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Blog
. Offices rarely approach insurance companies for an increase. They sit back, wishing and hoping that an increase will come through this year, while continuing to collect on average 55% to 65% on a D1110. Systematically approaching your contracted insurance companies for insurance fee negotiation is part
April 05, 2013
by LErwin
Message Board
Views: 214 | Replies: 4
I have heard dentists in Washington state, California, and Arizona say that dental business in those states is dominated by insurance (Delta). Are there any states where insurance is less dominant? Thank you As a general rule, the more rural you go, the less dominant it seems to be. I started
November 26, 2015
Patient Finance Plans
Message Board
Views: 116 | Replies: 6
New practice owner. I'm fee for service and do not participate with any insurance companies. We do, however, submit the claims to insurance and then send the patient a bill for their portion after we receive payment from the insurance company. This is creating a couple of obstacles for me: 1
August 14, 2019
Claims Processing
Message Board
Views: 147 | Replies: 1
I'm in the process of terminating my direct contract with several PPO insurance plans. I am still contracted with a few third party administrators (Zelis, Connection/GEHA) so the dropped plans will likely get picked up through one of those TPAs. What is a simple and clear way to explain
May 30, 2020
PPOs and HMOs
Blog
Once you get out of the house, finish college, and get your first job, it's pretty much a good idea to get a health insurance plan for yourself. A health insurance plan will enable you to take care of your medical costs more effectively. Health care costs can really put a dent to your wallet
November 15, 2020
by Luke Worlie
Message Board
Views: 4364 | Replies: 284
50%) I don't mean to sound like a jerk, but what is it that you provide that a regular insurance doesn't? You have mentioned you will get 1 patient per day into the office for the free diagnostic appointment, but what is the true value or guarantee in that? We do add for lab costs when something
February 13, 2016
Claims Processing
Message Board
Views: 463 | Replies: 3
I’m currently in the middle of start-up process and will need to sign up with most major insurance companies. How do I get the process started? Is there any resource out there to help the process? I believe I’m signed up with all the major PPOs being working as associate for the past 3
January 09, 2015
Claims Processing
Blog
Helping clients avoid private mortgage insurance is one of the most important things that we do. You want to try to avoid mortgage insurance at all costs for a couple of reasons. Number one, mortgage insurance doesn't fall off of most loans until you're in the 10th or 11th year
November 14, 2018
by Fairway Independent Mortgage Corporation
Message Board
Views: 356 | Replies: 11
Recently we have had insurance companies denying coverage either a sealant or a buccal pit if they are on the same tooth. One plan (state funded) will not pay for a sealant unless it is done on a virgin tooth. So we can either write-off the fee for the sealant, or bring them in for a second visit
April 03, 2014
Pediatric Dentistry
Message Board
Views: 312 | Replies: 8
reason they would do this is if they somehow benefit. Someone is cutting them .5-1%. We get them from time to time, our rate is crazy low so we just run it. I get several per month. I refuse out of principal to take another percentage off my payment. I usually contact the insurance company
July 22, 2014
Claims Processing
Message Board
Views: 85 | Replies: 1
and we split everything 50/50. However he made me credential with Delta Premier and MetLife individually under my own corporate tax ID so I could bill the specialist fees (and attract patients from other offices with Metlife). The insurance checks will be written to me but he will be collecting
June 20, 2020
Practice Management & Administrative Forum
Message Board
Views: 110 | Replies: 0
Just got an offer of only an $80 difference between (same company, just coverage amount) $1Million/$3Million vs. $2Million/$4Milliion That is pretty cheap. Any opinions/comments, is the getting the higher amount (same company) for just $80 worth it? Thanks
August 26, 2017
Dental Liability Insurance
Message Board
Views: 155 | Replies: 2
Delta Dental has lowered our fees across the board in my area and I am trying to see exactly just how dependant we are on Delta Dental. This is how I am doing it: *Utilizing the Dentrix Insurance Utilization Report to find my total insurance and then running a utilization report with just
September 08, 2014
Dentrix
Message Board
Views: 593 | Replies: 17
Dear Townies- I have been dying a death of a thousand cuts... Losing patients and low insurance reimbursement. I have found many sources for insurance fee negotiators... Aspen Reimbursment Udell Webb Everest Advocates Unlock the PPO Anyone check out these? What are the terms for paying
July 15, 2014
Practice Management & Administrative Forum
Message Board
Views: 345 | Replies: 8
I have always been under the impression that if you have a promotion, it must be available for all patients whether they have insurance or not. For example, if you a discounted exam or free xrays, you must write off that amount to the insurance even though technically insurance patients get
December 30, 2014
Marketing
Message Board
Views: 140 | Replies: 5
So I've been credentialing with a few insurance groups. If I get credentialed with the one big one such as INSURANCE A ->I'm automatically credentialed with all the ones (B,C,D,E,F) under it.... However, the fees are the same for all the insurances under the big one. A=B=C=D=E=F Is there any
March 28, 2017
Claims Processing
Message Board
Views: 370 | Replies: 12
Certain Insurance have different groups. Say Cigna A and Cigna B. My question is if I am in-network with Cigna A and accept a reduced fee, say $700 for a crown split 80%/20% (Ins/Pt) . If a Cigna B patient comes to our office and are out of network do they still get the reduced fee or do I get my
October 24, 2018
Claims Processing
Message Board
Views: 781 | Replies: 15
) it automatically goes to their medical insurance and pays 0 due to a 3000 dedctible......Anyone else heard of this BS? Apparently only two codes in the oral surgery codes are covered by the dental part....Apparently anything that involves much more than forcepts is considered medical....Hey maybe I am
November 09, 2015
Oral & Maxillofacial Surgery
Message Board
Views: 258 | Replies: 14
Our Financial Coordinator has made some lazy errors with end-of-day lately. Because of this, I began doing some auditing of her responsibilities. One thing that I noticed is that there is over $20k in over 90 day insurance aging, with estimate payment of 17k. I am thinking this is bad.... but I
January 28, 2014
Ask a Dental Consultant
Message Board
Views: 262 | Replies: 10
Patient already has a dental discount plan and then received guardian health insurance. What fees do we charge her? I thought that an in-house discount plan is typically for patients without insurance. If the patient now has insurance and wants to use it, then no more discount plan.It
April 11, 2017
Claims Processing
Message Board
Views: 105 | Replies: 3
Ok, so in our office we're only in network with two insurances, and i'm not 100% certain what the legality/ethics of this is.. the patient needs #10 extracted, and we're planning on replacing with implant. however, we would like to make him a flipper to have as a temp. my understanding is, if we
January 25, 2017
Claims Processing
Message Board
Views: 115 | Replies: 0
This is an article that a FB friend shared with me, since she knows the issues I go through with insurance. It is from 2008, but I thought it is worth sharing with you guys. http://thehealthcareblog.com/blog/2008/07/09/doctors-who-don’t-take-insurance-what-does-it-mean-for-patients/
July 31, 2015
Practice Management & Administrative Forum
Message Board
Views: 121 | Replies: 6
We are having second thoughts about taking secondary dental insurances. What do the majority of the practices do? Are we going to loose some patients? We accept most PPO plans, we don't take any HMOs. We will file 2nd insuranceclaim as a courtesy and submit with primary EOB. We don't accept
October 12, 2016
Claims Processing
Message Board
Views: 1799 | Replies: 45
I am running into a problem where cignas fee for an implant supported denture is $1390. The lab fee for that procedure is $4000 minimum plus parts. Their response when I call is I guess you can't do that procedure How do you guys handle this? refer to a prosthodontist or drop the insurance
January 19, 2019
Implantology
Message Board
Views: 13399 | Replies: 423
Your definition and mine of a FFS practice are NOT the same. I collect 100% of my fee prior to any treatment. NO assignment of benefit We fill out insurance claims, you have to, impossible for a patient to file themselves. But no insurance money comes to my office. To me if you accept assignment
January 12, 2017
Patient Communication / Education
Message Board
Views: 13399 | Replies: 423
, (for a fee) if Mr. Patient doesn't pay once he gets his check? Have them take out a no interest carecredit loan. Once they getthe check they can pay itoff.Of course I agree with all of the concerns everyone has about going insurance free. Patients are people. I had to pay $25 bucks to check a bag
January 11, 2017
Patient Communication / Education
Message Board
Views: 223 | Replies: 2
So we recently started a practice and have some family with dental insurance that we are going to treat. We were planning to waive their portion but still submit to insurance. I know a lot of places do this and just hope they don't get caught but it makes me a bit nervous. I did some reading on DT
July 26, 2016
Claims Processing
Message Board
Views: 275 | Replies: 3
Family is owed a refund due to having 2 insurance policies for a short time and both policies paid on treatment resulting in a credit balance. Would you refund to head of household or iinsurance subscriber? Not sure how it works in the US..... I would be wary. Perhaps the patient can
February 27, 2015
Front Office Discussion
Message Board
Views: 213 | Replies: 5
Hello,On the dental license application, it asks if I have malpractice insurance. I am starting residency next month and wish to moonlight on the side. I have not yet gotten my malpractice insurance and If I say no, will the board not approve my license? Or should I just get malpractice insurance
June 17, 2019
Licensing by Credentials
Message Board
Views: 344 | Replies: 16
I was told today that I am not supposed to collect insurance payments for my spouse's treatment. Supposedly it's in my Delta contract. Why would I send my spouse to another dentist for a crown if I can do it? Stupid... Ask delta about potential wife's treatment ( Aka GF) . Do they mind about
March 06, 2014
Practice Management & Administrative Forum
Message Board
Views: 44 | Replies: 1
A patient wants a copy of the ADA form for an appointment so they can submit it themselves to their employer. Apparently, its a self-funded plan, so there is no insurance company to submit to. Is there a way for me to create an ADA form that prints with all of the information included except for the insurance company? Our system is Dentrix G6. Thanks. Maybe. I would just create a new insurance company with the employer information.
July 24, 2017
Claims Processing
Message Board
Views: 195 | Replies: 4
. Insurance company is saying that they already paid that code for that tooth and root tip removal is a different code, 7210. The extraction was not surgical, so should I just charge the patient the full extraction fee or should I submit the surgical code, even though it wasn't, and treat
September 30, 2016
Coding Q&A
Message Board
Views: 283 | Replies: 5
We have this topic awhile ago but wanted to know if anyone has changed or found different ways to help staff get health insurance. Do you have health insurance through your office? If so, how does that affect your tax return? Thank you After extensive research I found that my staff can get
April 25, 2015
Pediatric Dentistry
Blog
Insurance helps the public access health and dental services at a more affordable cost. It’s a necessary component to the healthcare industry and economy. The work required for effective dental insurance management and processing requires strong tact in thorough investigation and research
February 25, 2017
by Sheri Jolly
Message Board
Views: 167 | Replies: 6
Just wanted to share if you have auto insurance from AAA or Autoclub, they now offer a professional discount for dentists. I called in and was able to get my insurance lowered right over the phone. Its new and only about a year old. They wanted proof i was a dentist and told the lady to go
June 21, 2014
Automobiles
Message Board
Views: 63 | Replies: 2
For some reason we have 5 un-deposited insurance checks in our deposit slip section. They were from some time ago, but we need to match them up to the correct deposit. The information that is showing is the date, the insurance company name, the check number and amount. Is there a way to search
April 21, 2016
Open Dental
Message Board
Views: 351 | Replies: 3
Asking for a quick smattering of opinions. Here's the deal. I'm 30 years old. I have a wife and two children. I am in my first year of residency. The only disability insurance I currently have is through ASDA and is their $1K/month free policy and their $50K free life insurance policy. I know
October 19, 2015
Pediatric Dentistry
Message Board
Views: 356 | Replies: 9
In states that have passed bills allowing us to charge full fee for non-covered procedures; why are insurance companies asking us to op in or op out. Who would sign an agreement to take the lower fee for these non-covered procedures. I called an ins company asking why. they would not answer. I
March 28, 2017
Dental Insurance for Dentists
Message Board
Views: 155 | Replies: 0
I am looking into switching from the ADA-sponsored disability insurance with Great West to another carrier. I am trying to assess the risk associated with staying with Great West given that 1) the policy itself is subject to change over time, and 2) the premiums increase with age. If I buy from
April 13, 2016
Medical / Health Insurance
Message Board
Views: 596 | Replies: 4
Hi all, I am wanting to work as a temp in my are as a general dentist. I have some worked lined up in 5 months but was turned down for malpractice insurance (by MedPro) due to me not having an official practice location. They said to apply again when the time I will be working is nearer. My
July 15, 2017
Malpractice Insurance
Message Board
Views: 66 | Replies: 2
Hello! Does anyone know of a Business Insurance Company/Underwriter that will cover subleasing an office? My agent looked at all their sources and none would cover me adding a sub-tenant (other specialist on my off days). I am hoping someone found one. Thanks I'm not an insurance professional nor
September 01, 2019
Practice Management & Administrative Forum
Message Board
Views: 142 | Replies: 3
I had my insurance broker give me options for the new insurance year starting in Jan. I presented everything to the staff who get insurance through the office and gave them a deadline of today to check to see if they want to stay on the group health insurance or get off and get their own plan
December 01, 2014
Practice Management & Administrative Forum
Message Board
Views: 137 | Replies: 5
Has anyone ever hired a front desk with no previous experience? (new grad, etc.) I'm wondering what would be the best way to train the individual regarding working with insurances, submitting claims, getting breakdowns, and more. The practice accepts assignment so we need to be 100% dialed
August 24, 2018
Canada
Message Board
Views: 831 | Replies: 25
Aborted treatment at GP, per mom, a sedative fill was placed. We checked with insurance and pre-auth and they billed out for: # S - Pulpotomy # T - MO Resin Insurance won't cover the MO that I have to do so the parent will eat the bill. I don't see any signs of that tooth being touched. Pardon
August 30, 2018
Pediatric Dentistry
Message Board
Views: 74 | Replies: 0
I have been told rural practices are able to better negotiate for higher fees with insurance companies because they are the only show or 2 in town. Any truth to...
March 15, 2017
PPOs and HMOs
Message Board
Views: 43 | Replies: 2
Hi, townies I have one patient who needs mandibular advanced device for her snore and I want to sentpredetermination for her medical insurance. How should I send predetermination for medical insurance? do I still use CMS-1500 form to medical insurance predetermination, similar to dental clam form
November 14, 2018
Claims Processing
Message Board
Views: 216 | Replies: 3
Hi, i wanted to check if hiring insurance contract negotiator is worth it. we are transitioning from a medicaid office to insurance based and want to get some professional help in contract negotiation. how much these guys would charge.. it will be great if some can share their experience
October 11, 2016
Practice Acquisitions
Message Board
Views: 50 | Replies: 0
Located in Ohio. Asking for my FD. Does anyone have any really good information or resources regarding the Affordable Care Act strictly for dental in Ohio? We are a new office and are trying to educate ourselves. We have a few patients, who we believe's insurance comes from ACA, but we are unsure
February 08, 2017
Dental Insurance for Dentists
Message Board
Views: 135 | Replies: 5
hello all, came across a scenario and seeking some input and advise from past experiences. i own a fee for service office. another opportunity of mainly insurance participation practice came up and wanted to see if its wise to merge both practices and such. ins office is larger facility and more
August 17, 2020
Practice Acquisitions
Message Board
Views: 365 | Replies: 1
Hi all, I'm applying for disability insurance and was quoted the following: 1. Monthly benefit: $4000/mo Optional riders: Future increase option $5000/mo Residual disability benefit rider Cost of living adjustment 3% rider Total Annual Level Premium: $2400 1. Monthly benefit: $4000/mo Optional
April 20, 2016
Personal Finance
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Page 55 of 817
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