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Message Board
Views: 331 | Replies: 6
I am purchasing a practice from the previous owner but I have been working in the practice as a provider. I am credentialed under all of the insurance plans that he takes. Everything will remain the same except the business entity(LLC) and the business npi number. Do I have to completely fill out
July 12, 2023
Practice Acquisitions
Message Board
Views: 256 | Replies: 14
Im an associate at a group practice that is FFS/PPO. New patient comes in to become established. She gets a prophy the same day and I end up doing 4 fillings later that week. Turns out she had an HMO insurance plan that my front desk didnt catch. Patient called in being expectedly upset over
July 07, 2023
Claims Processing
Message Board
Views: 1262 | Replies: 25
Looked on existing threads. When is it best time to cancel disability insurance? When is it no longer needed? When you feel safe and certain that without that disability money you can support yourself and family in case something happens to you.Because of my health history I pay a whopping $525
July 09, 2023
Personal Finance
Message Board
Views: 129 | Replies: 4
This is what a gorilla going to the dentist looks like: Gorillas... they're just like us! My brother GP DDS did some of this for a large metropolitan zoo years ago. They wanted a DDS to work with the vets. I think he worked with the large cats also. Edit to add he is retired now but a former...
May 01, 2023
In the News
Message Board
Views: 2206 | Replies: 82
We have decided to leave Dental Dental Insurance in our practice. We are notifying our patients that we will be out of network with the insurance. My partner and I do not know much about dental insurance and rely heavily on our staff for the answers in regards to dental insurance. Some of our
August 02, 2023
Delta Dental
Message Board
Views: 114 | Replies: 1
Hi, wanted to ask about your experience with malpractice insurance. I am finishing residency this month. I know new residents can get malpractice insurance for $50 the first year. Which one is better EDIC or medpro. What are the different benefits they offer? Some companies are bigger than others
June 30, 2023
Malpractice Insurance
Message Board
Views: 408 | Replies: 5
Which malpractice insurance company would you recommend for a specialist working as an associate in NY (0 claims)? What do you look for when you choose? I will choose occurrence policy and not waiving rights to settle. Is there anything else to look for? Medpro is too expensive. Debating between
June 30, 2023
Dental Liability Insurance
Message Board
Views: 389 | Replies: 5
So the partnership structure that we have is I believe pretty standard. We have an overarching partnership entity which is an LLC and then I have my own personal LLC (S filing elected) and my partner has his LLC (S filing elected) that each own 50% of the Partnership entity. Our local insurance
December 22, 2022
Partnerships and Associates
Message Board
Views: 38 | Replies: 1
I am looking into a renting an office on the days they are closed at a daily rate possibly 1 day a week to start. I am confused with how to get credentialed with PPO insurances. I am currently working at another practice where Ive obviously been credentialed but now since Im subletting Ive been
January 09, 2023
PPOs and HMOs
Message Board
Views: 52 | Replies: 1
So my office manager is frustrated with this one family who has dual insurance. We are now OON with Delta and that is the primary. She files with them and they cover like 75% of the recall prophy and exam. She waits to get the amount they cover and then submits to their secondary which is UC
January 11, 2023
Claims Processing
Message Board
Views: 170 | Replies: 2
I am in the process of an acquisition. I have not put in my notice at my current job. Can I start the process of getting credentialed without my current employer knowing? As long as you have a new EIN you should be good, but why do you care if you have given notice? Doesnt matter about your old...
January 30, 2023
Practice Acquisitions
Message Board
Views: 2301 | Replies: 130
plan is to work for a company big enough to take the money pretax and pay some of the premium! Unfortunately, most of us in private practice don't have that luxury. Spouse getting a job that has benefits? Wait, you're paying almost $3K per month for health insurance? Why? Average monthly premium
December 10, 2023
Just Plain Bitching and Moaning
Message Board
Views: 195 | Replies: 5
Hows it going, I work in a dental office in Boston area that has general PPO mix of government plans/private insurances. In an attempt to increase efficiency, the office is adopting block scheduling for doctors and hygiene. It was proposed to block by insurance. Is it legal to block new patient
February 28, 2024
Legal Issues
Message Board
Views: 115 | Replies: 7
Wondering if owner medical insurance is tax deductible in an S-Corp? If the s corp paid the premiums, then I think it is. But I think it is reported as wages on your W2. Check me on this - not 100% sure. Then deducted on the 1040...totally deductible Thanks, I thought so, but couldn't remember
January 20, 2024
Practice Management & Administrative Forum
Message Board
Views: 566 | Replies: 22
As we are entering a new age is it a good idea to provide medical insurance and what will that do with our overhead?What are dsos offering their staff and what percentage of their medical insurance do they cover?What kind of insurance to they provide ? Basic hmo or top of the line ppo
January 07, 2024
DSOs Dental Group Practice, Multi-location Dental Practices, and Dental Su
Message Board
Views: 89 | Replies: 0
I might have found a suitable startup space (pre built 4 ops with more room available) to finally transition from associate to owner. Flexible lease terms. I have two questions to ask the experienced folks around here: 1. If i were to use a company to help negotiate the best insurance participation
January 23, 2024
Practice Start-Up
Message Board
Views: 42 | Replies: 1
Greetings. We have a family of five who have been patients of record for a number of years. Apparently there's been a job change and they have different insurance in which we do not participate. My Front Desk asked if we had a duty to inform them. Do you have to no...but why wouldn't you? First
February 15, 2022
Front Office Discussion
Message Board
Views: 336 | Replies: 7
So just took over a FFS practice. Selling doc was OON for all insurances which I plan on continuing. We do submit claims for pts though. Do I have to go to each individual insurance company and fill out a form to get into their system? is there a faster easier way to do this? Selling dr didnt
April 23, 2022
Claims Processing
Message Board
Views: 124 | Replies: 4
Hi. One of the my procedures was denied by insurance. Instead of alerting me about this, my employee simply adjusted it off. What would be a better EOB/claim audit process that will alert me of any claim issue? Thank you. In the daily reports you generate. I pull daily sheet, adjustment report
May 01, 2022
Claims Processing
Message Board
Views: 42 | Replies: 0
Good morning. I am looking for a good CE course for my front office on posting and cleaning up claims.
May 11, 2022
Billing
Message Board
Views: 454 | Replies: 8
The only reason I am a ADA member is for their disability insurance. I just got a notice that the have transitioned away from Great West to Protective. Does anyone know anything about this? It says it is own occ on the website. I just wonder why they changed on me? I believe this change
May 03, 2022
American Dental Association
Message Board
Views: 411 | Replies: 8
an insurance audit on the practice, and if so what were the results. Is this public information? Could I, for example, just call up one of the contracted insurance companies and ask, or is there a better way? Thanks in advance for any ideas. This is not a public information. You wont be able to find
May 23, 2022
Practice Acquisitions
Message Board
Views: 149 | Replies: 2
Im confused with the terminology and codes. Is a screw retained crown an implant supported crown? If so would this just be one code? If cemented, would you use 2 codes? Why am I so confused about this?!!!! Weve only been billing one code. I think its usually 6058(?) please someone clear this up for...
May 23, 2022
Implantology
Message Board
Views: 17 | Replies: 0
For anyone who lives on the coast, has anyone been able to secure a business interruption policy or some type of line of credit in case a hurricane hits?
March 03, 2022
Practice Management & Administrative Forum
Message Board
Views: 1317 | Replies: 46
Patient comes to dentist. We offer to take insurance payment directly as a convenience. Insurance company sends patient the check. patient never pays us. They basically got paid to come to the dentist for treatment. How do you handle such poor behavior? In my financial statement it says
February 09, 2022
Claims Processing
Message Board
Views: 279 | Replies: 10
what will they owe out of pocket after insurance and then we take the check from insurance . it takes a lot effort for staff to do that . is there a better way ? can we charge full fee upfront and send them their insurance check ? the front desk is arguing that patients will be upset if the ended
May 25, 2022
Billing
Message Board
Views: 337 | Replies: 15
I know we must always collect deductible, but in certain cases is it allowable to waive patient coinsurance and only collect insurance portion? Sure, but the following will be true: you are committing fraud if you are submitting the full fee to insurance, you are inviting the most vile type
December 05, 2023
PPOs and HMOs
Message Board
Views: 136 | Replies: 6
I am currently looking into getting a scanner for crown impressions from a dental lab. I have to maintain insurance on the device. Anyone care to share their own recommendations with this? My businesses have insurance for the contents of the building and separately for the building itself. I use
December 23, 2023
Digital Impressions
Message Board
Views: 174 | Replies: 5
that is owned by MODA Insurance which also affiliated with Delta Dental. What Im worried about is Delta sending all their subscribers a letter saying they now have a Delta Dental practice in the area and they can be seen there. I have a big problem with an insurance company owning a DSO. Im under
January 15, 2024
DSOs Dental Group Practice, Multi-location Dental Practices, and Dental Su
Message Board
Views: 149 | Replies: 12
the patient already. Do I refund the patient or keep it since our full fee is $1600? Are you in or out of network with Delta? I assume you are INN because of the question. The patient is responsible for the lowest fee schedule. The office can collect up to full fee from insurance. Given your
October 20, 2023
Claims Processing
Message Board
Views: 185 | Replies: 4
Hello Colleagues, I'm reaching out for advice on improving the accuracy of insurance coverage estimates in my practice as an Out-of-Network provider. What strategies, tools, or communication techniques have you found effective in obtaining reliable insurance breakdowns regarding their coverage
January 25, 2024
Going Out of Network
Continuing Education
Continued drops in dental insurance companies' reimbursement fees and rule changes make the business of dentistry a constantly changing landscape. This course will show you how to make sense of this changing reality, its impact, how to re-position your practice in relations to insurance and, ultimately, enjoy new professional and financial success. If deciding to drop insurance, helpful steps and verbal skills are given to use with patients.
March 2019
Practice Management, HR and Accounting
Continuing Education
expertise as Lead Faculty for Mercer Advisors and 30 years of involvement with the Pankey Institute make this a unique learning opportunity. This program will help you and your team be more aligned towards the practice vision and mission. The shift from traditional dental insurance to over 80
September 2018
Practice Management, HR and Accounting
Message Board
Views: 106 | Replies: 3
for medicaid is higher than delta but the unreliability of these patients makes me want to consider taking this practice towards a few PPOs and away from medicaid. So my question is, is there a resource available to look at insurance popularity by zip code? I'd like to see what insurances are popular
April 13, 2024
PPOs and HMOs
Message Board
Views: 59 | Replies: 0
Hello everyone, I am a resident thinking to get disability insurance and was wondering what you recommend. I got a quote from Northwestern Mutual for $121 a month for $3,500 coverage with the option to buy more coverage. Does this sound like a good deal? Thank you
April 24, 2024
Disability Insurance
Message Board
Views: 185 | Replies: 12
Damn, spent 45 years without ever having to ask this damn question, I do not deal with insurance companys, I work for the dentist But i did evaluation for the dds (which ive done a hundred times before) basically he has 3 very old chairs, 2 deze and 1 chairman that got saturated over the weekend
July 17, 2024
Equipment
Message Board
Views: 290 | Replies: 7
As new grad first year was very cheap for malpractice insurance. Its time to renew and now its close to 4k. Any leads on reducing cost of malpractice insurance or any other companies that can give lower rate? Id recommend checking out Medpro. 4k? Is that just professional liability or does
July 24, 2024
Malpractice Insurance
Message Board
Views: 263 | Replies: 7
Insurance downgraded D4341 to D4342. Can we charge patient the difference? This is a depends type of answer: - Insurance cannot legally dictate diagnosis, it is a breach of every state dental board laws However, that being said, most dentists are inadequate in their documentation of cases
July 31, 2024
Coding Q&A
Message Board
Views: 77 | Replies: 1
Hi, whats everyone paying for disability?I got a quote from protective for $450/3 months. Im 27/M.Benefits COLA, $9500 a month, and a $1000 increase until I get to 15000/month for income. Lets see if anyone can get you some answers?
August 03, 2024
Ask a Dental Consultant
Message Board
Views: 138 | Replies: 3
I'm looking to outsource dental insurance collections in my office. Does anyone have any suggestions towards a company they recommend? Billing in general? Tom Lee outsource his to the Philippines and it works well for him. Mark Im looking for an outsourcing company to take care of my insurance collections and posting. The pt collections we could probably take care of.
March 21, 2024
Billing
Message Board
Views: 2871 | Replies: 80
it. That would be a piece of cake, any delta patient pays a clinical access fee per visit to make up the write off The insurance companies have bullied us into believing that any deviation from their dictates is fraud. It's a loaded and scary word that is used to bludgeon health care providers but also leaves
June 13, 2024
Coding Q&A
Message Board
Views: 92 | Replies: 3
buy health insurance for the entire family? I'd asked Gusto, but they said that I should apply for health insurance after COBRA runs out. However, on my end, I don't think COBRA running out is a qualified life event. I'd like to act intelligently. I don't want to be Penny wise, and Pound foolish
August 23, 2024
Practice Management & Administrative Forum
Message Board
Views: 175 | Replies: 4
From the article: Frequency limits within the dental insurance landscape are something that dentistry has learned to navigate. Now, the landscape appears to be changing, said Rod Hill, D.D.S., a former member of the ADA Council on Dental Benefit Programs. While we as dentists have learned
May 19, 2024
PPOs and HMOs
Message Board
Views: 73 | Replies: 1
Hello, I have been practicing for a long time and recently acquired my own practice, set up a corporation for myself,/FEIN and got an NPI 2. I'm having issues with getting paid by OON insurance. I am only in network with one PPO insurance, and to date that is the only one that has paid me
January 29, 2025
Claims Processing
Message Board
Views: 34 | Replies: 1
I own a building and use it for my own office. I plan to sublease 2 of 4 operatories for five days a week. They will share the waiting room, reception, lab, sterilization, lab, restrooms, and parking. Am I able to have them add me to their professional liability and business insurance
January 22, 2025
Legal Issues
Message Board
Views: 423 | Replies: 10
Hi all, just wondering if anyone has had a situation similar to mine. I have been in network with an insurance company since I bought my practice nearly 13 years ago. At the time, the insurance company was called POMCO, but several years ago it was bought out by UMR. My contract was grandfathered
September 25, 2024
Going Out of Network
Message Board
Views: 176 | Replies: 10
Has anyone received a premium rebate from their office health insurance plan?I received a rebate check because the insurer did not spend 80% per the medical loss ratio regulation. Im not sure how to calculate how much is due to each employee and how much is due to the employer. Any help appreciated
October 12, 2024
Medical / Health Insurance
Message Board
Views: 141 | Replies: 4
Insurance reimbursements rates vary between states. But shouldn't the rates vary a lot within a state also? Should a dentist's reimbursement form Insurance Company X be the same just because they are in the same state? The practice in Manhattan, NYC and the practice in Upstate New York
October 20, 2024
PPOs and HMOs
Message Board
Views: 170 | Replies: 4
the first set as D5810/5811 Interim complete dentures, the second set is the usual D5110/5120. The issue here is the insurance fee for the interim set barely covers lab and overhead. Are there any creative ways within the insurance rules to be able to do this profitably? Can I bill for Immediate
November 10, 2024
PPOs and HMOs
Message Board
Views: 105 | Replies: 3
So my front office sent out a pre estimate for exts and bone grafts. Per insurance they said they would deny if billed together. They said to bill grafts first. How is this possible??? How can you bill a graft first?? How do you code for coverage? All they are telling you is bone grafts aren't
November 28, 2024
Claims Processing
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