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Message Board (37849)
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Message Board
Views: 181 | Replies: 5
Are insurance companies operating like gangsters? Are they dictating terms and treatment? Please, post your insurance nightmare stories here. Thank you I don't see it that way. I make my diagnosis. I really don't care if the insco. agrees with me or not. My job is to make what I think
October 21, 2014
Claims Processing
Message Board
Views: 483 | Replies: 3
are you in? I have someone you can call. please send me an email...Hello. I am the dental malpractice agent that works with Dentaltown, as the endorsed carrier through their Townie Perks, for their insurance needs. I would be happy to discuss our dental insurance products with you as we can assist
January 19, 2015
Dental Liability Insurance
Message Board
Views: 482 | Replies: 15
Hello, Does anyone have a sample of an End of the Year Insurance Letter to send out to patients ie. The end of the calendar year is approaching - please book in for your check-up / cleaning or unfinished treatment to take advantage of your yearly insurance maximum. thanks, Andy Dear (insert
October 07, 2015
Ask a Dental Consultant
Message Board
Views: 2282 | Replies: 52
John- I'm not one of those consultants that promote outsourcing versus training staff to do it in house. I get to see all the effects of outsourcing because I've consulted hundreds of practices. You and I have both worked in dental practices as employees and have personally verified insurance
February 21, 2021
Practice Management & Administrative Forum
Message Board
Views: 44 | Replies: 1
Is there an insurance code for Class 1,2,3,4,5 glass ionomer restorations? And do you charge a fee similar to composite fees for similar surfaces? Thanks in advance for any answers! same as direct resin.
February 25, 2021
Restorative Dentistry
Message Board
Views: 126 | Replies: 2
Anyone out there using a third party to verify insurance, eligibility, sending pre auth, submitting claims and posting payments? I can't find experienced dental front desk. I'm thinking of hiring a receptionist and have a third party doing insurance details. I'm not sure if this is possible? I have
March 20, 2021
Practice Management & Administrative Forum
Message Board
Views: 651 | Replies: 13
I was wondering if anybody has considered hiring a profecional insurance negotiator for a start up. They claim that they can do a much better job setting our fees right vs DIY . Any thought? The budget is tight I will do aggressive marketing but do I really need that? Thanks What's the name
March 21, 2021
Claims Processing
Message Board
Views: 68 | Replies: 3
I had a medicare patient come in and we preauthorized dentures (RPD). The insurance doesn't pay until we deliver the dentures. I found out today that the patient changed insurance plans (don't get me started on this topic) and it looks like his new insurance has less coverage. Tomorrow is a wax
March 12, 2021
Claims Processing
Message Board
Views: 246 | Replies: 7
Is this reasonable/ competitive cost for business overhead insurance? Maximum of 10K / month benefit, maximum period of 12 months, waiting period of 30 days for a monthly premium of $215 With the other payments for liability, disability and worker's compensation, I decide to forego this ins.It's
March 13, 2021
Disability Insurance
Message Board
Views: 32 | Replies: 1
. Choose Misc. and then patient report by filters. The left hand column has filters for Dental Insurance and First Visit Date. Put in the parameters you are looking for. After the list runs, you can export it to excel.
March 17, 2021
Dentrix
Message Board
Views: 502 | Replies: 3
it required total coverage of a t least one cusp tip - but I've picked up from some that such is not necessarily the case. I'm familiar with what insurance requires (records/proof wise) for crown claims. How does this differ, assuming it does, with onlay claims? Is it a good idea to have photos of before
July 18, 2014
CEREC Forum
Message Board
Views: 266 | Replies: 11
Hi, I found this booklet while digging through a patients paper chart. Thought somebody might find it interesting. And here I am thinking this was the new Delta fee schedule...Inflation calculator says 1989 $169 porcelain crown should be $344.51 in 2019...
March 22, 2019
Dental Insurance for Dentists
Message Board
Views: 142 | Replies: 5
I have a question. If a patient has a small balance after their primary insurance pays and a claim is submitted to their secondary insurance, if you participate with a secondary insurance and there is a right off greater than the small balance, do you write off the balance amount or do you write
November 19, 2021
Dental Insurance for Dentists
Message Board
Views: 179 | Replies: 5
We have seen a very large uptick in insurances denying Perio Maintenance claims. The reason stated it they are requiring a history of SRP within the past 24 months. This is causing an issue with many of our patients who are now controlled and just keep coming on their 3-4 month recalls. Anyone else
January 01, 2022
Claims Processing
Message Board
Views: 222 | Replies: 1
Seems like most of the threads related to medical insurance options / health sharing ministries are pretty old. Wondering if anyone has anything new to offer regarding creative medical insurance options to keep the premiums down. I've personally been very glad we went to Liberty Health Share
December 08, 2021
Medical / Health Insurance
Blog
December 15, 2021
by BulletproofHygiene
Message Board
Views: 647 | Replies: 26
I have a small private practice that I purchased 6 months ago. Seller dentist was not in any insurance networks and was strictly out of network. I am the same, but I am young and wondering if I should get in-network since I'm not established yet. She did not have a hygienist and the vast majority
August 01, 2019
Ask a Dental Consultant
Message Board
Views: 643 | Replies: 9
by understanding how insurance companies function together. Blindly contracting without realizing most insurance companies are affiliated with others can hinder negotiation work in the future. Our startup practices generally see $100,000-$400,000 in additional revenue during those first 2 crucial
December 08, 2021
Claims Processing
Message Board
Views: 25 | Replies: 0
and obviously many docs have other docs in their practice and I've never heard of this or had to do anything at any place I worked. My general business insurance guy is not the same as my malpractice carrier. What do other docs that have employee docs do to cover their corp from the other docs? This seems like it should be easier than it is.
July 17, 2017
Malpractice Insurance
Message Board
Views: 389 | Replies: 6
concrete evidence of it. Obviously I do not want to continue working at this office but before I give my notice is there any info I need to gather to protect myself? All insurance claims have been sent out under his name so far but what is my liability since I am the person who actually saw
April 16, 2014
Legal Issues
Message Board
Views: 533 | Replies: 14
Is there a reliable website or system which can give real time eligibility and coverage quickly when patients come in for their appointments? We have tried 2 products, but the number of insurance companies we could check benefits was very limited. What type of software program do you have? We use
February 28, 2017
Ask a Dental Consultant
Message Board
Views: 353 | Replies: 16
completely since it is our fault. 2. Can we explain to the patient and have her come in for another cleaning and then bill to insurance again or that is a no no. Trying to understand the system.Some plans say 2 recall visits a year , does not have to be six months apart. It sucks
September 08, 2019
Claims Processing
Message Board
Views: 254 | Replies: 0
Quick question- 1) As a new graduate planning to work for a private office and having to buy my own malpractice insurance, What company should I opt for in California with the most reasonable prices and specials offered to new graduates. 2) Would getting a disability insurance be recommended
June 10, 2020
Disability Insurance
Message Board
Views: 141 | Replies: 0
Hi everyone, I'm looking to join several GP offices as a traveling endodontist but have never been credentialed with insurance companies. I understand that the credentialing process can take months to complete and was wondering how one would go about billing for treatment during the transition
July 02, 2016
Dental Insurance for Dentists
Message Board
Views: 182 | Replies: 2
So i have a really good friend that has mentioned some questionable things about his group practice. He works in a group practice with three or four docs, all owned by one guy. It's a real big ppo office, and all of the work is being filed to the insurance companies under one npi number. It's
January 16, 2019
Legal Issues
Message Board
Views: 208 | Replies: 5
Hi guys, We need to find out what percentage of our patients are cash vs. insurance in Open Dental. Does anyone have a query or know of a report that can help out with this? Thank you so much! I hope you are all have a great week so far :) I'm no OD SQL genius, but maybe this query would work
December 18, 2015
Open Dental
Message Board
Views: 191 | Replies: 0
Brought on new associate, looking at this firm- does any one have any experience? Here is their link: http://www.insurancecredentialing.com/ics/
October 21, 2015
Partnerships and Associates
Message Board
Views: 208 | Replies: 0
Our office does both the foam and varnish fluoride but we have had issues lately with insurance changes in coverage. Delta WI covers varnish under age 6 but not the foam. Anthem covers foam but not varnish no matter the age. Every insurance is starting to get more detailed on not only
April 21, 2015
Fluoride
Message Board
Views: 173 | Replies: 3
New patient seen in June. Recurrent and new caries on 4 and 5. Caries clinically present on 4 distal (dark shadow under marginal ridge). We replaced 4 and 5 as they were failing (both popped right out when prepping due to bond failure). When we got the insurance they only paid on the distal surface
November 20, 2017
Front Office Discussion
Message Board
Views: 335 | Replies: 5
I have 2 insurance companies requesting refund after work has been completed and paid for. When tx was done we have confirmed that pt has dental benefits. Metlife and Aetna one case was completed 2 months ago, one was 6 months ago. We are talking about $800 their reason is that pt did not pay
July 17, 2017
Patient Finance Plans
Message Board
Views: 259 | Replies: 8
If a patient has a Primary and Secondary dental Insurance, and I am a PPO provider for both of these insurances, am I required to file both insurances? Which insurance is considered Primary and which insurance is considered secondary? Also, do I have to provide a provider writeoff to BOTH primary
February 05, 2014
Coding Q&A
Message Board
Views: 98 | Replies: 3
read an article about how over-burdensome our government has become in the last couple of decades. The only sunny part of the article was that the government is now thinking about doing an investigation with recommendations for improvement in the insurance industry. I believe the last time
April 15, 2016
Practice Management & Administrative Forum
Message Board
Views: 368 | Replies: 5
about a year ago. Also, regardless of moonlighting, don't forget disability insurance. I saw 2 examples during residency where it was crucial. One was a co-resident who developed a heart problem required a valve replacement. The other was a plastic surgery resident who was a chief 3 months from
February 20, 2014
Pediatric Dentistry
Message Board
Views: 1005 | Replies: 24
there's no benefit to us. I'm sure the ins co gets something equivalent to 'points' by issuing payments this way, but we've started calling and requesting checks. Anyone else notice this? Any other tips for handling it? Give the insurance company a call and opt out of that 'service'. Most will let
May 01, 2015
Claims Processing
Message Board
Views: 309 | Replies: 10
Broad question but are there any red flags to look for when attempting to purchase an PPO insurance driven pediatric practice and how it would affect me as the buyer? For instance, I understand if the practice gets a lot of reimbursements for delta premier but I can't become a premier provider
January 28, 2016
Pediatric Dentistry
Message Board
Views: 96 | Replies: 2
Patient had RCT done on a tooth this year, and is needing tooth to be retreated with an endodontist. The insurance covers endo every 2 years . The office is reimbursing the patient her copay , patient is wanting the claim reversed so she can have insurance cover some of the cost for the endo. What
March 12, 2019
Claims Processing
Message Board
Views: 70 | Replies: 4
Hi everyone, What is the best way to find out who the biggest employers in certain towns are and which insurances their employees have? Could you use a reference librarian? Or is there a nice online source. If I could at least get a list of the major employers then maybe I could ask those
March 30, 2018
Ask a Dental Consultant
Message Board
Views: 200 | Replies: 3
We are going to terminate our insurance with several companies and only keep the top three. Does anyone have a letter they have used to send to insurance companies? Still wondering if anyone has written a letter to insurance company to end agreement of contract There's an oxymoron if I ever
January 17, 2015
Medical / Health Insurance
Message Board
Views: 268 | Replies: 3
All insurances ask for xrays and perio charting when you submit claim for SRP. But what if a pt have bone loss with recession and the pockets are not deep enough? Will the insurance company still accept the claim if pockets are 2-3 mm because of recession? If so do you have to chart recession too
December 08, 2014
Claims Processing
Message Board
Views: 93 | Replies: 3
% and is a standard of coordination then we will submit to both without collecting from the patient on preventive procedures. If the secondary is non duplicating then collect co-pay as if there is not a secondary insurance. LuEllenSounds exactly like a BCBS Federal copay.. But yes, you should send
November 14, 2018
Claims Processing
Message Board
Views: 66 | Replies: 1
I started a Facebook Page on the realities of dental benefits.. It purpose is to share the truth from all sides, dentist office, insurance industry, patient's and media. No need to make something up, no need to get nasty or mad. Just the facts!!!! It is starting to get active. Today's active topic is Pre Determination. Mac Ask to be a member and you will be signed up!
February 26, 2017
Claims Processing
Message Board
Views: 1446 | Replies: 32
So I have started an in house dental plan... and it is great. Wish I would have done it sooner. The problem is I am not sure of any legal issues that may be involved with certain requests. When we set it up I told the staff that this was for people without insurance and we have marketed
October 17, 2015
Claims Processing
Message Board
Views: 201 | Replies: 2
Hello all, I recently had a patient who had severe abfractions which were crossing the line angles on multiple posterior teeth. She was having major sensitivity issues. She wanted all 4 restorations done in one visit. Now, the insurance company is conducting a professional review and wants my pre
July 06, 2019
Claims Processing
Message Board
Views: 412 | Replies: 10
Bought a practice. Bank required, Busines: 1. Life Insurance the amount of the note 2. Business Overhead Expense 3. Property and Casualty Probably going with Trelor and Heisel. Looking into personal coverage. Do you have......? 1. Life 1 million 2 million 3 million? 2. Diability...how much? Thanks
April 12, 2016
Pediatric Dentistry
Message Board
Views: 284 | Replies: 7
I started a public Facebook Group named Dental Insurance - the Good and the Bad. The thread on Going Insurance Free got me t thinking about educating the public using social media. Here is one of my first post to use as an example of the purpose of the FB group: Anyone looking at the two teeth
January 21, 2017
PPOs and HMOs
Message Board
Views: 2550 | Replies: 84
I am OBSESSED with turning my practice into a same day CEREC dentistry practice. My friend has done this, but he works in a different area and sees only self-pay patients. I work in a practice that is primarily insurance, PPOs, and self pay. Most of our new patients come to us on insurance plans
March 06, 2017
CEREC Forum
Message Board
Views: 332 | Replies: 6
On the Insurance Verification List, the date is listed as 01/01/0001 under last verified. When I select a patient and mark them verified, it doesn't change the verification date in the patient's insurance section. Only until I click the verify now button does it give today's date. Why the double
August 18, 2016
Open Dental
Message Board
Views: 131 | Replies: 2
Pt missing #13 needs a bridge 12x14 and the two abutment teeth need crowns one has large filling and the other existing crown with open margin buccal with recurrent decay.. She has a missing tooth clause with her insurance. If we were not needing to bridge because of the space, crowns would
August 21, 2014
Coding Q&A
Message Board
Views: 581 | Replies: 27
, but a couple of flaws here and there like anyone. She just turned 60 yro, has a ton of pre-existing conditions too. Her health insurance premium went up 37% to $13,000! We split this with her as part of her benefits package. Needless to say her take home pay will go down. I am trying
February 12, 2015
Practice Management & Administrative Forum
Message Board
Views: 315 | Replies: 8
it, then go for it. I think the logic behind dropping the Low paying PPOs is that they require volume to make a profit and everyone is thinking our volume of procedures will go down. They want to get paid well for the patients they do see. In addition, people have lost their jobs and their insurance so
April 12, 2020
Coronavirus (Covid-19, SARS-CoV-2)
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