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Message Board
Views: 135 | Replies: 3
From what I understand, pending insurance doesn't convert from PraticeWorks to OD. How is this usually handled? Do we just create a claim and enter the payment at the same time? Print a list of outstanding claims in PW and check them off as they come in? Robert A Scott DDS We converted in November
December 23, 2014
Open Dental
Message Board
Views: 460 | Replies: 5
and radiographically obvious Class II lesion Roots of #14 were present and clinically visible; when we inquired when the patient had the extraction done, the patient stated he removed the coronal remnants himself, at home. The insurance history show that the doctor billed the extraction. It angers me
July 24, 2015
Ethical Issues
Message Board
Views: 46 | Replies: 1
and follow up visits)? We need to submit a medical claim to the auto insurance. Thanks! BigRedDMD. We have always sent an itemized statement with procedure on left and prices on right with total on the bottom. This would be your full tx. plan for fixing the problem that the accident caused. Remember that you aren't sending a claim to health insurance. Dave
July 10, 2017
Coding Q&A
Message Board
Views: 301 | Replies: 8
Hello, Ok so I have read several previous threads re staying away from the ADA and not joining just for insurance. But it seamed like each thread was a little disjointed and there would be a little confusion. I currently have have disability insurance with own occ. He is recommending joining
October 05, 2015
American Dental Association
Message Board
Views: 206 | Replies: 4
We’ve used e-services in the past and have partly transitioned away from them. I still use Insurance manager as well as Website manager (but probably don’t need to since I have a marketing company that hosts and manages my website). We recently switched from the Insurance manager
February 20, 2016
Claims Processing
Message Board
Views: 734 | Replies: 20
As the end of the year is approaching I decided to review my insurance reimbursements from several PPO companies i am contracted with and I realized something...I worked harder and longer this year and made slightly more than last year... Im not sure if its ok to post my reimbursements here
December 21, 2015
Coding Q&A
Message Board
Views: 136 | Replies: 9
This is second patient in a month that I am seeing from two separate local offices with old onlays, defective onlays that need to be replaced for various reasons. When we look on insurance history they are coded/submitted as crowns. Just wanted to see if this is something new or is it being taught
November 20, 2018
General Cad-Cam Topics
Message Board
Views: 226 | Replies: 5
I'm looking for ways to reduce the amount of State Insurance I'm seeing. I've decided the best way to do this is to limit the age that I will see NEW state insurance patients to 12 years old. I figure as a pedo, my time is better spent treating the smaller kids that truly need a pediatric dentist
July 21, 2015
Pediatric Dentistry
Message Board
Views: 31 | Replies: 0
DTers, I'm looking for someone to do a comprehensive review of my current insurance policies I have for my personal/dental office (life, car, disability, business overhead, workers comp, etc). I haven't done this in about 4 years and my situation has changed dramatically with my office (growth
November 26, 2017
Practice Management & Administrative Forum
Message Board
Views: 265 | Replies: 4
Does anyone have any experience charging medical insurance for Botox treatment? I understand many medicalins companies are covering Botox treatment for migraines. Good luck. I have found it rare to get any coverage for BoTox . Yes , they can get coverage for migraines but usual only after all
December 29, 2018
Botox & Dermal Fillers
Message Board
Views: 166 | Replies: 2
number of dentists are too busy to bother fighting this stuff, and simply write it off. I was at an AGD meeting once and there was a doc there that stated he was once an expert consultant for a major insurance company. He claimed that it's a known fact in the industry that 10% of these claims are not followed up on. Great way to add 10% profit for the company.
January 11, 2018
Restorative Dentistry
Message Board
Views: 50 | Replies: 2
If husband and wife each have dental insurance at their jobs, and wife is the patient today, which insurance is her primary? Is it hers or is it based on their birthdates in the year? Help. Front desk person not here today..... The wife is primary for herself with the husband's insurance being
March 28, 2014
Claims Processing
Message Board
Views: 332 | Replies: 9
I just hired a new dental assistant. At the 90 day mark, I force the assistant to take medical insurance (I pay for them) OR if they can prove they have insurance through a different source, I give them cash in lieu of medical insurance. This new assistant says she has state welfare medical
December 06, 2018
Staff Management Issues
Message Board
Views: 781 | Replies: 32
We have a patient that was seen February 15, 2017. Insurance paid in full for his visit. Fast forward to September. Insurance notifies us that the patient was never active under one of their policies and we owe them (the ins. company) the payment they sent us. I send the letter from dental town
February 13, 2018
Claims Processing
Message Board
Views: 115 | Replies: 2
My office manager wants to take a course on billing medical insurances for certain dental procedures. I looked on Dentaltown for a CE but couldn't find anything. Are there any good online courses that can teach this information? Thanks. We include this topic in our CE seminars. You are more than
May 10, 2018
CE Comments / Suggestions / Events
Message Board
Views: 451 | Replies: 8
So I recently performed an emergency Cvek pulpotomy on a perm max incisor (kid got shot in the tooth with a pellet gun). Had a complicated crown fx. Submitted vital pulplotomy and compostite filling to insurance. They denied the pulp stating their dentist consultants said performing pulpotomies
August 20, 2018
Pediatric Dentistry
Message Board
Views: 131 | Replies: 0
for this meal: $50 for the steak, $10 for the salad and $15 for the dessert. A change then occurs in the restaurant industry. A new form of eating out has been adopted. Your favorite restaurant has now contracted with over 30 different ”restaurant insurance companies.” Anticipating another
March 18, 2014
Dental Insurance for Dentists
Message Board
Views: 152 | Replies: 6
If someone has reached their annual maximum, would theystill have coverage fora recall appointment or does that also subtract from the annual max? Thanks Maxed out means there are ZERO dollars left until the next insurance year for any treatment, period.Most insurance counts preventative
July 31, 2018
PPOs and HMOs
Message Board
Views: 272 | Replies: 2
After several years of being an associate, I am in the process of opening my own private practice. I am looking for a good Dental Insurance Training course for my staff and me. I also need to get some CE hours before the end of the year. This has probably been asked several times before
November 08, 2017
Dental Insurance for Dentists
Message Board
Views: 716 | Replies: 9
will offer these limited benefit policies in order to be cost competitive but in the long run they only hurt the client at claim time. We would also recommend that you get quotations from one or two of the other leading providers of disability income insurance as many times a very similar policy can
August 20, 2016
Personal Finance
Message Board
Views: 580 | Replies: 10
there are no loans $11k seems like a generous amount, but would obviously need to save for retirement too. Is there a happy medium of how much is enough? My significant other always works and we could live off of her income too. Much like life insurance it's a personal decision. If I were disabled I would want my
January 19, 2017
Pediatric Dentistry
Message Board
Views: 55 | Replies: 2
Can anyone chime in on appropriateness of this? I was under the impression that 6057 abutment fee, 6059 crown fee is appropriate? I am in network with this particular insurance FWIW. Looks like I'm being hosed for this, but what do I know... Looks like you coded correctly, they just downgraded from high noble to noble. Good point. At times, I was fooled by the alternate benefit. Thanks
June 23, 2020
Implantology
Message Board
Views: 221 | Replies: 3
Am I the only one getting insurance refund letters disguised as overpayment.We are not receiving a lot of request but one or 2 a year. Your advice may be to bill the patient..Correct.Patients dont respond to our request to collect the refund and mail back to these insurance companies . I am now
June 02, 2020
Claims Processing
Message Board
Views: 419 | Replies: 6
Obviously you can't practice without malpractice insurance...... I own the building so I have property insurance (if building burns down) When I did have a loan from bank for the practice I think I had commercial general liability ( to cover if someone fell in the office or parking lot) but I
February 07, 2016
Practice Management & Administrative Forum
Message Board
Views: 208 | Replies: 5
For the doctors that do in office GA (as the operator with a separate anesthesia provider), have you noticed an increase in you professional liability insurance. I know as a DA I get hit with an expensive policy for good reason, but wanted to see if any of the non anesthesia providers have seen
March 09, 2018
Pediatric Dentistry
Message Board
Views: 273 | Replies: 10
Insurance companies are beginning to pay claims using a Virtual (POS card payment) payment. They do not send a check, but a POS Card Remittance Payment. The instructions state to Process this payment as you would any credit card payment you receive, using the virtual card information
August 30, 2014
SoftDent
Message Board
Views: 388 | Replies: 18
My current Individual Health Insurance Plan is getting cancelled at the end of this year. I found a new plan offered through my state dental society, but it is a Group Plan that MUST be offered to all of my employees. So, if I sign up with their plan, am I required to pay for their premiums
December 09, 2016
Medical / Health Insurance
Message Board
Views: 275 | Replies: 1
We verify insurance for medicaid patients before every appointment (since it changes daily and I've had to write off too much when things have changed) and for private insurance every month. My schedule coordinator is going on maternity leave any minute so she was showing me how she verifies so I
August 14, 2014
Front Office Discussion
Message Board
Views: 417 | Replies: 14
I have a patient who has Dual insurance. Primary is Principal and secondary is Delta. Patient needs a bridge replaced. I am in-network with the secondary (delta) but not the primary. Who will determine what I get paid? Would it be my UCR as I am out of network with principal or Delta, where I take
September 23, 2020
Claims Processing
Message Board
Views: 757 | Replies: 7
Here in Washington I was going with NORDIC as they were pushed by the school as being for dentists. I finally got around to doing some price investigation and found a great option. Angie at Professional Solutions Insurance Company was amazing. Got a much better deal by talking to her. She was great
August 04, 2017
Malpractice Insurance
Message Board
Views: 1321 | Replies: 15
limited exams are free for cash pts including xrays, diagnosis, and prescriptions. I do a lot of occlusal adjustments, application of desensitizer, pulp testing, and denture adjustments for free. My compensation is based on 30% of production for cash and 30% of collection for insurance. Recently I came
January 25, 2017
Ethical Issues
Message Board
Views: 105 | Replies: 1
Hello all, I m about to take impressions for my first oral appliance to treat osa. Do i need to alert my malpractice insurance company? What precautions do i need to take from medico legal point of view? Please advise. Thanks You just might need to after you change the occlusion, permanently
April 25, 2018
Sleep Apnea / Snoring
Message Board
Views: 186 | Replies: 2
Just wanted to share a fact sheet that you can keep handy the next time you need to have the conversation with a patient about why they owe what they owe AFTER insurance has paid for their free cleaning.... While I have been around dental practices for over 30 years - I recently also obtained my
September 20, 2017
Claims Processing
Message Board
Views: 120 | Replies: 0
Can anyone advise on a dentist covering clinic for a day or two, and how to file insurance claims if the new doctor hasn't seen patients in my clinic before? Thanks
January 29, 2015
Claims Processing
Message Board
Views: 400 | Replies: 8
My FD would like to attend an insurance billing course or receive some kind of guidance to make sure she's coding properly. Do any of you have suggestions on courses (online or onsite) or other helpful resources? She received a flyer in the mail and would like to go to Paul Bornstein and Cross
April 18, 2019
CE Comments / Suggestions / Events
Message Board
Views: 382 | Replies: 3
Like many of you I am in contract with many PPOS paying 800-1000 per denture. Right now I use a high quality local lab and with custom trays, wax rims, try in, and complete I can easily run up a $600 lab bill. What I'd like to do is formulate a cost effective insurance denture using either
August 17, 2018
Removable Prosthodontics
Message Board
Views: 116 | Replies: 4
Is anybody familiar with Aetna International? We live in a city with a few small community colleges around and started seeing foreign students with Aetna International insurance. This Aetna plan is very confusing. They paid for extractions out of medical so extractions are not counted toward
June 14, 2014
Claims Processing
Message Board
Views: 230 | Replies: 7
So nobody is happy with these debit card insurance payments so I'm thinking of issuing one to MetLife as I owe them 191$ on an... If you can find a way to pay them for that by credit card --- let us know --- I think we'd all do it!Those debit cards are a pain, AND if you process them you
February 19, 2016
Front Office Discussion
Message Board
Views: 116 | Replies: 0
Reprinted from , health insurance industry business, financial and regulatory news May 7, 2012Volume 22Issue 17 The reason I am sharing this is because there is a method to marketing that is not advertising, but included in advertising. Notice they market the brand, something private practice
January 28, 2015
Marketing
Message Board
Views: 199 | Replies: 5
I carry Anthem Blue Cross insurance and sought to obtain a few prescription items recently and am witness to a disturbing trend. We all know about Martin Shkreli, who jacked the price of a drug. There;s a lot more of that out there. I wanted to procure some Nasonex. Not covered by insurance. Cost
December 21, 2016
Just Plain Bitching and Moaning
Message Board
Views: 229 | Replies: 6
In my experience, most dental insurances will not pay for both an interim denture and a final denture, therefore I have the patient pay for the interim and then we submit the final denture to insurance. My question is : If I am In-Network with the patient's insurance, and we are not utilizing
July 17, 2019
PPOs and HMOs
Blog
Yes, you can win the dental game, despite the and the pressure you may feel from insurance companies. There are three magic words that, if applied consistently, will win the game: provide excellent service. The truth is, corporate dentistry and insurance companies have helped turn the dental
September 23, 2015
by wmjankowski
Message Board
Views: 149 | Replies: 1
I am a 4th year about to graduate and go active duty Air Force. I have heard it's a good idea to carry disability insurance coverage beginning beforeactive dutyand carried throughoutactive duty so you are not denied coverage after separating from the military. I have also heard it can lower
January 06, 2019
Military Dentistry
Message Board
Views: 704 | Replies: 8
I recently had a few patients switch to a dental PPO (through their employer) for which I am not a provider. I received the contract and reimbursement fee schedule but was curious as to how to negotiate these fees. I have never negotiated fees with an insurance company before and believe
September 28, 2017
Practice Management & Administrative Forum
Message Board
Views: 574 | Replies: 14
is what I had to do for most of my career.) My question has to do with insurance companies. That was never an issue for me, because my office was mostly FFS. Most other dentists in town, however, have become preferred providers for several inscos. Is it necessary for me to become credentialed
January 28, 2015
Practice Management & Administrative Forum
Message Board
Views: 102 | Replies: 3
Can someone explain how a disability insurance accumulation period works? Maybe give an example or two how the elimination period works within the accumulation period? The days within this period need not be consecutive but they must occur within the accumulation period I'm getting ready for my
August 12, 2019
Personal Finance
Message Board
Views: 140 | Replies: 1
Is there any way to be a provider with PPO insurance plans and offer different levels of dentures (base, mid level, premium)? Is this legal? What codes do you use? Thanks! You'll get 10 different opinions on this question. Basically it depends on your agreement with the insurance company. Most
July 22, 2014
Coding Q&A
Message Board
Views: 19 | Replies: 0
We have a good many state employees with BCBS state standard which pays very low (18 for a prophy for example). I think the state pays for that low budget plan for their employees. The state employees have an option to purchase a supplemental plan called Blue Cross plus. If there is a claim, the...
November 25, 2015
Dentrix
Message Board
Views: 54 | Replies: 2
Hello all, I have another question about primary and secondary insurance. My patient is retired and has 2 dental insurance plans, one of which is a Aetna PPO policy and the second of which is Horizon BCBS which only covers preventive services. When I took over as a dentist in this practice 2 years
August 11, 2016
Claims Processing
Message Board
Views: 178 | Replies: 6
Not sure if this is the right forum but I want to ask if any advise for wording to write to insurance company requesting info and the blank spot that asked me for additional comments to be in my favor. Thanks. Long story short- made a upper complete denture for a patient who has a flat palate
November 05, 2018
Legal Issues
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