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Page 24 of 817
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Message Board
Views: 383 | Replies: 13
in a temp and call it a day. We schedule him for the OR to do a SSC and several composites. We reschedule hospital 3 times because of sickness, insurance issue. Finally get him scheduled, parents pay up front as we require. Morning of, surgery they call the hospital (mom is an OR nurse no less
November 13, 2014
Pediatric Dentistry
Message Board
Views: 8891 | Replies: 289
and account for the actual hours seeing patients. Delta pays $60 for a cleaning. -Delta is my lowest paying PPO. All other insurance are at my UCR under the Careington umbrella. We get (I mean collect, not produce) $1426 from non-delta PPOs. Delta pays $720. This means I have to grind out 3 Delta
May 15, 2020
Coronavirus (Covid-19, SARS-CoV-2)
Message Board
Views: 1052 | Replies: 38
have some kind of verbiage in your financial or check in forms that states that patient is responsible for all services regardless of insurance payment. As to veneers -- I really would check if that's the case. Just because they appear on the fee schedule doesn't mean they are covered. When you send
May 27, 2014
Claims Processing
Message Board
Views: 341553 | Replies: 128046
it. Oh... and fairness? LOL. Lib definition of fairness is no less irrational than a right winger's Bubbles must be so emasculated that even wearing a mask during a pandemic is a threat to his manhood. Phase one: Denial ( According to Woodward as per Sal. Or Volman: just outright denial) Phase two
September 15, 2020
Politics - DO NOT Enter if easily offended
Message Board
Views: 1708 | Replies: 75
schools teach the correct way to do these, most dentists just get off track due to costs, insurance, etc. to doing it a very inefficient way. This is the reason I stopped doing removable about 5 years ago. I tried finding a less expensive lab, but still couldn't make it make financial sense when I
February 11, 2024
Removable Prosthodontics
Message Board
I agree. We all want to be helpful. But how can you NOT be negative when it comes to insurance companies? You just stated that they sign you up with plans you don't know about that you have to work to get out of! My pet peeve is being accused of something I'm not guilty of. Insurance companies
May 12, 2017
CE Comments / Suggestions / Events
Message Board
Views: 760 | Replies: 40
I am posting a topic here regarding a new insurance topic that I had never heard of until yesterday. I am not debating whether I should be PPO verse FFS. I am 90% PPO and am making a decent living. This is not the question. I get a letter in the mail yesterday from my electric cooperative
September 10, 2015
Claims Processing
Message Board
Views: 341553 | Replies: 128046
a complaint about President Donald Trump.First of all, I don't know who the whistleblower is, I haven't met them or communicated with them in any way, Schiff claimed during the Senate impeachment trial on Wednesday CBO report shows Washington in denial over entitlements by As the Manhattan Institute's
January 30, 2020
Politics - DO NOT Enter if easily offended
Message Board
Views: 934944 | Replies: 348121
. The facts arent much different. You havent figured this out yet. It always starts with DENIAL, then comes ACCEPTANCE. Then comes, it doesnt matter. You guys are at the denial phase. Trump is a con man. No he isnt. Okay he is. It doesnt matter You have conspiracy bunk. No I dont. Okay I do. It doesnt
November 08, 2022
Politics - DO NOT Enter if easily offended
Message Board
Views: 482 | Replies: 20
that you are dropping and as you see them while on insurance, address their objections before they can voice it at that appointment by doing things like saying 'we will still accept your ppo, but we are going out of network and will help maximize your benefits' and maybe enticing them to stay on at least
January 16, 2014
Practice Management & Administrative Forum
Message Board
Views: 1069 | Replies: 38
months unless history of high decay. Insurance companies can word things very creatively. I would question her on the denial if they specifically list once in 6 months and then deny. I would also question the need for 4 BW xrays every 6 month however.I pay my hygienist 33% of her production against
June 09, 2019
Ask a Dental Consultant
Message Board
Views: 4891 | Replies: 168
of the main leading causes were/are insurance reimbursement rate reductions and general practictioners not being able to effectively stay independent and there not being a reason for a young doctor to acquire or buy into an ongoing practice. ...and some of us are actually old enough AND fortunate
October 01, 2014
Dentistry In The News
Message Board
Views: 5194 | Replies: 56
For those of you who took breakaway, do you wait on insurance verification until the day patient is seen or do it beforehand? In my start up, we do it before hand because I wanted to be hard headed but I'm starting to get super frustrated with the amount of time each one takes and then people
January 05, 2023
Front Office Discussion
Message Board
Views: 194 | Replies: 5
certain denial appeal. My LLC is under my name and I have 4 different DBAs.. Make sure you get all the DBA variations on your name and business name... It'll make depositing checks easier when some one writes it a different way. They were only $5-10 each. Thanks, will need to consider this.
December 11, 2020
Marketing
Message Board
Views: 7563 | Replies: 382
for that much. why not now? When did you hear this before on DT? That person had insurance for them and family and still the out of pocket was high. If it doesn't work out you can always go back on insurance since there are no pre-existing denials now. Thanks Obamacare. ;) whoops wrong place I
November 02, 2016
Politics - DO NOT Enter if easily offended
Message Board
Views: 1747 | Replies: 79
in network with DD but OON every other insurance. Do understand, most of the people working at insurance companies knew nothing about insurance when they joined, and aren't always as well trained as they should be. NO, you can never do FMD and PX on the same day. Most likely the person you were
February 17, 2023
Claims Processing
Message Board
Views: 616 | Replies: 20
code. If you use an EMR encounter form, you would just add the possible dx's with that service to the encounter to simply select. But filing medical insurance is not mandatory, just a service we can add. (Although we are getting more requests from dental carriers for medical denials..impacted teeth
August 05, 2015
Practice Management & Administrative Forum
Message Board
Views: 4755 | Replies: 92
real insurance. 17. More likely to infect your waiting room furniture with fleas (happened to me a couple times). 18. More likely to turn off other patients from your clinic. 19. More likely to stink of smoke and other stuff in the waiting room... How did you find out fleas were in your waiting
August 11, 2017
Public Health Dentistry
Message Board
Views: 4277 | Replies: 40
lady with a sore spot getting worse over the past year and much self-neglect and denial. She had a fungating mass (obvious squamous cell carcinoma) extending from he midline of her palate, over to the buccal mucosa. down to the lower vestibule and into the mandible. Not interested in surgery at all
October 13, 2016
Oral Pathology
Message Board
Views: 1480 | Replies: 51
we have yet to collect anything above $200K. On average my daily production is around $1400. I currently work 4 days a week cos I started working one day a week at another office. I am OON but think I may be going IN with some insurances. post 2019 only, looking at jan-jun 2020 is useless as its
July 26, 2020
Ask a Dental Consultant
Message Board
Views: 445 | Replies: 14
audit with the dental boogey man? Seriously...I don't think I have done too many of these SRP cases that dont have bone loss radiographically, but if I did would this be seen as someone who is over treating and doing fraud and all that? Here is one SRP from a insurance patient who's implant I
July 08, 2015
Periodontics
Message Board
Views: 4070 | Replies: 127
.. dental materials: 6% That's $30k for the year Lab: low. Maybe 4% or so. $ 20k a year. Not big on C&B and removable so I have left about 10% left or $50k/yr for advertising, office supplies, repairs, interest on the loan, phones, insurance. Anything that I've missed? does it make sense what I wrote
June 07, 2021
Practice Start-Up
Message Board
Views: 727 | Replies: 25
I have some questions that I would appreciate your feedback on. I am currently OON with all insurances. Take medi but limited. Office has been growing steadily since I started up in 2011. We average about 60 NPs per month. We do accept assignment of benefits, so we file for our patients
June 02, 2018
Pediatric Dentistry
Message Board
Views: 5148 | Replies: 248
just did a second opinion and the lady had insurance. The insurance doctor was billing a 3 surface filling, caries detection, Bond fee, and PPE fee. A bond fee? WTF??? After all his BS fees, I was a better price and yes it was a very nice patient. Think what you want, but why can't I tell people I
June 06, 2020
Coronavirus (Covid-19, SARS-CoV-2)
Message Board
Views: 1272 | Replies: 46
. Consider outsourcing your Insurance billing and payment posting/adjustments to a company like eAssist. They take a % of what they collect from insurance companies, post and adjust all your payments and fight any denials. They also help clean up systems in the office that prevent you from being paid
August 22, 2020
Pediatric Dentistry
Message Board
Views: 11140 | Replies: 354
of the patient? Charge for handling / COB of 2ndary insurance? For pre-tx requests? A chair fee/setup fee for restorative visits? Why or why not? The monkey business of dealing with erroneous claim denials, re-procesing requests, etc... it's a real cost to the business. Why do it for free? Imagine
September 08, 2022
Delta Dental
Message Board
Views: 30341 | Replies: 503
don't have to submit any claims because the insurance company advanced you the money at the start of the month. No admin fights, no back and forth X-rays and narratives, no denials. The idea is like the Price is Right - get as close to zero without going over. So let's say it worked out to the tee
March 11, 2018
Ask a Dental Consultant
Message Board
Views: 2214 | Replies: 80
with the insurance companies and received a very snide letter back from Delta that basically said, F You. We do not negotiate. We'll pay you whatever we damn well please. Now bend over and take it. If I start getting denials of PAs and PANs I'm gonna drop Delta so freakin' quick.Mouth Janitor
February 10, 2015
Delta Dental
Message Board
Views: 1374828 | Replies: 39855
This remind me of my visiting a major dental insurance company headquarter. Hugh building... no visitors except me. All employee were holding claims in their hands and looking at dental x-rays above their heads, including receptionists.I had to visit the headquarter, asking for the immediate
November 11, 2008
Just Plain Bitching and Moaning
Message Board
Views: 1084 | Replies: 50
not need to know why. I created a binder with blank forms for my employees to easily access having a line for their name, date the request was submitted, days or time requested off, and at the bottom of the form an area for my approval or denial of the request. They get a signed copy back. In my
February 14, 2021
Practice Management & Administrative Forum
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: 256 | Replies: 9
maintenance appt. Was that the reason listed on the EOB for the denial? Is it listed in their plan that they only get a certain number of PM and/or SRPs in a certain timespan? Word for word, this is what is on the EOB. By the way, we are a periodontal office. The information submitted has been
November 16, 2016
Claims Processing
Message Board
Views: 722 | Replies: 49
I got Lyme as a young kid for a year. No symptoms in my old age (27). Got denied for listing myself as an old Lyme pt.Whats a disability insurance for dentist that will take me? Why did you say anythig Do people really get disability insurance? Ive never had it. Never saw a need for it. Work hard
May 09, 2024
Disability Insurance
Message Board
Views: 1016 | Replies: 42
I've been to a course or two that stated you just want to get them in the door. Even if they have Medicare of HMO dental plans that you are not a participant. You are supposed to win them over and then they don't want to use their insurance anymore. I don't want to do that. I want to be honest
December 18, 2014
Ask a Dental Consultant
Message Board
Views: 1446 | Replies: 65
in a Pediatric office. Is it possible to set up a GP office that way? Give 'em what they want if at all possible. It can be tricky in GP. Some insurances require preauthorization for SRP. Some patients may not be financially ready for SRP at initial appointment. Then that turns into a nonproductive appointment
February 09, 2026
Front Office Discussion
Message Board
Views: 2133 | Replies: 82
far as pts numbers go, I think you need to target about 2000 for the average dentist working 4 days a week with 2 hyg. 1300 pts total probably is not the time to drop a big insurance unless you want to work 3 days a week. There are ways to also look at specific plans with UC. A few of the employers
December 14, 2017
Ask a Dental Consultant
Message Board
Views: 11140 | Replies: 354
with LCOL and cheap staff, yes volume and cheap fees can work. In saturated areas, HCOL, expensive staff...good luck. Similar to dentical/HMO practices....it is hard to make good money and remain ethical.... = Remember Delta Dental is by dentist for dentist. Delta is the leader in all the crap insurance
September 08, 2022
Delta Dental
Message Board
Views: 7379 | Replies: 353
All insurances or just certain ones? I think it depends on which carriers are popular in your area. Estela mentioned that Guardian and GEHA were the carriers who were most delayed in paying. We don't have many patients who are covered by Guardian and GEHA. A few, but Aetna and Delta are more
April 11, 2024
Claims Processing
Message Board
Views: 1265 | Replies: 67
benefits when utilizing an out-of-network provider. This is more prevalent in different areas of the country (common with Delta of Colorado, Michigan and Ohio) but we anticipate it to become more wide spread. It will be important for OON offices to ask if an insurance plan allows out of network
January 06, 2020
PPOs and HMOs
Message Board
Views: 47573 | Replies: 1293
on October 12. Haven't received any word yet. I received the phase 2 payment as 2% of my 2019 revenue and looking to see what this next phase brings. I'm trying to amend my operating revenue figures. I inputted the Q1 and Q2 2020 collection revenues to include insurance checks that came in during
January 14, 2021
All Things Coronavirus (Covid-19, SARS-CoV-2)
Message Board
Views: 2709 | Replies: 281
of the operating business. The insurance benefits of captive planning are significant, filling gaps in coverage, which can otherwise lead to high out-of-pocket costs in the case of a loss event. Captives also eliminate the possibility of a claim denial, providing business owners with more control over
December 21, 2023
Ideas To Make Your Practice Grow
Message Board
Views: 17741 | Replies: 1414
this idiot does not spend a couple decades in Jail. The problem with healthcare in the United States is that about 50% of the country gets it for free. Another 30% wants it for free. Not enough people willing to pay. Makes it expensive for the ones who have to pay. Shooting insurance guys
December 19, 2024
Dental Insurance for Dentists
Message Board
Views: 2297 | Replies: 150
compliant... $600/month went to $1200/month overnight..... I now have the privilege of paying an EXTRA 7K per year for my Bronze plan with a 6K deductible... In effect, over one years time, I need to pay 20K before I can use the 'insurance'.... I'm sure I'm not the only one who is finding out
December 27, 2014
Politics - DO NOT Enter if easily offended
Message Board
Views: 482 | Replies: 18
accusation, then you might be telling the public that you actually held her son down during the cleaning? Isn't that a huge potential problem? She is accusing the Op of physical assault on her son. At the very least, there needs to be a direct denial of that. Perhaps my wording was a bit too direct
February 04, 2019
Social Media
Message Board
Views: 622 | Replies: 14
the covenant. Such harm may include restraint of trade, limits on employment opportunities, and denial of public access to necessary services.Organon, Inc. v. Hepler,23 Wash.App. 432, 436 n. 1, 595 P.2d 1314 (1979);McDaniel,37 Wash.App. at 370, 680 P.2d 448. But the court must still balance these concerns
March 25, 2016
Associates Corner
Message Board
Views: 1563 | Replies: 20
is in denial. Getting an accurate history would be tricky and the husband's never seen it before. I've been considering learning how to do biopsy myself. For some reason I see a lot of suspicious lesions in my clinic. I'm not an oral surgeon, but this is not one I would want to do my first biopsy
January 02, 2015
Oral Pathology
Message Board
Views: 13399 | Replies: 423
is dictated by insurance and by predetermination. When the policy quits paying, people still in pain quit treatment. Have a look at, join and share your stories you know to be true, ones that drive a wedge between you and your patients. If all of share your experiences, more and more of the public
April 17, 2017
Patient Communication / Education
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: 510 | Replies: 10
I'm the Debbie Downer in my office. There I said it. Whenever insurance denies a crown, I down. When my assistant starts creating drama with another assistant, I down. When my patient complains, I down. When my schedule is empty, I down. I never used to be this way until I got a few GTFO
November 03, 2016
Just Plain Bitching and Moaning
Message Board
Views: 544 | Replies: 14
as included with the crown. Cigna was paying me like $325 for a crown. They were also getting terrible with denials and I was averaging write offs of 38-45% on hygiene and 55+% on removables, extractions, etc. I was super busy, but not making profit on the patients, so it didn't make sense anymore. Don't
November 27, 2019
Practice Management & Administrative Forum
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