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Page 15 of 817
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Message Board
Views: 240 | Replies: 6
We need all Washington dentists, your staff, your patients, and anyone else interested in advocating for these important reforms to sign in PRO. --Sign in PRO for Senate Bill 5351: --Sign in PRO for House Bill 1535: The bills outline three key dental insurance issues: 1)Dental Loss
July 27, 2025
Delta Dental
Message Board
Views: 10648 | Replies: 3095
:22-AUG-2018 Climate change denial strongly linked to right-wing nationalism CHALMERS UNIVERSITY OF TECHNOLOGY With Chalmers University of Technology, Sweden, as a hub, the world's first global research network into climate change denial has now been established. Building on a brand-new research
February 28, 2024
Politics - DO NOT Enter if easily offended
Message Board
Views: 308 | Replies: 8
Hello townies, United Concordia is denying payment on core build-ups for teeth#23-#26. Root canals were done by a specialist. I believe their reason for denial is because they don't feel crowns will be necessary, and actually I hadn't planned on crowning the three teeth. Having said that I still
May 10, 2021
Claims Processing
Message Board
Views: 398 | Replies: 16
is that ? Contracted fees we have are terrible. Maybe it's just the DSO I currently work for... i just checked mine with them and its awful !!! For OMFS, have you considered seeing what fees the medical side will offer you for In Network? Typically, medical insurance has higher allowable than
July 31, 2021
PPOs and HMOs
Message Board
Views: 777 | Replies: 15
Doing a little bit of research of the feasibility of this in my practice. What codes are you guys using for LANAP treatment? What fees are you guys getting (ballpark), and how do insurances deal with this treatment? additionally, how much time does the procedure take? I take a few PPO's so
January 15, 2014
Periodontics
Message Board
Views: 433 | Replies: 13
that our contract would be ending on 8/31/2016. I completed the online re-credentialing application on 7/28/16, and as of today 10/14/16 the re-credentialing application is still not complete. Has anyone else ever had this issue? I have opened a service request with the Insurance Commissioner. All
November 18, 2016
Claims Processing
Message Board
Views: 621 | Replies: 16
pencils and made a bunch of circles around interproximal areas in each quadrant with an arrow pointing to those circles and wrote destruction ofcrestalbone and mailed it back in. That is all that is needed. Claim paid. The insurances are hoping you have no time to question their denial and you don't
November 06, 2018
Claims Processing
Message Board
Views: 267 | Replies: 11
I have only don't all 4 quads a handful of times at all but due to this patients work schedule she wanted to do them all and they were not extremely involved (4-5 mm) I agreed to it. I got a Denial from Delta Dental saying that as of Jan. 1, 2016 due to recommendations by the ADA
January 26, 2016
Claims Processing
Message Board
Views: 561 | Replies: 9
Hello all, need some help. I have 13 families at my office who have Guadian PPO insurance who we have always been in network with. We just recently started getting denials because apparently these patients have Medicare dental/Liberty dental plan and because 1.5 yrs ago I opted out of medicare
December 14, 2018
Dental Insurance for Dentists
Message Board
Views: 236 | Replies: 3
to do this for you. It will cost about $500-1000 for them to do it. Mistakes cost you a deley and delays with them is for ever. It can also cost you a denial. With Medicare you want everything perfect. I do know a few people that did it on their own. You need part A and part B to be doing sleep
November 16, 2015
Medical / Health Insurance
Message Board
Views: 284 | Replies: 3
average 10 new pts a month and 8-10 pts a day. A few questions? 1. Is the FD person going to be a long term employee who is in need of training or they just do the minimum and that's it? 2. AR of 5K is pretty low, is that $ out to insurance you are waiting on or failure to collect copays? 3. Are you FFS
May 12, 2022
Practice Management & Administrative Forum
Message Board
Views: 265 | Replies: 10
He is the scenario that is happening as I understand it from my front desk: We are in network with the Pt's Dental insurance. We perform services, say just a cleaning. We file our typical dental claim. Dental insurance says it is possible for the medical ins to cover some of the procedure
February 24, 2016
Claims Processing
Message Board
Views: 145290 | Replies: 10388
insurance to pay?MattIt's hard to tell from the pictures, but the amount of decay could justify a crown. Depends on what the insurance companies consider a crown. Unfortunately, insurance companies don't care if you are trying to be conservative with your preps. I think it's tough to get insurance
March 11, 2007
CEREC Forum
Blog
’ claims, in an effort to help dentists become more educated about some of the challenges they may face if they end up needing to file a disability claim. In our next post, we’ll explain why dentists’ claims are often targeted for denial and easy for the insurance company
October 01, 2017
by Edward Comitz
Message Board
Views: 368 | Replies: 14
to much liability for the fee. Back in 1997 I believe I charged $250 for oral sedation.Medical Insurance has never paid me a dimeTotal waste of time filing medical except to get the denial to send to dental insurance when requested.Tell the hygienist to shut up talking about finances. Tell her that she is responsible dealing with any angry patients that she told this 100% coverage lie too.
December 24, 2021
Claims Processing
Message Board
Views: 800 | Replies: 23
denial I have on this, anybody else encounter the same thing? Yup. New changeYou can send pre AND post op xrays along with a narrative and they will pay. Narrative can be short sweet and simple. But you MUST have pre and post op xrays, if you don't have the photo. You can always call the patient to come
March 05, 2018
PPOs and HMOs
Message Board
Views: 157 | Replies: 11
, because the front forgets about it since there was never a denial that I guess sparks their memory as a reminder. Has anyone experienced this recently as well? No, hes feeding you a load of crap. Not to say insurance companies dont play their stupid games, and there will always be a handful of claims
August 29, 2022
Claims Processing
Message Board
Views: 409 | Replies: 13
show a denial from medical, then you can bill the dental. It's obviously just a game to try to not have to pay. I would double check and make sure the insurance is not one like I described.I used to wonder why postal workers would lose it and end up killing people. Stories like this make me wonder why we havent seen a dentist lose it. Please tell me that it's justifiable homicide.
December 09, 2016
Claims Processing
Message Board
Views: 267 | Replies: 4
Hi, I've had some exchanges with people on my local board, but remain confused why organized dentistry isn't pushing for higher reimbursement for dentistry, improvements in excluding denials, etc. Is it a collusion issue? Is it a conflict of interest, persons on the dental board are part
March 09, 2019
American Dental Association
Message Board
Views: 756 | Replies: 10
to no options outside the clinic.....A friend of mine became a state employee, running various Medicaid dental plans. Exciting work.....Large labs, vendors and mid-sized distributors and insurance companies are the easiest. A lot depends on what you enjoy doing. Dentists like to hear things from other
August 29, 2019
Future Planning General Discussions
Message Board
Views: 1792 | Replies: 63
act by the insurance companies. This equates to a colluded act by a group of individuals to manipulate a process for monetary gain. The penal legality is vague but the civil is not. You may want to clarify your statement. They are 4999 with a narrative or 4240 with a narrative or if you are bold
July 31, 2015
Periodontics
Blog
fee, and in return receive special benefits and discounts to your practice and your practice alone. This allows your practice to focus specifically on quality dental care. It cuts out any middle man that interferes with your practice, and eliminates claim denials and delays. This helps your cash
December 09, 2020
by Jordon Comstock
Message Board
Views: 212 | Replies: 5
it and put implant in on the spot without attempting to contact me. Now her insurance is refusing to pay anything on the implant crown because they paid on the regular crown two years ago. Is there any kind of appeal I can write to get them to pay anything or is this patient out of luck? Reason
May 30, 2018
Claims Processing
Message Board
Views: 305 | Replies: 8
paid for a crown on the tooth if it has been less than 5 years. Told them that patient did not want a claim submitted and they said that if I did not report the actual placement date it was insurance fraud even if patient paid out of pocket and had requested to not notify UCCI of procedure. Can
July 08, 2014
Claims Processing
Message Board
Views: 735 | Replies: 40
with denials/stalls? 4. Are payments easy/prompt? 5. Does your state have any data reporting requirements or does it sync into your server for data? I've been told that our state will require data reporting and possibly need access to our dental PMS nightly. This is a huge deal breaker for me
October 19, 2018
Pediatric Dentistry
Message Board
Views: 762 | Replies: 9
Has anyone outsourced their insurance claims and entering EOBs? What does it cost, and is there a company that you recommend? I don't like being dependent on a single person in my office for billing and collecting money, it seems like it would be smarter to have a professional company that would
July 16, 2022
Front Office Discussion
Message Board
Views: 217 | Replies: 10
Long story made short. Patient was seen back in March. We followed up with claims. Got denials. Followed up over and over and turns out they have HMO insurance. We are not in network with hmo. Nothing was covered obviously. Patient is pissed, called us and told us they were gonna report us
January 25, 2026
Claims Processing
Message Board
Views: 110 | Replies: 1
the extra time for this so outsourcing insurance billing may be an answer. A billing service has the means to pursue denials that are going to come from lack of compliance to the changes brought about by insurance companies: See announcement below
June 26, 2015
Front Office Discussion
Message Board
Views: 432 | Replies: 21
-authorization. Insurance approved D7210 for #1, 2, 3, 4, 8, 16, 31, 32 for $138/tooth.The rest they downgraded to D7140 stating that there is no evidence that the bone needs to be cut to remove the tooth.His insurance only coversextractions 8 times per calendar year so#1, 2, 3, 4, 8, 16, 31, 32 are all we
December 22, 2024
Claims Processing
Message Board
Views: 183 | Replies: 2
are not going to qualify that tooth for a crown with United Concordia. Good luck For it to be cracked tooth syndrome, pain has to be present. You also have to document how long it was present, and if it is staying the same or getting worse. At least this is my take on it, for insurance to cover it.
February 22, 2016
Claims Processing
Message Board
Views: 503 | Replies: 5
This could go in multiple threads but I put it here. I am tired of staff excuses on why statements don't go out on time and why we have outstanding insurance claims. I get the demands with insurance, etc. So I am looking into outsourcing my billing and insurance. Medical offices do this all
September 25, 2019
Front Office Discussion
Message Board
Views: 218 | Replies: 10
codes for Medicaid claims. Monitor Claims: Follow up on claim status and denials. Educate Patients: Inform about coverage and non-covered treatments. General: Patient Education: Ensure patients understand their financial responsibilities. Compliance: Keep up with insurance and Medicaid regulations
February 15, 2025
Pediatric Dentistry
Message Board
Views: 473 | Replies: 13
for that nonsense as long as the insurance company provides you with straightforward coverages. This part takes the right front office staff. Denial for this particular tooth will only require 5 minutes of your time to write a narrative on the denied claim. Frustrating yes, but easily reimbursed. No one ever said
January 29, 2016
Claims Processing
Message Board
Views: 376 | Replies: 9
A patient who had not been in for 3 years was in today. He was seen, a radiograph was taken, a 3rd molar was extracted and a single surface composite that was planned 3 years ago next to the 3rd molar was filled. Will the insurance company (that I participate with) pay for a limited oral exam
November 08, 2022
Billing
Message Board
Views: 47573 | Replies: 1293
/2021 when compared to 2019, it does not offset the losses you record in another quarter. I think the people that saying there are spending all of it on payroll are asking for an audit, although that's probably really unlikely. I just don't want my report to raise any eyebrows. I used the Insurance
February 25, 2022
All Things Coronavirus (Covid-19, SARS-CoV-2)
Message Board
Views: 1732 | Replies: 40
for Illinois. Ask UCCI for yours. I don't think it'll be too different. For the most frequent codes, Region 44 and Region 60 are the same. My OM told me that UC has partnered up with Assurant insurance. This means that if you are in network with UC you will be forced to accept lower Assurant fees even
May 17, 2017
Pediatric Dentistry
Message Board
Views: 4678 | Replies: 244
that if they (the insurance company) continued to delay providing the patient the benefit which they are privy to then we will be forwarding the denial and reporting them (the insurance company) to the Georgia Dept of Insurance and Fire Safety. I also include a copy of the form from the State which I have on file
February 15, 2017
PPOs and HMOs
Message Board
Views: 17741 | Replies: 1414
shouldn't be FFS...I hate UHC, I think they know what they are doing with denials and games and BS, and they should be invesitgated and charges filed likely. I don't think execs should just be assassinated in the streets. Anyway I'm not defending insurance companies AT ALL. I'm saying that I literally
December 12, 2024
Dental Insurance for Dentists
Message Board
Views: 252 | Replies: 7
Greetings, Pardon my ignorance on this but if someone can please clarify. I recently partnered into my practice and was reviewing protocols. I'm told by the manager (and therefore all the front desk staff) that it is against HIPAA to gather new patients insurance info over the phone to verify
September 27, 2024
PPOs and HMOs
Message Board
Views: 256 | Replies: 8
Just got a denial for D7251 Coronectomy. The insurance said that the xray did not show that the tooth was impacted. I was surprised that was their reason since I never thought of coronectomy only being for impacted teeth. Sure enough the ADA code mentions impacted tooth . Anyway, I don't see why
August 09, 2022
Oral & Maxillofacial Surgery
Message Board
Views: 289 | Replies: 7
lay out the options for treating the tooth? Is there another underlying problem that could have been detected? Will your insurance deny your claim if they don't have a sufficient picture? I don't think you need to have a perfect picture to take out a tooth, but should anything go wrong, it'd be nice
July 06, 2017
Oral & Maxillofacial Surgery
Message Board
Views: 270 | Replies: 3
excellence. This autonomy allows for individualized treatment planning based on clinical need, not insurance limitations. Moreover, being out of network helps preserve the integrity of the doctorpatient relationship. It places decision-making squarely between the dentist and the patient, rather than
May 13, 2025
Delta Dental
Message Board
Views: 1779 | Replies: 156
Nobody is forcing you to have health insurance. They provide a service (a shitty service in my opinion) that is elective. I don't have health insurance because I don't want anyone dictating my care. Don't like how they run their business? Don't use them. Doesn't justify murdering their CEO. Have
April 04, 2025
Leisure
Message Board
Views: 152 | Replies: 1
wait for a denial then send the claim to dental with the denial? Do I need to fill out a 1500 form and send it to medical? Can I just charge the patient the PPO fee and call it even? What do I do? 20+% of the practice revenue comes from surgery THANKS ALL Did you ever find out anything with this...
May 16, 2016
Claims Processing
Message Board
Views: 672 | Replies: 19
relationships and value. I spent 1.5 yrs practicing in a large, army community. Those military families were something else...very insurance driven. Agree with this 100 percent. I take it step further and do with most insurances. Srp without preauth has the highest amount of denials, time wasted, and loss
January 14, 2020
PPOs and HMOs
Message Board
Views: 62 | Replies: 0
, and the final plan. Attach radiographs, photos, CBCT slices when appropriate, and product labels if your system supports it. In today's insurance world, the clinical procedure is only half the work. The other half is telling the story clearly enough that a computer denial engine does not murder
April 25, 2026
Oral & Maxillofacial Surgery
Message Board
Views: 2301 | Replies: 130
commissioner to me...my guess is that their lobbyists know them. Almost 17% of medical insurance claims are denied. What do you think the denial rate is of Medi-share/CHM? . That's lawyer language...of course they have to say that. The only thing that really matters is who is more likely to pay
December 30, 2023
Just Plain Bitching and Moaning
Message Board
Views: 371 | Replies: 14
I had a patient present with deep decay on tooth #3. I told him we would try to avoid a root canal by placing a buildup and intentionally leaving affected dentin over the pulp. We placed the buildup in July 2024. Insurance denied saying they wanted an x-ray or intraoral photo showing buildup. We
December 29, 2024
Claims Processing
Message Board
Views: 5874 | Replies: 181
is included. PPOs are making a big mistake. Word is getting around quick among patients. With the ObamaCare disaster, my patients are already primed not to trust insurance companies. We are with the culture. I've started CCing all my patients when I send a narrative after a denial. I send
October 01, 2020
Delta Dental
Message Board
Views: 551 | Replies: 12
narrative you wrote. Up to the pt to get better plan or pay OOP. If erosion and attrition arent covered then Id bill the pt. Principle is the insurance company denying for this reason in my world. Im going to dispute the denial,of the pre approval I just got denied for a similar case. That will lead
November 08, 2022
Claims Processing
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