient too if they knew what is good for them ) or the English dentist prefer private to the NHS. By definition, it cannot go well when the insurance company ( and socialized medicine is nothing more than an insurance company) want to have its say on what kind
January 17, 2019
Orthodontics
Message Board
Views: 338 | Replies: 5
, and (my personal favorite) $600 retainer insurance. I have never heard of this type of thing from other patients/other orthodontists. Most of the time, as I understand it, the full price of treatment is laid out at the beginning of the case. She was a little shocked at this, and I can't say that I
August 12, 2015
Orthodontics
Message Board
Views: 1254 | Replies: 27
So we did in-house financing for a patient for ortho....has dental insurance...... She made her $1000 down payment and was going to finance her out of pocket monthly for the next 18-24 months... First 3 months she was good...last 3 months...no good.....and as far as insurance goes it's little
August 11, 2014
Orthodontics
Displaying 1-50 of 251
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