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Dentaltown Magazine
In the December, 2012 issue of Dentaltown Magazine, I wrote an article about personal disability insurance for dentists. I spoke about personal disability coverage to protect your most valuable
June 2014
by Ivan M. Kirshner, DDS
Message Board
Views: 397 | Replies: 2
A copy of our latest blog in regards to PPO recredentialing issues: Requests for recredentialing with insurance companies is not something new however you will probably notice more requests coming your way. As part of some of the new healthcare changes, requests will be coming more regularly
June 27, 2014
Practice Management & Administrative Forum
Message Board
Views: 228 | Replies: 7
I have been receiving PPO checks dated December 2017 but I received and deposited them in 2018. Accountant would like to report them as 2018 income but obviously that would not be possible because I am pretty sure those will be reported on the PPO 1099s as 2017 income. So my question is should I...
January 29, 2018
Accounting / Bookkeeping
Message Board
Views: 191 | Replies: 2
Hi there! I was wondering if anyone could tell me of a good reasonably priced carrier for Malpractice insurance in Northern California for Claims based with or without prior acts? Thank you! ...I have dentists advantage but don't know expense in relation to other malpractice carriers.
November 29, 2016
Malpractice Insurance
Message Board
Views: 245 | Replies: 1
Does anyone here use this company? I'm a new dentist in CA who is interested in disability insurance with true own occupation coverage. Any pointer would be appreciated. P. S. ppl also recommended Guardian, not sure how it is compared to TDIC in term of protection and premium. Thank you TDIC acts
January 21, 2019
Disability Insurance
Message Board
Views: 681 | Replies: 20
We are only in network with Delta Dental Premier but we accept all PPOs. My staff more or less have a script that they go thru when patients ask if we accept their insurance, basically informing patients that we do, but are not preferred providers. On websites like healthgrades, when listing your
January 18, 2017
Marketing
Message Board
Views: 342 | Replies: 14
I recently submitted a claim to Anthem for sealants on a 13 year old. When we verified her benefits her plan says 100% coverage for Preventative but sealants only got covered at 50% When called insurance says its considered a basic service not a preventative service???? This is a start up just
December 16, 2015
Claims Processing
Message Board
Views: 221 | Replies: 19
If I provide insurance it will change next year as it always does and be pain in the neck. Was thinking I can get a group plan and pay 50% of their portion if they want it. Some of the staff may not need it and wonder why they don't get a raise. I could just give raises and call it a day
December 13, 2018
Legal Issues
Message Board
Views: 36 | Replies: 1
Moving out to Montana and looking for health insurance options. Any one know if the Montana Dental Association has a health care plan for members? Probably going on the Liberty health share plan if... There was one until last year. They had to discontinue it.
May 16, 2017
Medical / Health Insurance
Message Board
Views: 89 | Replies: 1
This may be a dumb question, but I always prefer to look at the procedure date to give us an idea of what the net production and expected collections would be for the day. For what reason(s) do you use the insurance payment date... We are the same as you as we only look at procedure date
March 11, 2015
Open Dental
Message Board
Views: 421 | Replies: 17
/parents when you first present the treatment plan? Do you give them any estimated cost or just tell them to hold tight until you get the pre-auth back? Any suggestions are greatly appreciated. If your office is computerized, you can create insurance plans and enter the coverage. That way, when you
May 10, 2017
Pediatric Dentistry
Message Board
Views: 3156 | Replies: 84
by BCBS to deny services to their insureds despite good faith payment of premiums. Due to the egregious nature of this claim decision and the pattern of denials for medically necessary treatment, a report will also be filed with the Texas Department of Insurance. This is the 3rd time I have written
October 31, 2015
Medical / Health Insurance
Message Board
Views: 882 | Replies: 10
For all those people who has acquired the office, Can you please provide me information, how you did manage insurance credentialing process? - Do you recommended third party credentialing firm to credentialing? - One credentialing firm told me that they could negotiate fee with the insurance
October 16, 2020
Practice Acquisitions
Message Board
Views: 203 | Replies: 3
Which state insurance commisioner do you file the complaint regarding Claim payments? Is it the State the Patients treatmendered or the State the Insurance Claims are processed. This not a self funded plan but from the employer. I would start with your own state's insurance commissioner
July 30, 2020
PPOs and HMOs
Message Board
Views: 223 | Replies: 2
I have a been a dentist for a year and a half and worked in corporate the whole time. I recently took some CE on PPO insurances and learned that submitting treatment that I render under another providers npi is fraudulent. Plot twist: every corporate group (and private practice) I have ever known
January 31, 2020
PPOs and HMOs
Message Board
Views: 48 | Replies: 1
I am working with Unlock the PPO, and they are asking for the Utilization/Insurance production report for the last year. I am running ver.13 of MOGO, which is no longer supported. I contacted MOGO and they will not help me unless I upgrade to a new version. I am planing to switch to another PM
August 31, 2018
MOGO
Message Board
Views: 298 | Replies: 11
, so the Insurance carrier refunded some money to the patient??? That is very kind of the Insurance Carrier, but it sounds like the dentist still got paid--- so where is the problem??? P.S. I personally do NOT believe that an Insurance Company would ever refund money to a patient
December 01, 2016
Legal Issues
Message Board
Views: 121 | Replies: 4
Reports within Eaglesoft. Search for the report named Managed Care Encounter Report by Insurance Company. After running the report you can find the subtotals for both Delta PPO and Delta Premier (Total Office Visits Numbers). You'll then reference your Overall Total Office Visit Number and then you
June 01, 2016
EagleSoft
Message Board
Views: 1119 | Replies: 19
Was wondering what the general consensus was on how to pay for personal disability insurance. My accountant is fine with having the office pay for it, but I have read that you should always pay for it personally. Perhaps pay for it personally and then maybe have the office reimburse me
March 01, 2017
Personal Finance
Message Board
Views: 182 | Replies: 2
When I first started practicing, the insurance salesman I started with talked me into one of these policies. Its from Minnesota life and its a Variable Universal Iife policy for 300,000. Its costs me around 200/ month and at this point has around a 9000 accumulated value. Additionally, I have
August 04, 2014
Personal Finance
Message Board
Views: 425 | Replies: 14
So i recently acquired a second practice and merged it with my own. The doctor was across the hall and we moved him and his staff into my office. It has gone well, except for insurance payments. We are not contracted with any company other than medicaid. He is now working for me part time
May 23, 2016
Claims Processing
Message Board
Views: 173 | Replies: 4
I was wondering what insurance code these are. I was thinking 1, 16 = simple ext 17, and 32 = surgical ext. 1,16=7140 17,32=7220 (soft tissue impacted) #17 could be a 7230 (partial bony) if the distal cusps have any bone over them. What if I could see the entire occlusal table including distal
November 11, 2014
Oral & Maxillofacial Surgery
Message Board
Views: 172 | Replies: 5
Hi All, I had a very basic question but don't quite understand how this works...if you do a new patient special, and a patient comes in with dental insurance-- do you charge out the insurance as the special?? I don't quite understand how it works Thanks I think you might best be served by dental
October 18, 2018
Claims Processing
Blog
Is there a marketing aspect to insurance? Mark and Howie explain.
July 15, 2016
by Mark D
Message Board
Views: 93 | Replies: 0
I just received a flyer from my liability insurance company (Professional Advocates Insurance) about a new insurance I can buy called Medguard. According to the flyer Medguard pays to defend you against certain administrative proceedings initiated by: -Hospital HMO/PPO Peer Review -Local
November 17, 2014
Legal Issues
Message Board
Views: 260 | Replies: 2
Anyone using a 3rd party for insurance verification. What I am looking for is a company with access to my dental software that will verify insurance then will place it as an attachment in my dental software into the patients chart. There is a company that does this called Medusind and they charge
October 24, 2017
Pediatric Dentistry
Message Board
Views: 59 | Replies: 1
I received a letter from dentalcareplus about stock offering. The guy said since inception (2005), the avg return has been about 9% including dividends. Has anybody done something like this before? The liquidity is not as much as you would get if you were selling your 100 shares of...
November 20, 2015
Personal Finance
Message Board
Views: 69 | Replies: 1
suggestions on whether this would be a good plan to sign up for? http://dealbook.nytimes.com/2014/01/07/oscar-a-new-health-insurer-raises-30-million try the NY insurance exchange brought about by Obamacare. My daughter is about your age. I got on the site and compared all the plans and found them
February 24, 2014
Medical / Health Insurance
Message Board
Views: 241 | Replies: 2
I was hearing a lot about billing/ preauthorization of certain dental surgical procedures in medical insurance. There are many services that claim they will do it for you . Also certain companies will train you and your staff,one that comes to mind is the Z Group headed by Dr Olya Julie Zahrebelny
February 06, 2015
Practice Management & Administrative Forum
Message Board
Views: 156 | Replies: 9
Is dental insurance dominating your practice? Is holding out on participation costing you patients? What if you could find some middle ground and a way to provide the patient care that meets your standards.What if dental insurance was just a small piece of the practice growth equation. Discover
October 10, 2018
CE Comments / Suggestions / Events
Message Board
Views: 319 | Replies: 2
Has anyone had an experience with being denied disability insurance benefits? What happened? What steps to take? Contact the company to learn their appeal process. I did for a knee replacement... It was a ADA policy with Great Western... I hire an Attorney and file an appeal in the state of origin.. And lost that one too. Stay healthy doug
May 07, 2014
Anesthesiology
Message Board
Views: 80 | Replies: 1
I think I already know the answer...If I am able to get an individual disability policy with prinicple with regular occupation (prinicples name for own occ) to replace my ada great west plan thats a no brainer right?My ada plan hd a small exclusion on it, principle is giving me no exclusions.Just...
February 28, 2020
Ask a Dental Consultant
Message Board
Views: 217 | Replies: 1
When does one need umbrella insurance? I am wondering if we are paying unnecessary premiums here. The office is rented, we don't perform sedation dentistry or oral surgery, have ample malpractice/liability along with the other required insurances. Thoughts or help here on questions I should
April 25, 2014
Disability Insurance
Message Board
Views: 193 | Replies: 7
Has anyone used a broker to help negotiate a fee schedule with insurance companies when considering joining... Contact Sandi at Unlock the PPO. She is a well respected Townie.Thank-you!... This podcast was an eye-opener for me. I had no idea this service even existed before I listened
May 02, 2017
Ideas To Make Your Practice Grow
Message Board
Views: 718 | Replies: 17
, United Concordia, DNOA and Delta then add associate. Otherwise revise your insurance roster and visit this issue again.One vote forgoing OON with delta would be best. Yes I would agree, if the PPO's your in network with have fees you can live with, then add an associate. If there are any
July 12, 2018
Practice Management & Administrative Forum
Message Board
Views: 158 | Replies: 4
I was looking at a the collections for a practice which is listed as 90% PPO and 10% FFS. The collections history for the practice breaks down the ~800k collections into patient pay (60%) and insurance pay (40%). the high percentage of patient pay was surprising to me considering the 9:1 ratio
May 09, 2018
Practice Acquisitions
Message Board
Views: 3683 | Replies: 139
. good luck. Let us know if it goes really good or really bad so I know if I should continue to recommend AHiX. DaveWe just went through this - our plan got dumped, and the new one they 'assigned' us was less than favorable. So we got together with an insurance broker and ended up getting a group
December 24, 2015
Medical / Health Insurance
Message Board
Views: 466 | Replies: 6
I am sure there are many topics on insurance credentialing but I can't seem to find the ones I need. I am in the middle of a sales (I am the buyer). I am already credentialed as an individual when I worked as an associate with a couple of insurance companies that the seller takes at the current
March 11, 2019
Practice Sales
Message Board
Views: 198 | Replies: 4
My first practice is being built and should open within the next 3 months. I have taken the initiative, due to recommendations here, and enrolled early. A major dental insurance company in February proposed a fee schedule. I signed and awaited my acceptance. Today I received contact that they had
April 07, 2016
Practice Management & Administrative Forum
Message Board
Views: 169 | Replies: 3
Do I need to keep buying professional liability insurance in early retirement? I'm 45 and preparing for permanent retirement within the next 2 years. It's extraordinarily unlikely but there's always a 'what if' chance of someone suing me for a short endo or open margin crown maybe 12 years
January 09, 2015
Personal Finance
Message Board
Views: 168 | Replies: 5
Hi All! I am starting to look for practices to buy and am wondering if disability insurance isrequiredfor a practice owner? Either by the banks or anyone else. Thanks in advance for the help! Was approved by Wells Fargo recently and disability insurance was...It is usually life and...Thank you
October 02, 2018
Practice Acquisitions
Message Board
Views: 358 | Replies: 2
I heard that Dentrix have a button that lets you verify/check insurance and another one that allows you to receive EOB digitally? This is what I heard recently but I really did not believe it. I want to switch to Open Dental soon and want to make sure that Open Dental offers the same capability
December 30, 2015
Open Dental
Message Board
Views: 202 | Replies: 4
such as yours. I can provide more info if interested.my two cents...the more doc providers you have (multi-provider practices) the less you NEED business overhead insurance since if one does go out for a length of time, the others will generally have rooms in their schedules to absorb the prod
August 20, 2016
Disability Insurance
Message Board
Views: 850 | Replies: 32
In my handbook I'm providing full time employees 50% of health insurance after 1 year of work. If the employee has a family and wants family coverage, then the individual will need to pay the rest of the family premium minus what their individual portion would be. However, my insurance broker told
February 21, 2015
Staff Management Issues
Message Board
Views: 418 | Replies: 5
Hello, I am considering using a vendor for outsourcing my claims submission and cleanup of aged insurance receivables. I'd like to hear from other folks on what their experience has been. It seems like a lot of money (3% of my production!) and I'm not sure if it's worth it financially. Also
March 13, 2019
Practice Management & Administrative Forum
Message Board
Views: 167 | Replies: 0
I'm writing, in short, to ask if any OMS on Dentaltown has had the PLEASURE of ever getting rid of insurance from their practice and still was able to put food on their table?? I practice in PA where reimbursement is about 50% of my dentalveolar practice and implant reimbursement is 85%. I find
April 19, 2014
Ask a Dental Consultant
Message Board
Views: 387 | Replies: 2
I'm looking at buying a practice and am trying to do my homework about whether it's a good location. One of the things I'm digging into right now is verifying how insurance heavy the practice is. My understanding is that insurance reimbursements are set by zip code (with certain differences if fees
July 10, 2017
Dental Insurance for Dentists
Message Board
Views: 480 | Replies: 10
We are growing and started taking some insurances. A/R is higher than normal due to outstanding insurance payments. I need to higher a new Insurance coordinator/collections Nazi. We currently have 1 front office manager and 2 assistants. We need to reduce the amount of duties my front desk has
September 21, 2016
Pediatric Dentistry
Message Board
Views: 435 | Replies: 21
Usually we charge 30k/arch with 15/15 split with the periodontist for a fixed hybrid. If pt has insurance usually the surgeon will use that up. We have a pt that is upset because she wants to use insurance fees and is insistent that it is higher than her insurance. Its Delta dental. The delta
September 03, 2020
Fixed Prosthodontics
Message Board
Views: 412 | Replies: 7
Hi guys, We recently started Invisalign treatment for 2 patients with Ortho coverage. They have $1500 coverage through Cigna and Aetna. The insurance companies told us to just submitD8090 (comprehensive orthodontic treatment of the adult dentition), and they would calculate the initial payment
February 01, 2019
Claims Processing
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