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Message Board (37852)
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Message Board
Views: 490 | Replies: 13
Just took over a practice so excuse me i'm still learning....I have no idea how long my front desk should really be spending on the phones calling insurance companies. We are out of network and now collecting upfront with the insurance check going to the patient. What is the protocol for new
October 18, 2024
Claims Processing
Message Board
Views: 636 | Replies: 20
Our dental office is in a rural area. There are 5 dental offices in our small town. We are preferred providers for nearly every dental insurance available in our area. With that being said, we do abide by the contracted fee schedules. We have always billed the insurance company our fee
January 20, 2018
PPOs and HMOs
Message Board
Views: 1202 | Replies: 37
I'm starting practice in a fairly rural area (nearest dentist is about 15 miles away). I was trying to decide if I want to go in network with insurance or not. Then I started wondering if I could just avoid insurance all together and market heavily to cash patients with some of my prices included
August 26, 2016
Dental Insurance for Dentists
Message Board
Views: 1248 | Replies: 52
Our Emergency Dental office is experiencing a high no-show and/or no-pay rate. Typically, these patients show up with no money and crappy insurance (DMO) and claim they have excellent insurance. We are not contracted with any plans. Is there any legal way to charge patients in advance for our
July 09, 2016
Ask a Dental Consultant
Message Board
Views: 2950 | Replies: 108
If Delta is sending you the checks, you must be in network? Do you by chance work with the Scheduling Institute? Jay- Are you filing insurance for your patients as a courtesy? That is a bit risky, but we know the insurance will pay something. Verbal skills during this call are key and you want
May 08, 2019
PPOs and HMOs
Message Board
Views: 839 | Replies: 28
here. Most doctor's and dentist's offices are very small and simple, with minimal decor, limited equipment, and simple but up-to-date technology. But they get the job done and for a much lower cost. Most expats here don't even need health insurance, beyond a high-deductible plan for catastrophic events
June 12, 2025
November 2024
Message Board
Views: 268 | Replies: 8
I am considering modifying some of my payment options. The most significant would be: 1ST OPTION: 10% off the ENTIRE treatment (not just a phase) only if paid at the time of scheduling. Entire treatment means patient portion only not patient portion + estimated insurance. I don't think I could
March 13, 2016
Front Office Discussion
Podcast
Tessina Barney is a high powered dental office manager in Salem Utah. She assists in managing the Utah Chapter of the Academy of Dental Office Managers (UDOLLS). Tessina explains her experience in policing unethical and illegal insurance practices by a particularly large national insurance
May 26, 2017
by Jordon Comstock
Message Board
Views: 311 | Replies: 5
In the process of purchasing my first practice and needed some help. Business owners insurance is a must. But the 3 optional ones are entity malpractice, business overhead insurance and business loan protection. Did y'all get the optional ones ? Any insights would be appreciated. Thank you :) Some
December 23, 2024
Practice Acquisitions
Message Board
Views: 169 | Replies: 7
through the insurance guidebook and did not see an exclusion. If it is not covered do I still need to bill it to insurance and then put a narrative explaining that it is not decay? On the mandibular teeth he will need crowns. The same questions for crown coverage for erosion. Insurance almost always
August 05, 2023
Coding Q&A
Message Board
Views: 1023 | Replies: 26
Spoke with a buddy recently and he mentioned something about how in-house dental plans are no longer legal (conflict with insurance companies). He said that Comfort Dental got sued over this issue. Can someone please clarify? Is this something I can do at my office without getting in trouble
September 25, 2016
Dental Insurance for Dentists
Message Board
Views: 2699 | Replies: 132
of your contract. I wish i was wrong believe me...but dont take my word for it verify with the insurance company or dont and put your license at risk. Honestly I GNF.....been doing it this way for many years and will to continue to do so until I 1)retire or 2) they take my licenseI'm ok either way
January 14, 2020
Restorative Dentistry
Message Board
Views: 247 | Replies: 5
We participate with MetLife PPO and electronically submitted a claim following all of the proper procedures and guidelines. The claim was for restorations on 3 different teeth. The EOB that came back with the insurance payment was only for 2 of the 3 teeth. The EOB showed the total amount charged
May 26, 2016
PPOs and HMOs
Message Board
Views: 2342 | Replies: 85
New patient calls our office and asks are you in network for my insurance? Front Office responds no we are not a preferred provider That's usually the end of the conversation. My question is …..do I just accept that some people have limited budgets and only want the least expensive care
June 03, 2014
Practice Management & Administrative Forum
Message Board
Views: 1062 | Replies: 35
I saw my hygienist's daughter for an exam, and she needs five crowns. She was ecstatic that I was going to provide it at no charge, as I provide no-cost dental care for children of my employees. A few days later, she found out that she has dental insurance, Delta. And Delta requires a co-pay
November 22, 2021
Dental Insurance for Dentists
Blog
wheel while overheads increase and the return just isn't where you need it to be. What are some common pain points and what can you do about streamlining and/or automating them? Let's take a look: What vital numbers should you monitor in your practice? Get our guide here. Insurance... Where
August 29, 2017
by jmrenken
Blog
Part II: What Every Dentist Needs to Know About Filing a Disability Insurance Claim byEd Comitz, Esq. and Derek Funk Esq. In this second part of a disability insurance claim series, attorneys Ed Comitz and Derek Funk answer common questions from dentists. The discussion covers key policy
September 12, 2024
by nareg
Message Board
Views: 1092 | Replies: 8
Hi. I just got a license to practice in VA state. I need to get malpractice insurance and DEA and I should be able to start working. But I have no idea which malpractice insurance to get and how much it costs. Could you give me basic idea of how much it cost, what are the plans available? Thank you
June 27, 2014
Malpractice Insurance
Message Board
Views: 277 | Replies: 4
For pts with insurance, is it possible to file a limited exam and also render treatment the same day? And if insurance pays for the limited exam, the doc I bought my existing practice from claims they will not cover a periodic exam for that year. Anyone have any advice on this?We currently do
October 28, 2023
Claims Processing
Message Board
Views: 3027 | Replies: 87
in this situation before? This is not an insurance treatment. This does not get billed to insurance. If you can't make the patient understand that, than you should not perform this treatment because you will not get reimbursed and you will end up paying for their treatment out of your pocket. It gets
February 03, 2018
Fixed Prosthodontics
Message Board
Views: 667 | Replies: 39
Lets say you have a patient. Lets say this patients insurance covers crowns 100% but does not cover bridges. Lets say this patient needs crowns on 18 and 20 and patient decides she would rather pay $0 instead of $3k. So we proceed with crown preps and lab accidentally fabricates a 3 unit bridge
August 28, 2022
Ethical Issues
Message Board
Views: 37 | Replies: 0
I am an associate in a privatepractice whosemain patient base isDelta Dental. They have been charging full fee or MPA fee for treatment when insurance will not beused, due to frequency limitations,instead of the DPO fee. Forexample; 1) non-restorable dentition. Patientwants immediate temporary
August 29, 2017
Delta Dental
Message Board
Views: 110 | Replies: 6
Hi, I just wanted to get a sense of what is out there for patients who cannot get dental insurance through their employer, so they shop for an individual plan. It seems that they get: 1.) free exam, x-rays, and prophy (sometimes) 2.) discounted fee schedule Are there any insurance business
June 11, 2017
PPOs and HMOs
Message Board
Views: 222 | Replies: 7
For those of you who have FFS/OON offices, how does your receptionist respond when a new pt who calls and says, Do you take my insurance? We do file the pts insurance if they have it. Feel like we are struggling with what to say, we want to be honest with the pt but also want to make it clear we do
May 10, 2023
Practice Management & Administrative Forum
Message Board
Views: 996 | Replies: 30
Need some recommendations on how/where to train all of my frontdesks to answer OON questions. When patients ask me about insurances, i am upfront amd bluntly say that we are OON with xyz insurances, but my receptionists fail to be clear on this and fumble on the question which has been bugging me
October 24, 2022
Front Office Discussion
Blog
Get paid faster? Well.......Not all EFTs are created equal. All my new clients know about EFTs and want to get set up with every single insurance that offers EFTs. Some clients are already set up with some insurances and the problem starts here. There are so many different insurance companies
November 14, 2019
by Davy Clay
Message Board
Views: 260 | Replies: 9
We are seeing removable claims denied b/c of a preexisting missing tooth clause. You know the situation. Bubba gets a new job at the factory in town. He is excited b/c he has insurance the first time in his life. He inherited his bad teeth and is gonna get a denture just like dad has. He
September 08, 2016
Claims Processing
Message Board
Views: 283 | Replies: 8
We saw a family of 4 last December. We checked insurance eligibility prior to exam date and on the day of exam and they were covered. One had to come back on another day for tx and was eligible when we checked it again before the tx and patient was covered. We got payed in Jan. Thyen we got notice
August 22, 2016
Claims Processing
Message Board
Views: 238 | Replies: 8
Hi, we are so confused how the none completed treatments were filed with insurance and Insurance actually ended up sending money to our bank. It was direct deposit so it took me a few weeks to realize that money is deposited. We use Clearing House for all our claims linked from OpenDental
August 23, 2023
Claims Processing
Message Board
Views: 711 | Replies: 36
Does anyone have a list of insurance companies that do instant or same day pre-estimates? Thanks! I'm not sure I understand the question. Estimates are done by the provider, not the insurance. We call the insurance and ask them for the benefits which are generally a percentage of their fees
February 06, 2018
Ask a Dental Consultant
Dentaltown Magazine
by Teresa Duncan, MS Oftentimes the insurance coordinator is expected to be aware of all plan types and every benefit clause, while the patient will be unaware of the plan's intricacies—this is a certainty! Now, our job as health care providers has shifted to include affordability
August 2017
by Teresa Duncan, MS
Message Board
Views: 122 | Replies: 5
I work for corporate so I don't know how billing works but for my knowledge I wanted to know if my current pt has some restorations and extraction need and only preventative were done with current insurance now if pt presents with a new dental insurance then can I go ahead and do the restorations
January 11, 2016
Claims Processing
Message Board
Views: 351 | Replies: 13
Often talked about are things like a 5% discount for pre-paying for treatment. But how does this work for insurances? If I charge$1,000 for a crownand I want to give the patient a 5% discount for their crown ---- what is the 'Right' way to do this?Let's assume the patient's insurance pays 50
September 12, 2016
Practice Management & Administrative Forum
Message Board
Views: 282 | Replies: 7
Does anyone know what the cut-off probings are for SRP insurance coverage? I know when a patient has periodontal disease, but does the insurance consider gingival margin position when determining coverage? I often get patients with lots of recession that qualify for stage I or stage II periodontal
July 29, 2021
Coding Q&A
Message Board
Views: 394 | Replies: 10
Delivered a lower RPD. Insurance paid their portion, patient never paid theirs. Patient doesn't want RPD. Patient never returned for any post-op appointments, will not return calls (tried several times personally), nothing. Patient filed a grievance with insurance to have RPD made somewhere else
June 27, 2022
PPOs and HMOs
Message Board
Views: 925 | Replies: 23
If a patient has primary and secondary insurance coverage, and both pay their portion and there is a credit remaining when all is entered...what do we do?? Do I adjust the ledger and keep the $ or refund one of the insurance companies? Following. I also want to know if the secondary
March 30, 2018
Claims Processing
Message Board
Views: 226 | Replies: 5
insurance driven. His policy allows for 3 cleanings a year (and he comes in for all 3) but only 2 exams per year. Patient came in for exam and cleaning in April and August. Insurance paid for both exams and both cleanings. Patient came in again for his 3rd cleaning in December. There was no exam
January 13, 2015
Ask a Dental Consultant
Message Board
Views: 188 | Replies: 6
Sorry if this is the wrong forum, I looked through everything and couldn't figure out where to post this question. I just bought a practice from a retiring dentist and yesterday was my first day. The practice is FFS where half the patients are out of network (the other half have no insurance
December 13, 2018
Claims Processing
Message Board
Views: 524 | Replies: 16
... and how do you get an insurance company to pay for it if you do? It's practically a virgin tooth. Tooth #12. Normal probing depths, vital tooth. Cracked tooth syndrome. Signs of occlusal wear, history of bruxism. well......the ins. companies have these wonderful
July 15, 2014
Restorative Dentistry
Message Board
Views: 3264 | Replies: 57
daughter needed one RCT ( done at an endodontist's office ) which we crowned , this after regular comp exams and prophies on both of them. Patients were very happy with the work and even left glowing testimonials. After going back and forth with insurance , in a couple of months , we realise
May 14, 2016
Legal Issues
Message Board
Views: 1479 | Replies: 78
Hey DT- It's Monday. It's a new day and a new month. Same SB champions :). I see patients will only do wha their insurance covers on message boards with regularity. I fall into that thinking as well because it can happen so often. There is a chance though that we care more than patients about
February 08, 2019
Practice Management & Administrative Forum
Message Board
Views: 917 | Replies: 16
forgive me for posting a stupid question but i figured the only stupid question is the one not asked.... What is considered frequent insurance irregularities? i see a lot of dentists get in trouble (a lot of trouble) and fined heavily by the Illinois dental boards for insurance irregularity. I
August 11, 2016
Legal Issues
Message Board
Views: 4528 | Replies: 64
I got so sick of this I decided to do a blog post telling patients exactly WHO they should be blaming. Think it will help ? The original is posted at Is your dental insurance company ripping you off ? by Mitchell Rubinstein DMD I tell all my
January 26, 2019
PPOs and HMOs
Message Board
Views: 156 | Replies: 3
if the insurance company denies payment? Thanks. Its simple: Insurance companies care more about their members than they do about their providers. But its even simpler than that: insurance companies care about maximizing profits. If an insurance company denies a claim and allows us to bill the patient
June 02, 2020
Coronavirus (Covid-19, SARS-CoV-2)
Message Board
Views: 526 | Replies: 9
I read a recent dental article that said a new trend with dental insurances is to extend the composite frequencies to 5 years. I have not seen this implemented yet. My FD told me that some insurances have zero frequency limitations and others have a 2 year frequency. It is something to keep an eye
June 17, 2024
Pediatric Dentistry
Message Board
Views: 595 | Replies: 14
for limited and PA.If you think the person won't be back I would probably also be charging for irrigation and a temp fill. I wouldn't assume insurance covers any of it except the limited/pa. If they cover great but the reimbursement is so puny it's barely worth arguing over so collectupfront
July 26, 2017
Endodontics -- The ENDO Files
Message Board
Views: 471 | Replies: 13
https://www.law360.com/articles/878061/antitrust-exemption-repeal-resurfaces-amid-aca-battle Time to write our local congressman about repealing it? Call me cynical ( I've been called worse) but the insurance companies and their lobbyists in DC have plenty of money to ensure it never gets...How
March 03, 2017
Legal Issues
Podcast
Episode 433: Cut Down Insurance Verification Time Question: Does your office need help verifying insurance? Episode 433: Cut Down Insurance Verification Time Kiera's here to share how to verify insurance the tried and true, Dental A-Team-approved way! DAT consultants have been to a lot
October 14, 2021
by The Dental A Team
Message Board
Views: 4269 | Replies: 242
?Mouth mechanics! Both corporations and governments are subject to the human condition. How someone can be so anti-corporate, yet so pro-government is beyond me. The problem with our healthcare system is that as a country we have accepted that you must get your insurance through your employer
September 24, 2013
Politics - DO NOT Enter if easily offended
Message Board
Views: 1444 | Replies: 27
As you know, very little about the business side of dentistry is taught in dental school. Can anybody recommend a resource for dental students interested in learning more about billing PPOs? Since dental school teaches us nothing, it would be nice to start from the ground up. Insurance Solutions
April 09, 2018
Claims Processing
Displaying 4101-4150 of 40842
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