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Message Board
Views: 220 | Replies: 1
i am in the process of purchasing an existing practice (in network only with delta premiere - however does accept some out of network assignments with a few insurance companies). i am currently an associate and will be leaving that job once I become an owner. when should i contact the out
August 21, 2015
Practice Acquisitions
Message Board
Views: 428 | Replies: 13
Hello, I am the only business assistant in my office, and we are growing! It's great, but I am getting overwhelmed with trying to keep up with everything. I don't think we need to outsource insurance claims and billing, but it is so time consuming to verify benefits on every patient, every day
April 16, 2020
Claims Processing
Blog
I am in charge of posting Insurance payments and we get most of our payments electronically and I just came across a situation where the insurance company deposited the electronic funds into someone else's account for 2 of our patients. After several calls to the insurance and insisting further
August 30, 2016
by rfdeleon
Message Board
Views: 170 | Replies: 4
forward 3 months and today they tell me sorry we can not do anything because our senior management is cutting fees and we aren't able to do anything. I am pissed. Do I file a complaint with the state insurance commissioner's office? Also I had signed up for a third party company with a higher fee
September 11, 2019
PPOs and HMOs
Message Board
Views: 233 | Replies: 5
So I decided to offer health insurance to my employees and at least pay for some of it . but I want to give them the option of PPO or HMO but it will cost me more if they choose it... So I'm thinking of saying if you choose the HMO or the PPO we will have to renegotiate your pay (for instance
June 02, 2017
Practice Management & Administrative Forum
Message Board
Views: 443 | Replies: 6
I work in a corporate office, I am the only dentist there. Recently, I had the regional manager coming over to my office and asking my office manager to charge an enhancement fee for PPO insurance for Full Zirconia crowns and Layered zirconia crowns. So they charge the patient his copy of D2740
July 22, 2014
Staff Management Issues
Message Board
Views: 59 | Replies: 2
Im losing a great insurance coordinator, and am wondering if outsourcing this part of the business is a potential good move. Is there anyone out there who has worked with one of these companies that could share their experience? Thanks! Current topic on this: Outsourcing is a great tool
September 28, 2020
Practice Management & Administrative Forum
Message Board
Views: 71 | Replies: 2
Hi, I was wondering what's the requirement in order to be preauthorized for braces in both PPO and Medicaid. Do we need to send them usual 8 photos with x-rays? If so, what are the x-rays that they want? And do we need to write anything such as % overbite, overjet, skeletal and dental...
June 02, 2021
Orthodontics
Message Board
Views: 46 | Replies: 0
Hello, I received insurance quotes for my startup for Life, Business Owners Policy (BOP), Lessors Risk Only (LRO), and Builders Risk Policy. Anyone know if these numbers are within reasonable range? Again, any input would be greatly appreciated. Thank you so much! Life insurance for $1mil term policy: $358 BOP annual premium: $1033 LRO annual premium: $1351 Builders Risk annual premium: $576 (this would less b/c won't be for the whole year)
June 16, 2021
Life Insurance
Message Board
Views: 67 | Replies: 2
Good morning everyone. Have a insurance question. I am in network with Dental Select Platinum and have a patient who has the silver plan. wondering what fee schedule Do I use? I cannot charge her the UCR fee right? Please guide me in the right direction. Thanks Dental Select fee schd is like less
February 05, 2021
PPOs and HMOs
Message Board
Views: 361 | Replies: 8
Would someone recommend a company to negotiate fees with dental insurance companies for a four doctor group. Three pediatric docs and one orthodontist. We signed up with Apex reimbursements last year and they are terrible. Mainly just send emails back and forth between your manager n someone
March 10, 2021
PPOs and HMOs
Message Board
Views: 100 | Replies: 1
If we take Bitewings and Pano on same day, insurance downgrades to Full Mouth Series fee. It was suggested to take them on different days so for a new patient get Bitewings and the next visit do the Pano. Is this ok? Would that raise any red flags with insurance? What do you do in your office? 1st appt you bill out 4 bwx and 2 pa. Next visit you bill out pano
July 17, 2021
Digital Radiography
Message Board
Views: 81 | Replies: 4
Hi, So we are having trouble with filing with the secondary insurance. We only have a handful of patients that have double insurance. We normally file insurance claims with our contracted fees. In the case of double insurance, what is the right way of filing? We file with the primary with our
June 24, 2021
Billing
Message Board
Views: 57 | Replies: 2
Hello All, I am in the process of negotiating my dental insurance plans and I am needing a breakdown of active patients and which insurance plan they belong to. I've contacted dentrix and they were not much help in retrieving this information. I was wondering if Townie knew how to run a report
May 10, 2021
Dentrix
Message Board
Views: 222 | Replies: 6
deposit. Buyers do not take that for granted- make sure your seller stops their direct deposits. I informed Delta and blue cross ( the two insurances we are in network with). That I will be buying the practice on the date of sale. I got the sellers letter we both signed it. Filled out all
May 21, 2021
Delta Dental
Message Board
Views: 162 | Replies: 2
I'm buying a practice, and the seller currently does not offer health insurance to staff. My spouse will be working with me at the same office as my associate. Is it possible to get health insurance only for myself and my spouse through my entity? Maybe a CPA can chime in here. But in my opinion
July 30, 2021
Medical / Health Insurance
Message Board
Views: 243 | Replies: 11
This is kinda a rant, but all Im going to say is if you plan to buy a practice get your disability insurance early. Had it through company previously which doesnt work. I thought I would apply 4weeks before closing and this has turned into a total nightmare. Im healthy too just on one pill
July 29, 2021
Personal Finance
Message Board
Views: 88 | Replies: 3
Hello All I'm looking for an insurance specialist who can help us with various insurance company issues, such as choosing the best insurance fee schedules to join, navigating out of the insurance alliance network, handling calls from insurance companies demanding refunds from claims they paid us
July 28, 2021
PPOs and HMOs
Message Board
Views: 102 | Replies: 0
Hey all I am interested in dropping some insurance plans, potentially delta dental. I was wondering if there are advisors or consultants out there to help with this. I reached out to Unlock the PPO but unfortunately they are not working with offices that have multiple doctors at this time(We have 2 doctors). Any other potentially good contacts? TIA!
August 04, 2021
Going Out of Network
Message Board
Views: 165 | Replies: 7
I'm not sure what to do in this situation. We have a patient who normally likes to pay at time of service and then submit claims herself. In one instance she paid at time of service for cleaning, exam, xrays a total of $170. My front office then submitted the claim for some reason. The insurance
January 06, 2022
Claims Processing
Message Board
Views: 104 | Replies: 0
We received notice that the Medical Insurance plan that we offer through the office will be going up 16% for 2023. The office pays a percentage of the premiums and the employee has the rest deducted from their pay. We are in the process of hiring another assistant. Thoughts on offering 2 options
November 11, 2022
Medical / Health Insurance
Message Board
Views: 280 | Replies: 5
verification perspective. I agree that it is misleading to call this 3 per year plan. Inscos suck like that. Great title for a thread, but I think among this crowd its understood. The crap they have pulled or tried over the last 30 years has led me to never refer to dental coverage as insurance.. its
October 27, 2022
Claims Processing
Message Board
Views: 346 | Replies: 15
For the practice I have a retirement account set up which I am maximizing in addition to a traditional IRA we are converting to a backdoor Roth IRA. In addition to the retirement account, my financial advisor is recommending overfunding a life insurance policy. He is saying that I can get
November 01, 2022
Personal Finance
Message Board
Views: 286 | Replies: 5
Has anyone had MetLife sent a letter wanting to visit the office for site evaluation and review x rays, restorative, and endo treatment in your office? Thanks! Ive never had any insurance companies come in for a spot visit. Should I be concerned? What are the ramifications if I decline their visit
February 18, 2023
Going Out of Network
Message Board
Views: 169 | Replies: 8
Hi! I have a question about patients with 2 different insurance plans. This is a bit complicated, but I will try to be clear. Normally we submit to the primary, then once paid, submit the EOB from the primary with a claim form to the secondary. What has raised some questions recently
February 21, 2023
Billing
Message Board
Views: 95 | Replies: 2
Here is my situation. Currently practicing in a small private practice out of network with insurance. I have purchased another practice and building within 2.5 miles of my current location and planning to merge into that practice so I can update equipment, control the rent, etc. Most of my current
February 22, 2023
Practice Acquisitions
Message Board
Views: 124 | Replies: 2
Hey there, I work in a two doctor practice - we have a PLLC made up of our two individual S corps if that matters We each have our own malpractice policies. Does the partnership itself, covering the practice name, also need a malpractice policy? My malpractice carrier (Medpro) said the...
March 20, 2023
Practice Management & Administrative Forum
Message Board
Views: 50 | Replies: 2
Does Guardian, Aetna, Humana, DHA-Sunlife has web acess to check for patient eligibilty? Humana goes through availity and their requirement is worse than acessing pentagon. So gave up half way Aetna doesnt display patient eligibility or pertinant info once you log in. Guardian.. Havent tried. DHA-...
March 21, 2023
PPOs and HMOs
Message Board
Views: 329 | Replies: 8
again because there are only 150 views on this thread yet it's one of the most relevant actions I've seen regarding requiring dental insurance premiums being used for actual care. There are thousands of posts and views about what a mess dental insurance is (many by me) and I'm really hoping every
March 26, 2023
Claims Processing
Message Board
Views: 278 | Replies: 2
I was lone wolfing it at work after hours today and had a question for Eaglesoft live. The question was in regards to something unrelated to the issue that came up ( I was trying to generate a certain report) but to make a long story short this rep was telling me that we posted an insurance write
March 28, 2023
EagleSoft
Message Board
Views: 536 | Replies: 16
to the tooth healed shortly thereafter. The insurance is paying for the crown and not the build up claiming it is not needed for the retention of the crown. I too am an ex insurance consultant (I reviewed rejected claims on appeal only). I would have to agree with lingual access restoration, declining
April 16, 2023
Endodontics
Message Board
Views: 157 | Replies: 4
who will come to the office under the pretense that they do not have insurance or have an alternate insurance that we are out of network with. Once they get in we have had multiple families switch to Delta dental and expect to see me because of their new insurance plan. Does anyone have a letter
June 20, 2023
Delta Dental
Message Board
Views: 319 | Replies: 15
I'm using a company to help negotiate and credential with insurances. They recommend signing up with Delta Premier only since Delta PPO fee schedule is low. A couple questions from those that have been through it before: 1) My concern is patient retention, I have no patient loyalty since I just
August 18, 2023
Practice Acquisitions
Message Board
Views: 367 | Replies: 15
Per a recently enacted state law (July 22), insurance companies have found a way to not cover nitrous oxide. The intent of the law was to prevent insurance companies from dictating charges for non-covered services, BUT it seems to have backfired on us. For example one company set the limitation
October 11, 2023
Pediatric Dentistry
Message Board
Views: 302 | Replies: 7
Having a hard time finding the Stark laws applied to dentistry. I have in-laws and nephews that would like dental work done. They have dental insurance. Could I bill their dental insurance? Dentistry cost and I will be billing them otherwise... Yes You can be their dentist and bill the insurance
October 16, 2023
PPOs and HMOs
Message Board
Views: 210 | Replies: 9
Are we allowed to bill insurances codes that are not a part of traditional ada code book? For example use of fiber reinforced compsite or use of rubber dam (obviously not for endo but restorative). Can we create our own codes and bill the insurance? Clearly insurances will not pay for these codes
October 17, 2023
Coding Q&A
Message Board
Views: 248 | Replies: 15
I have a couple of patients that insurance sent checks to them. The patients were pissed that they had to come back to the office. Anyway they dropped off the insurance checks but they are in patient's name instead of them cashing the check and paying us. they made a big fuss about it. they signed
September 28, 2023
Practice Management & Administrative Forum
Message Board
Views: 1480 | Replies: 60
in network with any insurance plans? Or should I try to accept 1-2 PPO plans to help fill the voids in the schedule to help grow the practice faster? Thanks for the advice! Don't accept PPOs bro. You don't know how good you have it I would exhaust every other avenue before I took on insurance if I were
October 24, 2023
PPOs and HMOs
Message Board
Views: 228 | Replies: 2
I saw an ad for a company called Airpay dental. They claim to be able to do automated insurance verification, so that your front desk no longer needs to call and verify coverage. They claim to be able to reduce about 80% of insurance verification phone calls. Their website looks good and so do
June 09, 2022
Dental Insurance for Dentists
Message Board
Views: 285 | Replies: 3
Is there a website that you can log in to verify benefits and check claims for ALL insurances in one place? (Instead of logging into each insurance website individually)Im looking for ways to streamline this process for front desk.The alternative was outsourcing insurance verifications to third
May 25, 2022
Claims Processing
Message Board
Views: 137 | Replies: 4
to pay each year for this code book? The simple answer is that the CDT codes are accepted by dental insurance companies as the standard coding set that is used to file all dental claims in the US. Then I was thinking, but who owns the CDT codes, and has the right to print and sell official copies
March 26, 2022
Dental Insurance for Dentists
Message Board
Views: 226 | Replies: 1
Medicare supplements are starting to ask us to sign a waiver of liability that states we can't bill the patient when a claim is denied. This is only presented on appeals of denied claims, and they state they will not process an appeal if we don't sign it. We are 100% OON and have never come across...
July 28, 2022
PPOs and HMOs
Message Board
Views: 16 | Replies: 0
My cell phone number is listed in the insurance directories instead of our practice phone number.Is there a way to change the number for all directories? Or do I need to just call each company individually?
August 09, 2022
Dental Insurance for Dentists
Blog
and not in a dental insurance plan? You must know these things to make the most of your dental insurance. What's Not Covered? Since insurance providers are in the business of saving money, they have to be selective about what procedures to cover. That's why it's essential to read your plan carefully and understand
March 08, 2022
by FFD419
Message Board
Views: 146 | Replies: 2
Hypothetical question. In a 2 doc practice, if one doc is the owner and in network with an insurance company, and the employee/associate doc is OON, can you bill under the owner doctor for work the associate does? My thought would be is it's similar to an EFDA walking out under supervising doc
March 18, 2022
Claims Processing
Message Board
Views: 256 | Replies: 5
Trying to learn more about the front office/OM responsibilities. Would anyone recommend Understanding Dental Insurance: A guide for dentists and their teams or Ultimate Guide to Dental Billing and Reporting? Peds resident if that makes any difference. Thank you. I have been working in dentistry
March 18, 2022
Billing
Message Board
Views: 131 | Replies: 2
If you sign up to be a PPO provider for an insurance company, are you required to treat all patients and all plans offered by that insurance company ? For example United Health Care PPO fees for prophy is $48 and $504 for a crown. I have a significant portion of my patients under the UHC Medicare
March 13, 2022
PPOs and HMOs
Message Board
Views: 257 | Replies: 0
Any suggestions for malpractice insurance for recently trained AEGD dentist? What kind of coverage? Best company to go through? If I work at an office that provides malpractice insurance is it wise/necessary to still have my own? What kind of coverages is sufficient? Sorry Im a little unfamiliar with malpractice insurance..
June 27, 2022
Malpractice Insurance
Message Board
Views: 52 | Replies: 0
I'm in a partnership and my partner is more cautious than I want to be when dropping insurances. We are both booked out almost 2 months. Hygiene is almost in 2023. We needed to drop yesterday. Right now we are planning to go in network with careington and the drop the plans under that umbrella
August 15, 2022
Partnerships and Associates
Message Board
Views: 117 | Replies: 3
If a person has dual insurance and you participate with both insurances; does the patient account get both write offs? Good question. NO!! The patient gets the largest of the two write offs, that is it. Which means do NOT add in a write off until after secondary comes in. Now, if the patient
April 18, 2023
Claims Processing
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