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Searching: insurance denials
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Page 1 of 64
Message Board
Views: 95 | Replies: 4
for insurances, and general legality. Overtime my notes where getting more abbreviated and generic. Then I had a few insurance denials that I had to fight and just had crappy notes. You should try templates. Much less work in the long run .You can even have your DA start them for you and you can review, change/add then sign. If I do an exam I make a chart note of my findings. I agree templates are the way to go
November 30, 2023
Practice Management & Administrative Forum
Message Board
Views: 553 | Replies: 21
if unsure. It is better to refund the patient and be seen as a hero for making insurance pay more than under-collect and chase them for the money. So you guys never get insurance denials on a crown copay... and even if you did, you just collect the full amount upfront and let the patient receive
July 14, 2023
Practice Management & Administrative Forum
Message Board
Views: 394 | Replies: 15
the procedures..using dentrix. Attachments are also very simple also. We never miss a code submission this way. We also get a lot less insurance denials, I know frequencies etc, I know what the dumbass insurance is looking for in attachments etc etc so everything that is submitted is usually collected
November 29, 2020
Practice Management & Administrative Forum
Message Board
Views: 94 | Replies: 4
current humana patients, you may have to collect in full all payments for services at the time of service and have the assignment of benefits aka check go directly to the patient. "Ms./Mr. X, your insurance company is not a reliable payer and through their own incompetency has borderline defrauded our
May 21, 2026
Practice Management & Administrative Forum
Message Board
Views: 701 | Replies: 34
for the dentist's credentials who issued the denial 4. state that you will be turning said dentist over to your states insurance commission. This works for us in a very heavy PPO office with ridiculous insurance companies such as MetLife. While ya'll are lamenting... Doug gave you some really good
February 14, 2014
Practice Management & Administrative Forum
Message Board
Views: 2534 | Replies: 62
50% with hygiene, should be above 90%. This is all in communication skills. - Are your insurance denials a problem for SRP? They should be near 1%, sadly many are near 50%. It is all in the documentation of cases. - Insurance fees. Are you directly contracted or indirectly? Indirect through umbrella
October 03, 2023
Practice Management & Administrative Forum
Message Board
Views: 437 | Replies: 33
this. Is my understanding correct? I pay mine on adjusted production. Flat daily rate or %, whichever is higher. Calculated every two weeks. Insurance denials factor into adjustments, but are rare if your FD knows how to verify and quote correctly. Don't make it harder than it needs to be...just
August 28, 2024
Practice Management & Administrative Forum
Message Board
Views: 18 | Replies: 0
and coverages, denials, waiting periods, etc. Can also add pre-tax money to HSA. Advantage to Dental Office: Payment in full at full office fee at the time of service through a debit card. No more dealing with insurance issues. He would also provide to the HR department a list of providers, for employees
March 14, 2017
Practice Management & Administrative Forum
Message Board
Views: 377 | Replies: 19
a 2 or 3% processing fee for check payments too. So its moot if i get paper check or VCC. It's highway robbery. First you pray the patient comes. Then you accept negotiated fees, then have some a-holes still not pay co-pays on time, then fight insurance insurance claims n denials - pour hours at times (pick up pennies by throwing away dollars), then when you get a check they still want another 3% off that. Total BS.
July 26, 2020
Practice Management & Administrative Forum
Message Board
Views: 550 | Replies: 22
that PMS like Open Dental would have an option to produce a report for Associate collections. Also collections are so variable. There are insurance delays, denials , patient's slow to pay etc. Then there are the claims you need to fight that can take six months. Throw in FD errors. Ask the front desk gal
February 29, 2024
Practice Management & Administrative Forum
Message Board
Views: 75 | Replies: 1
setups (instruments/materials Phone scripts Hygiene protocols Scheduling policies Staff task checklists Process of how to do Insurance claims and billing For example, the other day we had a repeat offender who consistently denied X-rays, so I ended up creating an SOP for handling X-ray/exam denials
April 16, 2026
Practice Management & Administrative Forum
Message Board
Views: 175737 | Replies: 8045
500K+ for a 40% stake in a practice? Fwiw, things are great here post partnership. I still practice like I always have. Nothing about the office has changed except we get more help on insurance denials, IT support, marketing, more user-friendly mobile website, etc. One of the best things has
November 15, 2019
Practice Management & Administrative Forum
Message Board
Views: 299 | Replies: 9
that they produce. You want them to be paying attention to whether or not firm financial agreements are in place, the office has proper records and documentation to get reimbursed, the employees are collecting money at time of service, promptly writing good narratives for claim denials, etc... Insurance
February 26, 2021
Practice Management & Administrative Forum
Message Board
Views: 359 | Replies: 14
? is adding the are billing etc just to much extra work for them and overwhelming? Are you saying this just simplifies the job for them and keeps everything running smoothly as you dont have to worry about appeals denials and complicated insurance stuff? finally what happens if one of your patients
June 16, 2024
Practice Management & Administrative Forum
Message Board
Views: 2443 | Replies: 92
satisfaction but I highly doubt people are happy drilling 3 modl 4 mod 5 do and then fighting insurance denials and dealing with staff problems If you didn't want to be a business owner then dental school, with today's debt load, just isn't worth it. Zooming out a little though, most of what makes
October 02, 2025
Practice Management & Administrative Forum
Message Board
Views: 3129 | Replies: 105
-posting payments -processing EOBs -answering phones during and outside of business hours -scheduling -rescheduling -dealing with cancellations/no shows -insurance denials -pretx estimates -handling patient questions about billing
April 10, 2019
Practice Management & Administrative Forum
Message Board
Views: 439 | Replies: 12
, denials, pt denials, etc, etc, etc, that doing srp just didn't make any sense for ME. If a patient has perio, I inform them and refer to to a perio that takes their insurance. IMO, depending on your area and reimbursements, dicking around with SRP will only bring grey hairs and minimal returns. I have
September 28, 2020
Practice Management & Administrative Forum
Message Board
Views: 995 | Replies: 26
(example Delta of Georgia) may have a slightly different fee schedule. There could be downgrades that were not anticipated (composite to amalgam, implant paid as a partial). And there is always denials, termed insurance, maxed out at another provider etc. I wish it was as clear the people
August 23, 2017
Practice Management & Administrative Forum
Message Board
Views: 705 | Replies: 17
From a practice management point of view: I've always been OON for United Concordia. But honestly they have to be the worst of a bad lot of insurance companies. Yesterday we got a denial for a PAN, with a note asking us to document dental necessity. No kidding. So I photocopied my hand
November 05, 2014
Practice Management & Administrative Forum
Message Board
Views: 1125 | Replies: 26
while someone is in denial about their insurance and wants to waste this much time over 141.00. What could/should be done differently? Dismiss the hyg right away. 45 minutes seems short for even a simple rest, X-ray, exam, prophy (what about perio?). Debatable about how much you want to mess around
June 25, 2015
Practice Management & Administrative Forum
Message Board
Views: 54639 | Replies: 1537
management duties, fees charged, insurance interference (denials, down coding), changes in monthly income, vacation time, days working per month, number of assistants, number of hygienists to check, length of hygiene appointments, just the facts as they compare to your private practice. Thanks
June 01, 2015
Practice Management & Administrative Forum
Message Board
Views: 1249 | Replies: 73
for a reconsideration. How bout that, AI ! I thought that was supposed to make things better. Maybe only better for the insurance company. Thanks for the input! Did you send a bitewing or did you also send a PA?MOD is right, the majority of claims are processed by AI.Write on the denial your diagnosis, cite
October 18, 2023
Practice Management & Administrative Forum
Message Board
Views: 573 | Replies: 26
Happy new years! Just acquired practice and the OM retired with owner. She was not available to train anyone. Who do I hire for dental billing? Title? Who bills insurance and patients in your office? And makes sure everything is current? I need to hire someone but don't know how or where to look
November 23, 2025
Practice Management & Administrative Forum
Message Board
Views: 3288 | Replies: 93
- do so with legal counsel before proceeding. how is sending a pre-estimate for needed treatment doing anything wrong? ok, we expect the insurance to send back a denial because their records should show treatment already done... unless they don't show treatment done ... and in that case can't you
April 26, 2018
Practice Management & Administrative Forum
Message Board
Views: 9960 | Replies: 257
be an office... We have learned that we are PPO providers only for companies that allow online eligibility and verification, accept electronic attachments and claims, and pay within 7-10 days for standard claims. Now the other BIG issue with Insurance is denials and downcoding. Again
June 22, 2004
Practice Management & Administrative Forum
Message Board
Views: 3143 | Replies: 103
with root canals. Do you get denials from insurances? You must also be aggressive with your crown diagnosis. probably all mod premolar/molars you would suggest a crown?Most big cases are cash pts.(thus carecredit) we just offer PPO fees to them. single crowns arent done a whole lot. main tx is bridges
January 15, 2014
Practice Management & Administrative Forum
Message Board
Views: 7172 | Replies: 81
day in my face...I didn't do it...we do it...insurance companies have blanket denial policies on inlays...why in the Fuck do we even have an ADA code for them? and why did I learn how to do one in dental school? Why does my operative dentistry textbook have a few chapters on how to do them? Why does
May 25, 2018
Practice Management & Administrative Forum
Message Board
Views: 140 | Replies: 2
to 79% of Gross production. Does anyone else see this trend?? Do you have fee schedules set up for each plan? Who is making the adjustments... manual by insurance coordinator or through the software? You should have a contract that spells out the accepted fee's... so anything other than denials.... I don't get it... and denials should always be appealed! Janndid you increase your fees ?
January 20, 2017
Practice Management & Administrative Forum
Message Board
Views: 256 | Replies: 4
.. maybe there are insurance claims just floating around? Has anyone else gone through this situation? Thanks in advance. I don't think the PM software matters... This has become a yearly problem... Run reports on insurance claims... Depending on your state laws.. we do use PPL(legal shield) to file
February 02, 2015
Practice Management & Administrative Forum
Message Board
Views: 1249 | Replies: 73
insurancecompanymoney I don't know what is. Just say F.. you to all insurances. That's what we did and we are much better off as a result. What makes you believe they are telling the truth? Why will they ever admit to denials based on AI only? Of course they're doing it, it's cheaper Btw, I really
October 24, 2023
Practice Management & Administrative Forum
Message Board
Views: 5265 | Replies: 91
. On top of that dealing with mean, rude, entitled patients that if they don't get their way threaten and throw a fit until they do. Wifespends a lot of her day just calling insurances to deal with denials,Or sending claims or answeringPhones, she can hardly get to the accounting which
October 15, 2018
Practice Management & Administrative Forum
Message Board
Views: 913 | Replies: 33
can train new staff yourself or have one of your other staff fill in temporarily. Train yourself first. Seriously. If you have Dentrix, you can call them and they will walk you through how to create/send/receive claims. Learn how to log in to all the insurance websites. There are youtube videos
November 30, 2022
Practice Management & Administrative Forum
Message Board
Views: 127 | Replies: 2
at scheduling when the patient may need to move or budget funds. You really need your FD staff to have some rules and make them confident when asking for it from the patient. I'll respond to the last part first: IF your team is verifying insurance and ensuring your fee schedules are up to date, the should
January 10, 2023
Practice Management & Administrative Forum
Message Board
Views: 1552 | Replies: 35
with that insurance I've decided I'm not taking assignment of benefits. Just don't want anyone else with UCCI. Submit build ups with BWs, they want PAs. Submit PA's, they want BW. Send 4 BW, they want FMX. Exactly. I mean I can see denials of scaling, crowns, as you need some radiographic proof
October 15, 2015
Practice Management & Administrative Forum
Message Board
Views: 938 | Replies: 49
I am interviewing candidates to fill a lead dental assistant role in my practice. The previous owner was offering health insurance to employees. They were all on HMO policies. He was paying 100% of the premium for the policies. He was very generous. One of the candidates asked if I offered health
January 21, 2026
Practice Management & Administrative Forum
Message Board
Views: 202 | Replies: 8
will be there. Curious- do you refer to the uploaded EOB often? These can be accessed on the insurance portals. Just wondering what benefit there is to uploading them if you have access elsewhere. We only upload EOBs that are unusual (denial, partial pay for large case, etc) or that we would have difficulty getting
November 15, 2022
Practice Management & Administrative Forum
Message Board
Views: 134 | Replies: 3
Sometimes I wonder... Care to discuss? Well, my answer would be insurance. Only because theircoverage of benefits is pretty straight forward. It's either a covered benefit or not. Beyond that, if it is a covered benefit, you have toknow if there's an alt. benefit, frequency, and limitations. If you
September 16, 2017
Practice Management & Administrative Forum
Message Board
Views: 151 | Replies: 9
Hello, So I am in the current position of selling my practice to another dentist who wants to see our united concordia patients. So his office manager reached out to me as they continue to sign up for united concordia insurance and wanted me to forward our current fee schedule that we are receiving
March 30, 2026
Practice Management & Administrative Forum
Message Board
Views: 132 | Replies: 8
Hello guys, Onboarding a new hire/ treatment coordinator without dental background. great at customer service. trying to shorten learning curve and faster, effective onboarding. 1. any resources to get best insurance estimate for treatment presentation? tired many services and not much luck. one
April 10, 2024
Practice Management & Administrative Forum
Message Board
Views: 284 | Replies: 3
average 10 new pts a month and 8-10 pts a day. A few questions? 1. Is the FD person going to be a long term employee who is in need of training or they just do the minimum and that's it? 2. AR of 5K is pretty low, is that $ out to insurance you are waiting on or failure to collect copays? 3. Are you FFS
May 12, 2022
Practice Management & Administrative Forum
Message Board
Views: 120 | Replies: 3
I want to outsource insurance verification, but the company we used before was horrible and got everything wrong. Are there any good options of 3rd party insurance verification companies that you have used? What company are you using? I will have something soon for you to check out. I'll show you over some beers. If you use Weave, they have an eligibility function that has been very good. Also Pearl's PreCheck is excellent. Status works for us.
February 07, 2026
Practice Management & Administrative Forum
Message Board
Views: 855 | Replies: 33
. Just a consult. Worst dental experience of my life. I am on Amerihealth and this doctor was supposed to file a Benefit Limit Exception to get me treatment. He claimed he did. The insurance company, three times, said they had received nothing from him. Today he spoke rudely, crudely
December 07, 2014
Practice Management & Administrative Forum
Message Board
Views: 862 | Replies: 29
will cover xxxx and started saying We will submit a claim for XXX to you insurance company on your behalf. If we were to take a hit on every single denial and not bill the PT we would be doing community service. Oh wait... we did that a while ago, but we called it accepting medicaid (the scars
April 14, 2014
Practice Management & Administrative Forum
Message Board
Views: 520 | Replies: 14
reimbursements were lowered by 4%, and we have recently had a lot of random denials. I am just getting frustrated with dealing with it on a daily basis, plus even after 3 years my FD lady is still just confused by it as I am. I am contemplating dropping it for any individual once they turn 19. Or even
October 13, 2016
Practice Management & Administrative Forum
Message Board
Views: 373 | Replies: 20
January and February were improvements over the same months in 2025, but March not so much. Fewer calls, tons of no-shows and cancellations. Big delays in payments from both insurance companies and patients. Some patients' credit cards declined at check-out, and they go into collections. My reading
March 25, 2026
Practice Management & Administrative Forum
Message Board
Views: 2097 | Replies: 68
I challenge all of you to show when the insurance companies actually increased your payments There's a reason i call them the MAFIA Premiums go up without fail payments to you go down without fail What am I missing here? you're missing nothing...everything is getting tighter and tighter... I
December 03, 2021
Practice Management & Administrative Forum
Message Board
Views: 176 | Replies: 7
to consult with another specialist in the area. The doctor will share the information with such specialist and obtain input. Example of use of your health information for payment purposes: We submit a request for payment to your health insurance company. The health insurance company requests
October 17, 2022
Practice Management & Administrative Forum
Message Board
Views: 457 | Replies: 16
. If someone comes in for LOE, PA and BWand I extract a bad tooth, I only am allowed to charge insurance for EXT? This seems to be couterintuitive especiallyifa patient need of an extraction and is in major pain. I don't get the logical. If I had to go to the medicaldoctor they ask
May 17, 2016
Practice Management & Administrative Forum
Message Board
Views: 326 | Replies: 6
. Brian, Why not increase 10% like the old Kodak study advised. According to Kodak if you cut fees 10% you would have to double your work load… Overall dentists in PPOs are seeing what fee reduction with delated insurance payments cost in increased OH. We increased fees, but are prepared
January 02, 2014
Practice Management & Administrative Forum
Message Board
Views: 378 | Replies: 17
. In all honesty, I would not be as great at billing if I didn't also have the clinical knowledge that I do. My entire team sends me x-rays to review when they are working denials - especially when their offices don't make the best clinical notes. I have one that can do both. She was a surgical
March 26, 2023
Practice Management & Administrative Forum
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