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Message Board (37850)
Dentaltown Magazine (455)
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Message Board
Views: 501 | Replies: 43
Insurances require an IO photo to show evidence of need for a build up. Can we bill the code to insurance? I would otherwise not take the photo, its sole purpose is for the patient to gain approval. If the insurance does not pay this code, I would be tempted to bill the small fee to the patient
August 21, 2023
PPOs and HMOs
Message Board
Views: 276 | Replies: 13
forms. She stops me and tells me that our Aetna insurance wouldn't cover one of the boys' visits because of the limit on how often he could get his annual checkup. Mind you, the route sheet only had the name of his plan and no insurance specifics. She said verbatim: 1 year and 1 day from his last
August 22, 2023
PPOs and HMOs
Blog
October 26, 2023
by The Dental A Team
Podcast
Season 2 - Episode 5 We'll often hear from doctors,I'm at a crossroads. I'm so busy that I need to do something. Should I add an associate or drop an insurance provider? If you're approaching a critical transition juncture like this - whether it be selling your practice in 1-5 years, bringing
April 08, 2022
by Bob Brooks
Message Board
Views: 105 | Replies: 1
I am considering filing a formal complaint to my state's division of insurance against an insurance company that refuses to pay. Has anyone done this before? Good idea or bad idea? What I do not want is my dental office to be included in any investigation. Opinions appreciated. The scenario
July 28, 2022
Practice Management & Administrative Forum
Message Board
Views: 194 | Replies: 4
My wife and I both have our health insurance through her employer. My wife is going to be retiring within about a year so we'll need to find healthinsurance. As you can probably tell from the title of my thread, I haven't really begun the search for what is available until just now. One year
March 16, 2022
General Health
Message Board
Views: 1525 | Replies: 59
Delta is worse than medicaid, because the patient benefits suck. I am seeing Delta kids, where the insurance dictates no pano until age 12 or 14, only sealants on 2nd permanent molars. This insurance company just keeps getting worse. I am also considering dropping Delta, but I have just starting
July 21, 2022
Pediatric Dentistry
Message Board
Views: 629 | Replies: 12
I have taken some denture courses and am using Dr. Massads techniques which requires compound impression and gothic arch tracers so I want to charge more. I am also starting to use a lab that charges more in the hopes of getting better quality. ButI am in network with one insurance company
July 18, 2022
Removable Prosthodontics
Message Board
Views: 93 | Replies: 3
We are talking at work about how patients do not know/understand how poor their insurance plans can be. In a quick search I saw a couple of websites in which patients can rate their dental insurance. Their ratings are obviously based on their perspective, ie how many free exams/cleanings they get
June 23, 2022
PPOs and HMOs
Message Board
Views: 179 | Replies: 7
Hello everyone! Can a provider who is in-network with an insurance company give a discount to the patients on their co-pay? E.g if the patient opts for same-day service, can we give a patient a % discount on their co-pay? Thank you! You are already giving insurance patients discounts. Why would
June 27, 2022
Claims Processing
Message Board
Views: 161 | Replies: 12
and submitted to secondary. Best way to ensure full payment and cooperation from patient, but most likely to hit resistance from patients with insurance. Do a best estimate of both primary and secondary payments, collect that and then bill the patient if they fail to provide the EOB in a timely manner
April 20, 2023
Claims Processing
Message Board
Views: 144 | Replies: 3
I am a second year dental student and wanted to know the best resources (podcasts, videos, books) to learn the basics of dental insurance from coverage, plans, groups, etc. I hear a lot of these terms in podcasts but I am lacking a basic understanding, so its lost on me.Also, is it different
May 15, 2023
Medical / Health Insurance
Message Board
Views: 1017 | Replies: 25
actively looking to hire but how do I manage the front in the meanwhile . How to learn verifying insurance and correctly estimate the copays.- a lot of candidates from other fields have been applying . I dont have room for error and bandwidth to deal with mistakes anymore .- I already have about 20 claims
March 12, 2023
Front Office Discussion
Message Board
Views: 1665 | Replies: 57
I am wondering if anyone could offer advice on disability insurance. I am in my forties and am currently healthy. My current policy has a monthly benefit of $12,000. I have an option of purchasing an additional policy for ~$1900 a year for an additional $5000 monthly benefit. So I would have
May 27, 2022
Disability Insurance
Message Board
Views: 115 | Replies: 6
Hi all I dont accept medicaid but it shows up on google search right below my office address in places listing like below. When I search myself with dentist ...xyz zipcode I logged in to google business profile and updated insurances I accept. But there are no listing or info regd medicare
July 04, 2023
Dentist Websites
Message Board
Views: 119 | Replies: 2
Do hygienists need their own professional liability insurance? They are licensed providers, after all. I'm in Illinois, fwiw. -M bump YesIts very inexpensive for them
July 16, 2023
Dental "Pearls"
Message Board
Views: 418 | Replies: 23
Call to verify benefits, insurance representative states twice what the annual max is. Person verifying asked twice because the amount was somewhat unusual. - $3900. I have proof this conversation took place. Did about $3800 worth of work. Of course EOB comes back that there was only $1,500
July 19, 2023
Claims Processing
Message Board
Views: 64 | Replies: 1
As the title says, can insurance terminate the contract with a dental office? I know dental offices can terminate contract with notice, I want to know if the opposite is true. I recently had a call with an insurance company with a complaint about our front desk insurance person. She is great
July 19, 2023
PPOs and HMOs
Message Board
Views: 79 | Replies: 1
Other than BOA, does anyone know which banks don't require life/disability insurance for practice loans under 1 million? thank you in advance Why you against the life insurance it is cheap? They won't require disability. I have a 10 year life ins plan for the loan it is less than 400 bucks.
May 03, 2023
Practice Acquisitions
Message Board
Views: 593 | Replies: 13
This is an insurance question, so not sure if this is in the correct section. I am in-network with an insurance company that has a very low D7953 (socket preservation graft) fee. Is a CollaPlug considered a type of Resorbable Barrier, since it is resorbable and it is abarrier to the graft material
December 22, 2022
Implantology
Message Board
Views: 185 | Replies: 3
What company do you use? And how is it set up? I'm embarrassed to admit that I haven't gone over my policy closely till now. Commercial liability - 1 mil damage to rented premises - 300k medical exp - 5k (does it need to be higher?) personal and adv injury - 1 mil Aggregate - 2 mill workers comp...
December 12, 2022
Equipment, Acquisition & Practice Expansion Financing
Message Board
Views: 1449 | Replies: 55
benefits contract you would probably find precise language in there about when surgical extractions are a billable charge. You will have more success fighting insurance company disputes when you fight on the terms they actually care about (i.e. contract law language). Wow In my current gig we are all
October 03, 2022
Claims Processing
Message Board
Views: 325 | Replies: 15
actually had a different deductible than my building and roof. It took six days untill we had cell service and even longer for internet so communication with your insurance might take as long as a week to get started...... Now the important part of salvage after a day or two of sunshine there should
October 06, 2022
Dental "Pearls"
Message Board
Views: 61 | Replies: 3
So I have a pt that has primary insurance with metlife and secondary insurance as medicaid. Im trying to bill a cast metal framework denture and metlife covers 50 percent for it. The remaining 50 percent, can I collect from the pt since medicaid does not cover for that procedure? My office manager
January 20, 2023
Claims Processing
Message Board
Views: 2301 | Replies: 130
of retirement so Millennials and Gen Zs can count on it as well. But, Timmy, lets not get this thrown into the political thread eh? Do you have an out of pocket maximum with Medishare? Thats the only thing I want with health insurance. Protection against financial ruin. How dare you!This is a public website
December 12, 2023
Just Plain Bitching and Moaning
Message Board
Views: 2206 | Replies: 82
not sure what you mean by that. I just asked my front desk. They never call. We also do not accept AOB. If a patients says their insurance didn't pay, my front desk will resubmit it again for them but that's it. If a patient says can you call and appeal, she simply says No. I won't do that but I
December 10, 2023
Delta Dental
Message Board
Views: 397 | Replies: 10
I have had term life insurance for a while but I need to do some revamping of our policies. My wife and I are in our 40's and are looking at term policies with long-term care. However, we are wondering if we should consider whole insurance in addition to or instead of term. But I honestly do
February 13, 2022
Life Insurance
Message Board
Views: 240 | Replies: 15
I lost all suction in all 4 of my operatories because a pipe underneath the concrete floor broke. I now need all new pipes and the plumber recommends ceiling pipes because he doesnt want to drill out all the concrete floors. will my building insurance help pay for this catastrophic repair? How old
February 14, 2022
Equipment
Message Board
Views: 415 | Replies: 9
Seems like insurance companis are getting more agressive with declining periodontal treatment these days. I need to write an appeal to Aetna on this one. I would appreciate your thoughts. Healthy 40 year old female. BOPs multiple locations. My substitute hygienist (the world we live in now) probed
February 16, 2022
Periodontics
Message Board
Views: 595 | Replies: 31
verifications for free. 10 bucks seems cheap. Thanks, paf. We have recently dropped some insurance plans and picked up others so we are doing quit a few breakdowns right now. But yes, I agree with you. I delegated a lot of this stuff and am now having to relearn it. That seems like a tremendous amount
April 28, 2022
Practice Management & Administrative Forum
Message Board
Views: 276 | Replies: 4
Am I able to deduct my health insurance premiums as an expense either through my S-Corp or my personal return due to being self-employed? I'm a 50% owner in a dental office (ABC Dental, LLC). Both myself and my partner are structured as employees of our individual S-Corps. (I.e. Dr
December 30, 2023
Personal Finance
Message Board
Views: 85 | Replies: 2
I had a fire last year and lost my entire practice and all my equipment. I have bought all new equipment but my cpa is saying I cant put any of it on a depreciation schedule because I used an insurance pay out to purchase the equipment? Is that right?Also I have a big tax bill this year
April 10, 2024
Taxes
Message Board
Views: 159 | Replies: 3
Are there other insurance options for someone who has already been denied disability insurance due to sleep apnea (managed with a CPAP)? Thanks in advance. They actually stated that ? Thats crazy! Yep. They said sleep apnea is a big pre-existing condition and they're very stringent about
August 13, 2024
Disability Insurance
Message Board
Views: 390 | Replies: 6
Seattle-area dental insurance is like a joke. But few are smiling. Grandy Au, a dentist, right, and Limei Li, a dental assistant, give Jason Wu from Renton a checkup and cleaning at the International Community Health Services on June 11. ICHS provides low-cost dental services. The people
August 23, 2024
Medicaid and Welfare Issues
Message Board
Views: 215 | Replies: 7
I am starting an office and have a few oddly specific questions... 1. How do I find an insurance companies Payer ID for a third party clearing house? Having a hard time because patients have no idea and my software requires this. 2. If my third party clearing house doesn't have the Payer ID
May 16, 2024
Practice Management & Administrative Forum
Message Board
Views: 434 | Replies: 17
you want to do fluoride? then they should be retrained. They need to understand why they are recommending it and actually say, I recommend bla bla bla. I don't let insurance dictate what I think it best for the patient It is a great preventive treatment IMO but certainly up to the patient to pay
May 06, 2024
Fluoride
Message Board
Views: 123 | Replies: 2
I have a small FFS private practice which I'm getting ready to transition to a new owner. She will be staying OON as well. We don't accept assignment of benefits, but do file insurance claims for our patients. For the next couple months she's working scattered days as an associate to get to know
January 12, 2025
Going Out of Network
Message Board
Views: 350 | Replies: 16
Ok dentists... Medical Insurance Plans for our Families... What do you do for a family? I am getting my renewal for insurance and it has gone up another 18% so my auto monthly payment for 5 people is $2,120/mo! That gives me a deductible of $3,200 per person where I pay 100% out of pocket
October 03, 2024
Retirement Planning
Message Board
Views: 1480 | Replies: 60
1. Buy a lot of business cars and encourage each existing patient to give one to their friends, family member, co-worker, neighbor. For each referred new customer you might want to give a small reward to your current patient who did the referring. You can track it by asking current patient to...
November 30, 2024
PPOs and HMOs
Message Board
Views: 109 | Replies: 2
There was a thread about using Claim connect to verify insurance and benenfits on Open Dental back in 2016. Now eight years later, I am asking the same question. For everybody who is using Open dental and software to check insurance and benefit, what do you use? I am told that Claim Connect works
February 19, 2025
Open Dental
Message Board
Views: 544 | Replies: 16
I am considering offering an employee health insurance stipend as opposed to offering health insurance. Pros 1.) It takes away the headaches of the admin associated with a health plan 2.) It takes away the scenario of employees coming and going and finding myself in a situation where only 1 or 2
February 16, 2025
Staff Management Issues
Message Board
Views: 406 | Replies: 6
As we wind down 2024, a few insurance oriented thoughts that may be helpful as you gear up for 2025: 2024 continued to be a year of very challenging staffing costs. One of the biggest complaints in dentistry is that hygiene costs in particular have gone up substantially and insurance fees
January 02, 2025
Practice Management & Administrative Forum
Message Board
Views: 103 | Replies: 9
Hey All, I ran into a situation today that my insurance/AR coordinator made me aware of. We have been fighting with a patient's primary and secondary insurance to get a claim paid. The total amount outstanding is approximately $285 and no one seems to want to pay it. Is there anyone out
December 20, 2024
Claims Processing
Message Board
Views: 248 | Replies: 11
I've always been taught to submit a dental insurance claim on seat of a crown, partial or occlusal guard, etc. Is this a national thing that all states do? Or is is state specific? Thank you! Submit the day you started the work, AKA prep or impression day. Some insurance plans make it where
May 25, 2025
Claims Processing
Message Board
Views: 110 | Replies: 0
Supposedly had the highest RCT billing for a gp. Did she do them or just say she did?If she did them were they done well?Either way what about dentists pulling good ones claiming they cause cancer?
June 06, 2025
Ethical Issues
Message Board
Views: 52 | Replies: 0
Hi all, I close on my practice a couple weeks ago. I am working on getting credentialed with insurance at this location - many insurances I am already in network with, just need to add this as a new location. I am seeing patients in the meantime however. What is the best way to handle this when talking to patients? I'm not sure how to bill them or what price to set? Looking for some guidance. Thanks!
June 02, 2025
PPOs and HMOs
Message Board
Views: 352 | Replies: 14
Insurance co's have been sending us payments via credit cards -- that dings us for another 3% of the total (merchant fees), AND the insurance co gets points which they can redeem. Someone please give me a tip on how to fight these beasts. Thanks ;) Jim Just request for efts or checks. Also you can
April 03, 2025
PPOs and HMOs
Message Board
Views: 113 | Replies: 4
someone you've never seen before, is there some D9999-type code that you add, or do you just tell them their insurance is garbage and you can't/won't help? If the lab fee is above the Insurance fee I won't do it. On some of that low reimbursement denture stuff I'll repair the crack with a little
October 07, 2025
Coding Q&A
Message Board
Views: 1804 | Replies: 142
good But the next question patients always ask is does my insurance cover it? I can't understand why everyone is so focused on what insurance covers in this office vs what they NEED. My office manager has said the same thing to me as well about our patients here. They're just so focused on insurance
August 21, 2025
Ideas To Make Your Practice Grow
Message Board
Views: 524 | Replies: 25
insurance plans, most of which are duplicates, and they do not have any fee schedules. We're leaning towards just starting over in CareStack instead of trying to clean up Dentrix -> migrate. I know this will be a time-consuming process up front but think the accuracy and lack of clutter will justify it when
September 08, 2025
Practice Management & Administrative Forum
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