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Message Board
Views: 134 | Replies: 3
We are having a rash of significant secondary insurance overpayments. It appears that the ins company doesn't read the primary eob and just pays the claim like they are the primary. When this happens, we call the secondary and tell them to reprocess... and they don't. So, we call them again a month
November 16, 2021
PPOs and HMOs
Message Board
Views: 375 | Replies: 6
i have made the decision to drop the lowest paying insurance of the 2 that I contract with. Whats the best way to actually do that. 1. From a communication standpoint with the company? Do I just have my front office call and provide a date that we will be going OON? Do I send a letter
January 03, 2022
Practice Management & Administrative Forum
Message Board
Views: 65 | Replies: 2
I have a question about what the requirements are regarding documentation when a patient's insurance coverage is terminated. In our PM system, we can resubmit claims with the new insurance. However, if the month is closed out, we cannot rebill to new insurance through the software if there has
December 03, 2021
Ask a Dental Consultant
Message Board
Views: 400 | Replies: 5
. integrateswell with open dental. You don't need NEA. we used it once this year. just do tesia.How well does electronic attachment work with Tesia? We found that many insurance companies did not accept it as well as NEA. Went back to NEA - and we're doing much better now.
December 13, 2014
Open Dental
Message Board
Views: 189 | Replies: 4
We are a GP and have started doing more Invisalign cases. This is great, however, knowing how insurance typically pays for ortho (1/2 now 1/2 in 6mos, 1/4...) is hurting our A/R! Does anyone have any suggestions how to get a handle on this? We have attempted to ask the patient for payment in full
June 18, 2014
Orthodontics
Message Board
Views: 99 | Replies: 1
adjust off then remainder without being in network? Sure, you can do what you please. Some insurances will pay your UCR anyways, if this is the case patient's might not care...
February 10, 2017
Delta Dental
Message Board
Views: 213 | Replies: 1
i have a question regarding purchasing a practice that already has a bulk of patients from various insurance companies. I know it takes time to credential with insurance companies so do the new owners usually wait until they are credentialed or do people buy the office then apply and waste a month waiting? Do people generally just see patients and bill out of network for the time being? It depends on your transaction and who your advisors are.
February 23, 2016
Practice Sales
Message Board
Views: 201 | Replies: 2
Hi guys, I just got some mail about this new dental insurance company, Dentegra. Has anyone used it and can they shed some light about them? I haven't heard of them before so I don't know anything. I practice in Seattle, WA.... They are operated by Delta Dental. Know what to expect? Some
August 06, 2014
Dental Insurance for Dentists
Message Board
Views: 333 | Replies: 3
Hey everybody. I'd appreciate some advice. I would like to hire a 3rd party to negotiate my fees with PPO's. I currently am contracted with only 3 but that still means a significant w/o and adjustments each month. Last year I grossed $1.6M but after all the adjustments of $35,000/mo or more, the...
May 02, 2016
Practice Management & Administrative Forum
Message Board
Views: 368 | Replies: 10
So over the last couple of week we have been occosionally billing medial insurances for wisdom teeth when dental insurances say medical first. I want to get better at doing this because i have an uneasy feeling that more and more oral surgery and basic dental codes aregoing to fall under medical
December 27, 2015
Claims Processing
Message Board
Views: 72 | Replies: 0
For those that have an associate do you add them to your malpractice ins? Also do you have them add you the owner and the practice to their malpractice ins? Thanks
July 18, 2018
Malpractice Insurance
Message Board
Views: 193 | Replies: 1
and therefore complained to insurance company. the patient speaks two languages and we spoke with this patient in her native language and inenglishbefore and during treatment and explained everything to her on multiple occasions, the patient never called us between her appointment to complain of any
April 04, 2017
Endodontics -- The ENDO Files
Message Board
Views: 384 | Replies: 5
So I am in the process of getting credentialed for a few insurance companies. Aetna probably has the worst fees and is not willing to negotiate. After I told them that I was not going to move forward, they presented me with an increased fee schedule for my PPO but wanted me to accept the DMO
August 26, 2014
Claims Processing
Blog
Posted by David Dorley on August 5, 2015 Have you ever engaged in any of the following forms of financial and insurance planning? Purchasing life insurance Estate planning Designing an investment portfolio Retirement planning Setting up a savings plan Of course you
September 14, 2015
by Michael Bark CPA CVA
Message Board
Views: 178 | Replies: 3
I'm a new grad working in Michigan and looking to get disability insurance. Does anyone know a good agent I could trust? Does it matter to find an agent where I live or could I go through the process over the phone? Thanks Ryan Mansfield | Financial Representative | Living Legacy Financial Group
October 13, 2014
Disability Insurance
Message Board
Views: 306 | Replies: 11
Greetings I would like to know more about the origins of dental insurance here in the US, specifically that of Delta Dental, MetLife and Aetna. And how they changed over time (leadership, the influence of dentists upon said companies, when they stated dictating fees for procedures, lawsuits, etc
February 02, 2020
PPOs and HMOs
Message Board
Views: 104 | Replies: 0
Hello! Not sure where to post this but figured to try here. I have had a couple patients come in who are uninsured and was curious to see what are rules and regulations on implementing and in house insurance plan. Do you advertise with direct mailers? Do you determine fee based on insurance comps? Thanks for the insight!
May 15, 2018
Restorative Dentistry
Message Board
Views: 988 | Replies: 6
I am a recent graduate. I have Medpro as professional liability insurance. It seems the premium is way high. which professional liability insurance is good ? Is medpro a good choice with high... How much is your annual premium? Claims made or occurrence policy? State of...I have mine with Fortress
June 18, 2014
Personal Finance
Message Board
Views: 208 | Replies: 5
I'm overdue for my dental exam and prophy! I have PPO dental insurance, is it wrong to charge out for exam, xray, and prophy as the patient and the provider? My hygienist will be taking the radiographs and performing the prophy...? Is this insurance fraud? A dentist with a PPO plan for himself
July 27, 2016
Claims Processing
Message Board
Views: 1330 | Replies: 17
Insurance verification sucks a lot of time out of a FD person's day. I'm trying to come up with ways to make the process more efficient. Here is what I have so far. I understand this is a problem most have probably solved to some extent, but I just want to make sure I haven't missed anything: 1
February 17, 2017
Front Office Discussion
Message Board
Views: 345 | Replies: 3
I'm looking for holes in my insurance coverage that would expose me to potential liability. does anyone know if the tdic insurance (or any other) covers sexual harassment lawsuits or hippa violations? ive heard of some pretty big fines and lawsuits that arose from those. thanks maxell Liability
July 15, 2017
Malpractice Insurance
Message Board
Views: 174 | Replies: 3
Just curious how many here are having patients send secondary insurance in on their own? It would seem that most of the time these days secondary insurance is paying very little at all and typically takes forever to get both insurance through. Are most finding this to be the case? K Are you
February 27, 2014
Claims Processing
Message Board
Views: 13399 | Replies: 423
This thread is meant to help dentist who have a long term goal of not having to deal with insurance in any fashion other than help file claims. For those who are interested, it's a great topic for a new year. If you have this goal, it only makes sense to learn from others who have been able
January 02, 2017
Patient Communication / Education
Message Board
Views: 133 | Replies: 2
Hello, I purchased a practice and take ownership in about 30 days. I am attempting to credential with their PPO networks, but it's a disaster. I reached out to Unlock the PPO and a few others, but they don't really do transitions and the sellers are so disorganized, that I'm sure they couldn't help...
February 24, 2020
Practice Management & Administrative Forum
Message Board
Views: 197 | Replies: 2
Hi, I'm an associate dentist at a practice in NJ that accepts 3 PPO insurances which I've signed up for as part of that practice. I'm applying for a job at a different practice in the same state which accepts those 3 insurance plans in addition to a whole host of other ones, for example Aetna. My
July 30, 2014
Claims Processing
Message Board
Views: 477 | Replies: 12
Hi all, Would like to see what some practices are doing for their employees regarding health insurance. I have two staff members, one has kaiser through her husband and the other just turned 26 so she is no longer under her parents coverage. I was planning on getting health insurance for the 26
November 06, 2015
Medical / Health Insurance
Message Board
Views: 434 | Replies: 7
I'm doing a start-up. Dry wall went up Friday. Gonna open soon. What are the 'Need to Knows' for insurance processing and claims and that whole world. I'm gonna be taking lots of PPOs (Unlock the PPO). I'm trying to learn the Open Dental Software and watching all of the Youtube videos. Something
May 08, 2017
Practice Management & Administrative Forum
Message Board
Views: 30 | Replies: 1
A number of patients in my practice over the last few months have changed their insurance coverage from United Health Care community plan to Dentaquest. We have been updating their insurance in dentrix as the patient has changed. Is there a way I can print out a list of all the patients that have
September 12, 2019
Dentrix
Message Board
Views: 317 | Replies: 7
What are you doing for your (and family) health insurance coverage? I am married. 4 kids. healthy. 30+. No conditions. Family is very healthy no conditions (Thank Heaven!) How much per month? 1,500+/month 10/20k...43, husband 45, 3 kids: Assurant dropped us in December, so now we have an HSA
April 22, 2016
Pediatric Dentistry
Message Board
Views: 47 | Replies: 1
Hello all, I was always under the impression that GEHA either is under Aetna Dental or leases Aetna dental network, so Aetna providers are in-network with GEHA. Is this still correct? Thanks for the info! GEHA currently runs with Cigna
March 27, 2020
Claims Processing
Message Board
Views: 462 | Replies: 10
Is there a program that anyone uses to verify Dental Insurance coverage? Our insurance person seems very bogged down calling insurance companies for verification. It seems there should be an easier way to verify insurance coverage and percentages. Any help would be greatly appreciated
March 31, 2019
Claims Processing
Message Board
Views: 287 | Replies: 9
A little trouble understanding how this works: example, Charge is $200, insurance allows only $150 and pays $50, says patient owes $150.00 because doctor is in network. We post payment of $50 from insurance and $150 from patient. However, because of being in network, the provider must write off
June 16, 2014
Claims Processing
Message Board
Views: 63 | Replies: 0
How do most dental offices handle federal dental plans? Is it worth it to even accept it?! HELP!
December 09, 2015
Claims Processing
Message Board
Views: 178 | Replies: 5
trying to credential are 600 for a crown, 40 for a prophy... and I'm being told that the seller's fee schedule is 'no longer available to new providers'. How is anybody getting into a practice with decent insurance fees? Is there some magic I'm missing? Would a workaround be to start
August 26, 2019
Practice Acquisitions
Message Board
Views: 395 | Replies: 8
What percent of premiums do you all pay for your employees health insurance? Thanks I capped it at $350 per month per employee. I add it to payroll and unfortunately have to pay all the payroll taxes on it. No way to avoid payroll taxers as far as I know. There may be a tax credit available
January 06, 2015
Medical / Health Insurance
Message Board
Views: 441 | Replies: 11
Dear All, I recently received an envelope from an insurance company touting the benefits of their plan. Sign up with us and get oodles of patients! they proclaim. So, I look. The fees are phenomenally low. I politely declined. However, the thought that comes to mind is that SOMEONE takes
February 01, 2016
Pediatric Dentistry
Message Board
Views: 203 | Replies: 6
Has anybody besides me ever wondered why dental insurance exists? Why is third party reimbursement for dental procedures not part of health insurance? If you go to a podiatrist and have foot surgery the podiatrist gets paid by the patient's health insurance company. Is this correct? If so, why
July 22, 2017
Medical / Health Insurance
Message Board
Views: 43 | Replies: 1
When RCT is done through PFM crown. What is the code to close the access ? Thank you. occlusal...
December 21, 2017
Restorative Dentistry
Message Board
Views: 428 | Replies: 5
Ok, townies. I need some wisdom posted down below please. My current Disability Insurance is good. -true own-occ lifetime -reasonable premiums My employer offers a policy and pays ALL of the premiums for long-term and even a short-term policy.....but.... -36 month own-occ If disabled I cannot
December 19, 2015
Disability Insurance
Message Board
Views: 345 | Replies: 5
I have been given several differing viewpoints on this issue and am looking for some clarity. Some of our staff have dental insurance. Obviously for preventative work we submit to their insurance and collect payment since it is covered at 100%. Currently for restorative work we have not been
October 12, 2015
Staff Management Issues
Message Board
Views: 390 | Replies: 14
I was in the military for 4 years and recently got into private practice as an associate. I have been shopping around for Health Insurance and it seems with Obamacare there aren't any options under $900 a month. What plans are you on? Is there any affordable insurance out there? Thanks Welcome
December 30, 2014
Personal Finance
Message Board
Views: 170 | Replies: 2
I think this may have been covered in an earlier thread here on DT, but I can't seem to find it. Does anyone know where I can get a list of insurance carriers who offer coverage for SDF (D1354)? I know delta does and so does ameritas. Should I just assume if a carrier as crappy as delta pays
June 11, 2018
Pediatric Dentistry
Message Board
Views: 302 | Replies: 4
Looking for feedback on how you handle insurance verification. We use.Stella and ecentral through dentrix which doesn't always work. Stella desk is ok but sometimes we don't get it fast enough for quickly scheduled appointments. We have a new front desk girl who has been doing it her way
November 14, 2015
Claims Processing
Message Board
Views: 1046 | Replies: 23
Hey guys! So, a huge reason for me being OON with most insurance companies is not having to waste so many staff hours on dealing with all of their tricks and obstacles. Due to inaccurate quotes and some claims not being paid, I recently had my FD begin verifying ins for all patients, which
February 12, 2017
PPOs and HMOs
Message Board
Views: 277 | Replies: 9
, but I usually just write it in the notes. Out of site and out of mind so I don't know if they really value or appreciate these things. This last week I went through and charged out, but went in and placed a fee of $0 for the procedures. I haven't billed out to insurance, but is this legal? I
January 23, 2014
Pediatric Dentistry
Message Board
Views: 160 | Replies: 2
on the phone being passed from one rep to another and no one doing anything. I'm feeling my next step is insurance commissioner. I read people say here on dental town to contact the state insurance commissioner for issues, but I am curious to what extent they would be able to help me with this, if at all? Any
November 16, 2019
PPOs and HMOs
Message Board
Views: 399 | Replies: 5
I am graduating this spring and know I need to make a decision about disability insurance soon. I am torn between the ADA's policy and Mass Mutual's unisex policy (I'm female). Over the last several years, we've been battered with so many sales pitches from reps and financial planners with big
April 13, 2017
Dental Students
Message Board
Views: 141 | Replies: 3
Does anyone have advice on how to get insurance companies to increase their acceptance rate for implant placement and restorations? When the implant is a better option (usually) it is a substantially better option than the alternative, and it drives me crazy that the vast majority of our pre
January 13, 2014
Claims Processing
Message Board
Views: 320 | Replies: 2
Does anyone have experience with... It's HMO but you can set up your fees. The way I understand it, for example: Regular HMO's copay for a crown is $300 ProCare let you set up you fees and then discount it. Let's say you want $1400 for a crown and then you have to give 80%off, this will end up at...
September 10, 2017
Patient Finance Plans
Message Board
Views: 219 | Replies: 1
I Would appreciate any recommendation regarding to any agency that help in PPO insurance negotiation. Edit by administrator. The post you made promoting your company/product has either been edited or deleted as this is considered self -promotion and is not allowed on the Dentaltown Message Board
August 12, 2020
PPOs and HMOs
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