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Searching: insurance denials
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Page 1 of 29
Message Board
Views: 477 | Replies: 9
credentialed. 1. For surgery, many dental insurances require a denial from medical insurance before dental will process a claim. I used it be in network with Cigna medical and dental. So we would send the claim to medical for a bone graft. They would approve it and pay me $53. I had to accept
October 09, 2018
Practice Acquisitions
Message Board
Views: 1056 | Replies: 40
in their mouth was done. It may come up with an insurance denial discussion though. If it does, then deal with it however you feel best. I would NOT let this be a deal breaker!! none that i'm aware of...pretty standard to have them in the APA.... Redo did you say???Here is the best answer youre gonna
June 29, 2019
Practice Acquisitions
Message Board
Views: 647 | Replies: 54
patients. The buyer folded within a year, 2nd buyer also folded within a year, 3rd buyer currently struggling. The problem is wages have gone up substantially and insurance payments have not budged There has to be something going on, because why would 3 buyers all not decide to do something different
May 31, 2026
Practice Acquisitions
Message Board
Views: 647 | Replies: 54
have to be fully FFS yourself as there is not enough volume to be an insurance office. That may not be a factor if that was your intention anyways Goal is definitely to be fully FFS Can you explain more, your thought that the seller needs to stay on? I actually always say it's more important
May 31, 2026
Practice Acquisitions
Message Board
Views: 36 | Replies: 4
Hi all, How do you handle A/R checks? I am still getting insurance checks made out to the selling corporation. They are no longer around. How do you handle this? Who owns the a/r? We are past the 90 days. We own it now. have you tried depositing it into your account? many times the bank will allow that, especially if "for deposit only" is stamped on the back of the check... No I haven't. I will try that. Thanks.
May 08, 2026
Practice Acquisitions
Message Board
Views: 245 | Replies: 3
for my state of South Carolina, but they can help me sign up for these three if needed. I will attach a doc of the fee schedules. There is a monthly fee of $750 to get you verified with all the insurances and to get the increased fee schedule. This monthly fee also includes an account manager
September 30, 2022
Practice Acquisitions
Message Board
Views: 2451 | Replies: 57
While we are talking about ethicalness of forgiving the patient portion how about this: You do a crown for $1000. Collect the patient portion. You go though all the steps in submitting the claims to prevent the denial of the build ups etc. You finally get paid $500. Two month later you get
October 19, 2019
Practice Acquisitions
Message Board
Views: 402 | Replies: 10
have substantial amounts of disability insurance in place? I hate to think that my future in dentistry is determined by whether I can get disability coverage or not. Thanks for the help. Most banks will work with you. I know of a bank that requires three denial letters
August 25, 2015
Practice Acquisitions
Message Board
Views: 420 | Replies: 2
policies through National life of Vermont, they were great. 1 policy through Priincipal Life (newest policy) made me jump through too many hoops and I did not bother.I have had clients been denied by second/third tier insurance companies, even companies with big names associated with them. Overall
June 06, 2018
Practice Acquisitions
Message Board
Views: 568 | Replies: 15
I plan to close on a dental practice end of this month. I know credentialing can take long time and I do not have enough time to get it completely done before I close. Practice I am acquiring takes at least 5 dental insurances including Delta. Questions: What happens if I am not credentialed when I
March 22, 2026
Practice Acquisitions
Message Board
Views: 129 | Replies: 10
If you change the name of your existing PLLC but are keeping the same EIN does that mean you need to re-credential with all of the insurance companies you're currently contracted with? No, they require a provider update request. Most insurances required a statement letter, a new W9, and supporting
February 20, 2026
Practice Acquisitions
Message Board
Views: 396 | Replies: 10
a provider . It takes effort from the patient to change providers. FFS PPO go wherever and whenever they want. Thanks for all the replies. It's all what I've read before but I guess I needed to be reminded. A lot of brokers/sellers seem to be in denial about the value of Medicaid patient based and I
May 05, 2018
Practice Acquisitions
Message Board
Views: 3425 | Replies: 159
not an owner but humbly ASKING for advice. How do I avoid this type of a situation when I buy my first practice? There are way way way to many dentists that do not know how to: file a claim know what insurance umbrella tpa they are under dispute a denial check ar Do quickbooks post a check send
December 14, 2024
Practice Acquisitions
Message Board
Views: 197 | Replies: 4
I am buying an office they are in network with most insurances so I guess I have to go in network too. Unlock PPO does not do transitions so let's go to the next. Unitas, Lakes somthing? What have you guys use lately?Thanks Feedback on Unitas please?So I just went through this. I went through
June 07, 2019
Practice Acquisitions
Message Board
Views: 91 | Replies: 3
complaints.Is this a red flag to add the seller or is this standard? Is a better option to add a time limit to him being added to the professional liability insurance? It is standard but it is supposed to be for name on door insurance, so if the seller gets named in a lawsuit because of something you did
May 01, 2025
Practice Acquisitions
Message Board
Views: 2384 | Replies: 60
as insurance aging. You can have 100 new patients a month, but if you aren't doing the dentistry, the number will be low. Another favorite of mine is patient retention. How many are...Sugarsandy, We're all hoping to see you turn this around. Please advise if you are planning on firing the OM and your
August 09, 2018
Practice Acquisitions
Message Board
Views: 8 | Replies: 0
what lease terms create the best value for your real estate? Here are the ideal lease terms that you should push for: Long term lease - ideally a 10 year initial term if possible (the longer the lease, the more valuable the building) NNN - tenant should cover all taxes, insurance, and maintenance
April 10, 2026
Practice Acquisitions
Message Board
Views: 13 | Replies: 0
what lease terms create the best value for your real estate? Here are the ideal lease terms that you should push for: Long term lease - ideally a 10 year initial term if possible (the longer the lease, the more valuable the building) NNN - tenant should cover all taxes, insurance, and maintenance
April 09, 2026
Practice Acquisitions
Message Board
Views: 406 | Replies: 16
) Purchase Price $515,000 Gross Income $900,000+ Adjusted Net Income $225,000+ Projected Cash Flow ~$ 180,500 after debt service, including $50,000 working capital Number of Active Patients 800+ "Out-of-network" Insurance 50% No Insurance 50% Number of New Patients 5-10 per month on average Hygiene
February 26, 2026
Practice Acquisitions
Message Board
Views: 255 | Replies: 4
I am in the process of acquiring a practice (only the LOI has been signed). I am starting to look at insurance credentialing. The owner IS NOT staying on after the closing date. How do you go about billing to insurance with the previous owner out and the new owner being in the middle
May 12, 2023
Practice Acquisitions
Message Board
Views: 940 | Replies: 73
now reimbursed at an average of 82.4% of private insurance" You in Colorado? Yes it is worth it In Colorado Medicaid/DQ plays better than most ppo for a lot of procedures. And no annual limits. Medicaid pays more than BCBS, UHC, Careington, dentemax, delta ppo. aND they don't bundle. If I do a crown
March 30, 2026
Practice Acquisitions
Message Board
Views: 354 | Replies: 11
I am buying my first practice and need to be credentialed with insurance companies. Would you recommend CAQH service? If not, what's your recommendation? Thank you in advance! CAQH like the program through your ADA login? You don't have to be an ADA member to utilize the CAQH part. I found CAQH
February 18, 2022
Practice Acquisitions
Message Board
Views: 201 | Replies: 0
Hello everyone! Any suggestions regarding the companies to help with the insurance credentialing with the new practice acquisition? I want to make sure I am credentialed before the loan is closed and before the first day of my opening. Thank you, Have a great day!
May 06, 2021
Practice Acquisitions
Message Board
Views: 355 | Replies: 11
week? How many of those got paid? No hygienist? You prob want to look at their claim denial rate and A/R. Look into perio charts and compare with X-rays. Also look for crown delivery X-rays, see if those are actually there. If you suspect fraud stay way, that's prob not the only thing they may
November 15, 2019
Practice Acquisitions
Message Board
Views: 494 | Replies: 35
hour lunch break. Hygienist works 2 days a week. 1 doc, 1 part-time hygienist, 2 assistants, and the doc's wife handles all billing/insurance. Including the seller, there are only 4 dentists in the county. No dentist in the county does endo or implants. It is all referred out to a city about an hour
March 20, 2026
Practice Acquisitions
Message Board
Views: 63 | Replies: 0
me that it all depends upon the member insurance. As long as the patient is in premier or EPO plan, whether they are part of Northeast Delta Dental or Delta Dental of Rhode island, I will be in network and can provide service to them Given the above, I came to know about my friend, who bought
December 12, 2016
Practice Acquisitions
Message Board
Views: 198 | Replies: 4
I am in the process of buying a practice. What are some good carriers for contents insurance? If this is not the correct forum mods, please move it to the correct... I just worked with my home and auto agent as they have a commercial branch as well. I was in a bind because the bank required e
September 07, 2016
Practice Acquisitions
Message Board
Views: 44 | Replies: 1
Anyone have Business Intervention Insurance or Employee honesty... bump...
April 07, 2016
Practice Acquisitions
Message Board
Views: 591 | Replies: 8
Hello, I am currently in the process of buying an office and have been working on insurance credentialing. The closing date is scheduled before I will be credentialed. How have others handled this? Can I use the seller's credentialing with insurance until mine comes through since she
January 04, 2016
Practice Acquisitions
Message Board
Views: 1407 | Replies: 55
sounds promising, but watch pitfalls. Those 3000 active patients might be inflatedcheck 18-month records or risk overpaying. Pending insurance claims can mess up cash flow if AR isnt clear in the contract. Sellers billing errors or Delta Premier status could lead to denials, hitting your $200k+ take
June 26, 2025
Practice Acquisitions
Message Board
Views: 326 | Replies: 2
What am I supposed to do to make sure that from day 1 of the transtition I am able to be in network and submit claims with the insurance companies. I am already credentialed at another practice. Do you just go around and call (not that they ever answer) the insurance companies and tell them
May 14, 2015
Practice Acquisitions
Message Board
Views: 172 | Replies: 3
Hi all, I am in my due diligence phase of a practice acquisition. I received a 17 page report with all different insurance companies that the existing provider is in network with.There are many different delta plans listed.....does this mean that all of these different plans have different fee
January 17, 2024
Practice Acquisitions
Message Board
Views: 115 | Replies: 0
Will be purchasing a practice and planning for the seller to work as 1099 during the transition. Given that I will be the owner and forming a new entity with new tax ID, etc, I'm trying to plan out the best way to keep a smooth transition with insurances. The office is fully OON and will remain
February 23, 2023
Practice Acquisitions
Message Board
Views: 159 | Replies: 6
What is the reasanable percentage to pay seller to use seller credentials and bill under the seller untill one gets into panales? I am thinking 3% Zero percent.It should be expected as part of the deal. Im thinking you need to hire advisors that understand this Isnt that insurance fraud plain
January 23, 2023
Practice Acquisitions
Message Board
Views: 329 | Replies: 13
I am hearing mixed reviews from insurance specialists and my dental specific transaction attorney. What is the legality of billing under the previous owners tax id for credentialing purposes for 3-6 months post close? As many people experience, insurance companies do their best to put you
August 04, 2025
Practice Acquisitions
Message Board
Views: 72 | Replies: 0
to bill under his EIN . The selling dentist is relocating after sale , and has direct deposits set up for his insurance checks .Whats an easy way to receive a 1099 from him for the procedures that would have been performed by me .Any other suggestions to go around it . Delta takes almost 120 days , some others also do take anywhere between 6-12 weeks.
September 03, 2021
Practice Acquisitions
Message Board
Views: 178 | Replies: 5
trying to credential are 600 for a crown, 40 for a prophy... and I'm being told that the seller's fee schedule is 'no longer available to new providers'. How is anybody getting into a practice with decent insurance fees? Is there some magic I'm missing? Would a workaround be to start
August 26, 2019
Practice Acquisitions
Message Board
Views: 69 | Replies: 0
i would like some pointers on what sort of business insurances etc. need to be taken care of for a practice acquisition. I find this is one area of practice acquisition that is not discussed much. thanks!
June 05, 2018
Practice Acquisitions
Message Board
Views: 98 | Replies: 0
When purchasing a practice or startup, Does one have to contact all previously contracted insurances and let them know you will no longer be in network with them? What if you were credentialed in a different state? What if you were credentialled in a different city?
August 02, 2017
Practice Acquisitions
Message Board
Views: 318 | Replies: 1
Need recommendations for business liability and workers comp in California other than... I have done dentist package policy from Cincinnatti Life Ins.for 26 years. No problems ever. Don't know if they do business in California. Can't hurt to find out. Dave
July 30, 2017
Practice Acquisitions
Message Board
Views: 1405 | Replies: 33
care anymore. Why get this filling done today when I don't care. I want to sell and be done with dentistry. ... And the other issues... declining economy, more insurance, cash patients not coming, no calls going out for overdue etcFYI - The demographics of the town are higher than the state
June 19, 2015
Practice Acquisitions
Message Board
Views: 491 | Replies: 13
I am currently in the process of purchasing a practice and had a question regarding insurance. The practice I'm purchasing is FFS so I would need to end my agreement with all PPOs I am contracted with at my associateship. How do I go about doing this? Do my agreements with the companies end once I
April 18, 2017
Practice Acquisitions
Message Board
Views: 60 | Replies: 2
In the lease agreement the owner of the building said that I need to provide a one million dollar policy for publicLiability insurance. Doesn't the owner of the building pay for this? Or is it the renter? It all depends upon what the landlord can get you to agree to. If you're referring
April 14, 2016
Practice Acquisitions
Message Board
Views: 320 | Replies: 3
So I spoke to a rep regarding setting up Business owner's insurance (BOP) and he wanted to know the replacement value of the equipment in case of catastrophe. I know there is a value on the bill of sale but I tend to believe that is significantly lower than replacement value. I am looking
April 07, 2016
Practice Acquisitions
Message Board
Views: 117 | Replies: 0
What is the best way to determine how many insurance members are in an area? Is the easiest way just a phone call to the insurance carriers? Looking in regards to a potential practice purchase. The town is small, most employers are 30 minute or so away. Thanks!
October 12, 2015
Practice Acquisitions
Message Board
Views: 188 | Replies: 4
I am about to purchase an existing practice - currently the practice is only in network with delta premiere. do I need to contact the other insurance companies (aetna, cigna, etc) to have them list me as an out of network provider? or do I just submit the paperwork for the services and they see
September 28, 2015
Practice Acquisitions
Message Board
Views: 171 | Replies: 2
signing up for insurances. I am in the process of doing that, but don't know how long the process takes. I've submitted some applications for credentialing, but we are having to transfer Delta premiere status and it hasn't been done yet. How long does the process take and how would you go about
April 21, 2015
Practice Acquisitions
Message Board
Views: 106 | Replies: 1
hOW IS THIS TYPICALLY HANDLED? credentialing AND PAYMENT THESE DAYS? Based upon your posts you are either trying to do this on your own (definitely not recommended) or using advisors that don't know these issues (definitely not recommended). Every situation and practice is different, the...
January 05, 2025
Practice Acquisitions
Message Board
Views: 224 | Replies: 1
The practice that I'm taking over only has 2 employees who currently have half of their medical insurance premium paid by the current doctor. I am already insured through my husband's insurance policy and will not be needing coverage. So, how do I go about finding an affordable medical insurance
May 19, 2014
Practice Acquisitions
Message Board
Views: 319 | Replies: 15
I'm using a company to help negotiate and credential with insurances. They recommend signing up with Delta Premier only since Delta PPO fee schedule is low. A couple questions from those that have been through it before: 1) My concern is patient retention, I have no patient loyalty since I just
August 18, 2023
Practice Acquisitions
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