Search Results

Searching: insurance denials
Results: 40,839
Displaying 40651-40700 of 40839
812 813 814 815 816
Page 814 of 817
Message Board (37849)
Dentaltown Magazine (455)
Podcasts (815)
Blogs (1565)
Message Board
Views: 510 | Replies: 8
Mid December 2014 Patient wants badly to have her smile restored, and more specifically asked to have the six maxillary teeth crowned and ideally shaped. We quoted what she would be responsible for and what her insurance would pay for. She swiped her credit card and asked us to come
November 21, 2015
Legal Issues
Message Board
Views: 202 | Replies: 8
Is it insurance fraud to offer a new cleaning/exam for uninsured patients only? Wouldn't I have to offer the same price to every patient?I think based on reading previous posts it probably is fraud, but it doesn't stop me from seeing them plastered everywhere. I'm doing a pedo startup in a month
June 15, 2018
Marketing
Message Board
Views: 428 | Replies: 12
has told me that I should contact the pt to get my $300 or have the pt call Metlife to pay them the $300. Mark...I have not heard of that, but it doesn't surprise...I've heard something similar from an Endodontist friend that said they were overpaid by an insurance carrier and to refund the money
December 19, 2016
Claims Processing
Message Board
Views: 1810 | Replies: 40
professionals. Stop the fantasy of comprehensive dental care, & the low ball, low end levels of care. 3. Pay & Chase is a highly disturbing & flawed method of Medicaid oversight. That's also addressed in the article. I offer alternatives, which the insurance industry employs. 4. Check
January 22, 2016
Legal Issues
Blog
with a focus on patient’s needs, concerns and most importantly their tooth health. The doctor values health and educates patients on the benefits of good oral hygiene without judgment. She accepts all insurances and offers huge discounts for those who do not have insurance. - See more at: http
February 22, 2017
by seodentals
Message Board
Views: 2378 | Replies: 66
on production. Unless you take production... If you do, I will switch... Not to be an agitator, but this argument only has two valid points and they are both based on assumptions. One, you assume that by submitting your UCR to an insurance company even though you are a participating provider that you
August 13, 2015
Practice Management & Administrative Forum
Message Board
Views: 4323 | Replies: 121
If I hadn't already terminated the PPO contract(s), I didn't like (Delta Premier), I would be doing so now. Never in the history of the insurance age of dentistry, or managed care, if you want to call it that, have ALL DENTISTS ACROSS THE ENTIRE COUNTRY had the opportunity to terminate
April 10, 2020
Practice Management & Administrative Forum
Message Board
Views: 7570 | Replies: 357
to the do you take my insurance question which there is so much disagreement on DT about a simple concept. From personal experience I will say that as long as patients get their free sh*t they don't care much for the in/out of network since it doesn't cost them a penny extra. Now I do need to ask
January 19, 2019
Location and Property Dynamics
Message Board
Views: 324 | Replies: 14
Hello, I am in network with United Concordia :( I billed insurance for a crown and buildup. My fee and the allowed amount are now different. $751 vs $637 (United concordia sucks) Coverage is 50%. So the patient paid their copay of the $751, but the payment was 50% of the $637. I can't bill
November 13, 2021
Claims Processing
Message Board
Views: 373 | Replies: 7
to be in their system. But, what to do with United Concordia and guardian tomorrow? It makes sense to submit w9 and dental licens to get paid... Thank you, Kayla what is the deal with insurance?... Sounds like a Seinfeld bit. I don't really know exactly what the deal is.... But RESCHEDULING
December 18, 2015
Practice Management & Administrative Forum
Message Board
Views: 808 | Replies: 24
Hello Doctors, I have an issue with my Hygienist saying that by doing alternating adult prophy and perio maint due to guideline from insurance is fraud. Her reason is that if we recommend perio maint than it has to be all 4 times perio maint in this case insurance allows 2 perio maint and 2 adult
May 15, 2019
PPOs and HMOs
Message Board
Views: 2989 | Replies: 79
. $450 porcelain fee u must be kidding me what was he billing the insurance for a all metal crown?I have never seen a PPO contract that allows...It is most certainly NOT legal. By participating with the insurance company as an IN NETWORK provider, you are contractually agreeing to accept their payment
February 15, 2015
Coding Q&A
Message Board
Views: 3336 | Replies: 74
and they are able to survive, but they certainly aren't what I would consider growing practices (50 + new patients per month). Most people in Alabama that you would consider good patients have a job that provides them with insurance through a PPO plan. If a person doesn't have insurance
March 17, 2014
Delta Dental
Message Board
Views: 106 | Replies: 1
) and billed the COE to insurance. Her insurance (BCBS of TN) is stating that it only covers 1 COE in 36months. I called her ins and complained that this rule of theirs: 1. places an unreasonable expectation on the pt to go back out of state for an exam, or 2. places me in a position where I
February 16, 2016
Legal Issues
Message Board
Views: 147 | Replies: 10
I haven't seen this before from insurance. The want a ceph analyisis. Any recommendations as to how to go about this and who would do the analysis? Maybe the Insurance company wants ceph numbers to show the patient is a class 2 skeleton due to a mandibular retrognathism? But what they should
July 01, 2019
Sleep Apnea / Snoring
Message Board
Views: 251 | Replies: 5
recourse? Ya. You get full fee and patients a good lesson that their insurance is a rip. Sounds like a winner. Tell the patient to file a complaint with insurance, state, employer. But first pay you your money. Did the patient/parents choose resin over amalgam? Sucks! This falls
March 12, 2015
Claims Processing
Message Board
Views: 104 | Replies: 1
Have a pt. who will be having multiple exts with OS and I will deliver immediate complete denture. Pt. will easily exceed annual insurance maximum. Can I bill the immediate denture once it has been fabricated by the lab and before the extractions? Or do the extractions get presented to the ins. co
August 16, 2023
Claims Processing
Podcast
Part of having an Investment Grade Practice is having the wherewithal to manage the levers so you can continue to operate successfully. - Nicholas Partridge Would you throw away $150,000 of profit every year? Of course not. But that's what you might be doing if you get rid of an insurance plan
October 03, 2023
by VictoriaPeterson
Message Board
Views: 136 | Replies: 1
Have a specialist that comes for implants and some difficult extraction. One extraction and bone graft was done on patient A. Sent the specialist as provider on the claim and got paid. For patient B , same procedure ,same insurance plan ,the claim has come.back twice with no payment. Though
May 08, 2024
Claims Processing
Message Board
Views: 139 | Replies: 5
Hi there! I have run into this scenario a couple of times with dental insurance companies, and would love help evaluating if this is legally allowed or at least be pointed in the direction of who to contact for help: - A patient is covered under two plans - Primary and Secondary. Our dental
August 08, 2017
Claims Processing
Message Board
Views: 274 | Replies: 3
I recently purchased a practice and the front desk is a mess with insurance. I've been searching and am trying to figure out if I can charge the patient for insurance downgrade on amalgams to composite and the like. I've read that on alternative benefits I can but on contracted rates I can't? How
January 04, 2016
Claims Processing
Message Board
Views: 330 | Replies: 6
I have had some insurances like Guardian, Cigna coming back on preauths saying Build Up is part of crown and I cannot charge pt. The other day I was shocked when I received preauth saying even crown lengthening cannot be charged and is part of crown. What's next? RCT ? Has anyone else had similar
January 24, 2017
PPOs and HMOs
Message Board
Views: 506 | Replies: 16
Below is the letter we are planning on sending to all of our BCBS patients informing them of the new BCBS policy of sending payments directly to patients, and not providers (same policy as Delta). Let me know what you guys think. Thanks! We recently received a letter from your insurance company
January 08, 2014
Dental Insurance for Dentists
Message Board
Views: 1903 | Replies: 56
So I place a piss poor sealant, and the patient migrates to your office. YOU put in a perfect sealant and you don't get paid. Please post your address, I will make referrals. NOW DO YOU GET IT??? On our initial insurance verification my staff would have already found out seals were done
February 13, 2022
Pediatric Dentistry
Message Board
Views: 87 | Replies: 2
Hi I recently acquired my first practice and I am looking for some help with insurance EOB's. I have used medical EHR's before such as SimplePractice, and when I send an electronic claim to insurance from that EHR, when the insurance processes it the patient ledger is automatically updated
April 10, 2022
Claims Processing
Message Board
Views: 436 | Replies: 8
of signing up time for receiving ERA from insurances online through DentalXchange. We only participate with 4 major insurances and have Careington Umbrella insurance. Once ERA was approved by the insurances (which took about 2-3 weeks), we started receiving the Electronic EOB. Here is how it works
September 30, 2024
Billing
Message Board
Views: 2707 | Replies: 72
and/or is demanding something you dont doyou could say it doesnt sound like we are a good fit. But with her and being a townie you could say I will when you bring in your last years tax return, your mortgage loan, credit score,bank accounts and your psych report! J/k HeidiIf she has an insurance
March 22, 2016
Pediatric Dentistry
Message Board
Views: 3570 | Replies: 45
for D0350 to private insurances...and do you normally get paid??? Mark We don't normally bill this, but after reading your post... Mark. Have to at least try. What is code D0350? Thanks Intraoral photos. I think. If that code is I/O photos...then yes we bill for them. Only a handful
November 11, 2021
Coding Q&A
Message Board
Views: 391 | Replies: 10
When I bought my practice, the selling doc was quoting her fee schedule to all patients regardless of insurance status. They would submit to insurance, and then adjust for write-offs when they got paid. I hated this for a few reasons... 1) patients were presented inaccurate fees that were
August 10, 2016
Practice Management & Administrative Forum
Message Board
Views: 715 | Replies: 20
before. When a patient with regular insurance (as opposed to our majority medicaid pts) has a plan that only covers the least expensive alternative treatment for restorations (amalgam) and we do a composite, we just write off the difference or what every other office where I have worked call
April 25, 2014
Claims Processing
Message Board
Views: 618 | Replies: 23
So I'm an associate at a longstanding practice and have come across a few that's the way we have always done it situations that after some digging needed to be changed (coding issues, write-offs, ect). As an office we participate only with Delta and are OON with all other insurances. Yesterday I
October 31, 2017
Claims Processing
Message Board
Views: 12598 | Replies: 517
to this thread but I do have a question. Dentaldaddy, are these collection numbers or production numbers youre using (before insurance write offs)? You know, you are allowed to offer benefits in private practice. We offer medical, pto, 401k with match. We do PTO with 401k and match. Could you give some
March 03, 2023
Staff Management Issues
Message Board
Views: 63 | Replies: 0
Just received this email...please take action!! Just received this email from the ADA. Please contact your representatives!!! With your help, we can end the free ride that the health insurance industry has enjoyed for over 70 years, and hold these insurers accountable to the principles of fair
February 23, 2017
PPOs and HMOs
Message Board
Views: 131 | Replies: 4
from the ADA for guidance on this....great reference books to have. Remember it's the ADA that owns the CDT codes but each insurance company tends to bastardize the codes to minimize what they pay.....hence some craziness between insurance companies and even between plans within the same company
August 10, 2018
Coding Q&A
Message Board
Views: 247 | Replies: 0
I have this PITA patient that has a horrible mouth and even worse attitude. We have seen him a number of times over the last few months for exams (comp and limited), cleaning and extractions. Each time our patients come in my FD asks if they have any changes to their insurance. Each time he has
June 22, 2015
Just Plain Bitching and Moaning
Message Board
Views: 84 | Replies: 3
I had a patient in last week and her insurance (maybe CIGNA) stated the following Insurance will only pay for build up same day of crown if using a CEREC machine? They will not pay for the build up if using a lab? Why would insurance care if I'm using a lab vs making it in office when it comes
July 08, 2022
Claims Processing
Message Board
Views: 7048 | Replies: 244
Hi there - I bought my practice 15 years ago and am in network with pretty much any ppo that presents itself. I'm getting sick of the insurance games and horrible reimbursements. Will most ppo plans still pay an out of network rate? Anyone on here regret going out of network? I'm not sure how
September 21, 2021
Going Out of Network
Message Board
Views: 2003 | Replies: 31
Ok, I know this has been asked before, but after doing a search, I saw mixed answers. If I participate with a few insurances (Cigna, Delta, and Metlife) and a pt has ortho coverage. Delta says they will pay $1500 and we can charge pt max of $335 so total is $1835. My lab bill for invisalign
August 12, 2021
Claims Processing
Message Board
Views: 594 | Replies: 18
and the patients just paid in full up front the office fees and were reimbursed by their insurance company. I can see how that would work since it was a very established practice but as a start up I need to be able to make it as easy for my patients as possible and I want to be able to file and accept assignment
December 18, 2017
Ask a Dental Consultant
Message Board
Views: 929 | Replies: 29
I have learned that if you participate with Delta NJ, you cannot have an in house reduced fee plan where any of the fees go below any insurance plan fees that you participate with. Also, I believe that your in house reduced fee plan cannot have a yearly fee, for example where patients pay $200
March 18, 2014
Delta Dental
Message Board
Views: 5189 | Replies: 190
Are you suggesting dancing dentists on youtube to Drake music is not a way to garner trust, establish a doctor-patient relationship???? Yes, it's about trust. I'm saying the general public has misplaced trust in their insurance companies. Largely because the insurance companies have positioned
August 15, 2018
Delta Dental
Message Board
Views: 102 | Replies: 0
I did post this recently but received no replies and am posting again as this is a very huge frustrating issue that our office is currently dealing with. Many of the insurance companies which we are providers for are now demanding that we send them predeterminations before doing major dental work
January 30, 2015
Ask a Dental Consultant
Message Board
Views: 50 | Replies: 2
I'd like to know if there's a way to print out the contracted insurance fee for procedures on the treatment plan proposal/summary in Dentrix. We do what the experts suggest and always submit our full fee, not the contracted insurance fee. However, when we print the treatment plan to review
January 26, 2017
Selecting / Installing Software
Message Board
Views: 195 | Replies: 5
After 30 years of doing this I should know this by now but I'm kind of fuzzy about these questions.... If I prep two teeth for a bridge but don't take the impression can I file insurance for it? (Pretty sure the answer is NO) If I prep two teeth for a bridge and take an impression can I file
December 31, 2016
Claims Processing
Dentaltown News
ARLINGTON, Wash.—, a new company offering doctors anywhere in the U.S. easier filing and faster payment of medical insurance claims, is now open for business. The company’s owner and operator, Sarah Durbin, said her company will handle the entire insurance billing process for a health
January 28, 2022
Message Board
Views: 167 | Replies: 3
I had a patient with 2 loose implant crowns. I could not remove them. They must have used permanent cement. So I ended up creating an access opening through the crowns. I replaced the screws as well. Is there any part of this that can be billed to insurance and what codes can be used? Insurance
July 18, 2023
Coding Q&A
Message Board
Views: 192 | Replies: 7
to be redone and is now costing the patient ~$2k because theyre out of network. Pts dad (pt is 21) is pissed and wants a refund. Well they never paid out of pocket to us..insurance covered it. I frankly dont care but dont know how these situations are handled so I can guide my OM.My question
May 16, 2024
Endodontics
Message Board
Views: 669 | Replies: 17
photographs. We plan to cosmetically renovate the office in the new year. We are trying to make small progressive changes to the practice so we don't alienate the current patient base. Our big problem is new patient flow. We are out of network with all insurances except HRI. We
November 08, 2014
Practice Management & Administrative Forum
Message Board
Views: 169 | Replies: 10
would probably do the first one if I like the family and they are nice . OP, every case o like this over the years will be different. I never answered your insurance question. Iam not an expert in that my my guess is no, they will not cover it no mattter what explanation you give. A lot of Medicare
July 18, 2023
Claims Processing
Message Board
Views: 1027 | Replies: 43
I removed decay , build up and crown prep Later patient had pain because of deep caries. So I referred him to Endo.. He apparently went to Ukraine and got his root canal done there. Now he wants his crown from our office. He paid for it, and insurance paid their part. he doesnt want me to insert
August 18, 2025
Legal Issues
Displaying 40651-40700 of 40839
812 813 814 815 816
Page 814 of 817
Dentaltown Magazine
May 2026
Dentaltown Magazine May 2026 Read Current Issue Read Archived Issues
Sponsors
Townie Perks
Townie® Poll
What’s actually driving most of your new patient flow right now?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Pods & Blogs Classifieds Dental News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
The Dentaltown Team, Farran Media Support
Phone: +1-480-445-9710
Email: support@dentaltown.com
©2026 Dentaltown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450