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Podcast
tessina 33 During this episode Tessina answers several of the most common insurance related quetions sent to us by the listeners. Per popular request Tessina has been asked to make a 4th appearance on the podcast to address
May 26, 2017
by Jordon Comstock
Message Board
Views: 333 | Replies: 6
The title states it all. The office manager at the office I am moving to (FFS) is really worried my NPI is going to follow me and make insurance billing a nightmare. My understanding is if the tax ID number changes it shouldn't be an issue. has anyone switched offices and had problems
April 25, 2019
Dental Insurance for Dentists
Message Board
Views: 230 | Replies: 2
I am GP and just started few invisalign cases at my office. But I encountered some patient with PPO insurances who are interested in invisalign, but I am wondering if most PPO insurance cover invisalign? If not, I think I will quote PPO patients the same fees I charge to FFS patients. Any GP doing
January 23, 2014
Orthodontics
Message Board
Views: 1216 | Replies: 21
I just received an invitation to sit in on a webinar for insurance industry folks. Below is the description: Tiered and Narrow Dental Networks Competition is fierce for commercial business and growing stronger for individual and exchange customers. Tiered and narrow networks give you
November 10, 2015
Dental Insurance for Dentists
Message Board
Views: 259 | Replies: 2
their insurance. Do you see that those people actually DO come back once they are gone? Not sure what to do, but the current rate of attrition is not acceptable If you are content where you are you will have to be reactive instead of being proactive. Ideally you would be never in a situation where dependence
April 07, 2016
Dental Insurance for Dentists
Message Board
Views: 103 | Replies: 2
hey guys, i just noticed one of my 5 insurances covers a basic preventative procedure that my other 4 dont. What is the easiest way to just add that code and fee to my one set of insurance patients? Insurance A pays $53 for oral hygiene instructions and $34 for nutritional counseling. Please
September 18, 2017
Dental Insurance for Dentists
Message Board
Views: 214 | Replies: 2
From Marc Cooper: THE NEXT ASSAULT ON SOLO PRACTICE Insurance companies Guardian, Met Life, and others are now reducing, or not covering, numbers of restorative procedures, especially implants and crown and bridge, for out-of-network dentists. They are still maintaining reimbursement at a reduced
August 17, 2016
Dental Insurance for Dentists
Podcast
002: Ben Tuinei – How to Successfully Negotiate with Insurance Companies Listen Welcome to another episode of The Dentalpreneur. On today’s show we’re covering an extremely important topic: how
June 29, 2015
by DrMarkCostes
Message Board
Views: 721 | Replies: 20
cleaned up well, on to maintenance, they do well. She desired to have the scaling in one sitting. Not our norm but sometimes we will. Blocked out a couple hours and completed the treatment. So we get insurance EOB requesting information wanting WHAT WE ALREADY SENT--radiographs, charting. Now
August 30, 2018
Claims Processing
Message Board
Views: 111 | Replies: 3
Case in point Metlife. I forgot to bill them and it's now 3 months ago. Most insurances have a 6 or 12 month time frame so send it out right away. There are a few that have gone to 90 but you won't know until you send it. You should bill it out regardless of time. More importantly
March 09, 2015
Claims Processing
Message Board
Views: 121 | Replies: 0
I got an insurance update from UPMC Dental Advantage which is a big player in the Pittsburgh area b/c UPMC is the largest employer in Western PA I believe. The updates say that rct re-tx's can only be done by a specialist to get insurance re-imbursement. I don't do many retreats, maybe an anterior here or there, but this is really screwed up to me...
December 17, 2014
Claims Processing
Message Board
Views: 17 | Replies: 0
If you are dentist credentialed in a group practice and move out of the state or to a new city and say are with Humana/Delta/others. Does the previous insurance credentialing have any bearing or create issues for future credentialing if one acquires an office in a negative way? Example, you work
August 29, 2018
PPOs and HMOs
Blog
Kiera welcomes Donna Dinette who emphasizes the simplicity of getting a 97-98% return rate on your insurance claims! It is all about knowing what the insurance companies want as well as being sincere and confident when speaking with your patient. Kiera and Donna lay out useful instructions
April 09, 2020
by The Dental A Team
Message Board
Views: 346 | Replies: 3
I am a fourth year dental student about to enter the workforce. Because I have Type 1 diabetes, it has been remarkably difficult (and remarkably important) for me to find disability insurance coverage. I did come across two guaranteed issue policies that might be of some help for me, but not a lot
May 11, 2017
Disability Insurance
Message Board
Views: 167 | Replies: 3
I am processing an EOB and for the first time since I've used Open Dental, the insurance estimate isn't defaulting on the claim edit/payment screen. Have I changed a setting to make this happen? Don't think I've done anything with my setup for this to occur. Does anyone know how I can change
June 30, 2015
Open Dental
Message Board
Views: 77 | Replies: 0
It is always a good idea to have disability insurance just in case......
October 21, 2019
New Grad 2019
Message Board
Views: 1617 | Replies: 56
Insurance Exchange. I got this email recently
November 19, 2015
Personal Finance
Message Board
Views: 108 | Replies: 3
Hello Townies, I am looking at a practice to buy where the seller has Easydent as a PM software. Problem is he has no idea how to use it other than for scheduling. He does not pay for support either. We need to look at what % of production comes from each ins co. Can anyone that knows Easydental...
October 07, 2014
Practice Management & Administrative Forum
Message Board
Views: 800 | Replies: 38
So I bought this practice. And the doc that retired was very lazy about updating health histories and insurance information. And privacy policies? Not existent. I've been working very hard to get health hx updated and HIPAA forms signed. Some current patients hadn't been updated in 5+ years
January 06, 2015
Claims Processing
Message Board
Views: 67 | Replies: 1
I'm trying to incentize my HYG with doing more elective sealants and fluoride etc........but trying to filter the reports from sealants/fluoride that's covered by insurance and those that aren't.............one way to filter them is to NOT file the ones NOT covered by insurance .. Can we
January 03, 2020
Front Office Discussion
Message Board
Views: 315 | Replies: 11
I am really having a problem with obtaining accurate fee schedules from a number of insurance companies. I know these schedules vary by zip code, but is anyone aware of an accurate way to obtain this info with out having to call the insurance... I'm sure that they aren't online. Insurance companies
February 10, 2014
Practice Management & Administrative Forum
Message Board
Views: 7532 | Replies: 346
on max claims paid on per subscriber. Like the half million or million dollar caps were gone. Was that not the case or has this provision already been gutted?That is not true. >2% owners of s-corporations have to add the health insurance premiums paid by the corporation on their behalf
October 10, 2017
Politics - DO NOT Enter if easily offended
Message Board
Views: 186 | Replies: 5
efficient. thanks.. Most major insurance companies have an up to date website. My office checks all ins online take less then a minute instead of hours on the phone. It's awesome. U or your OM can setup all the username and password. It's pretty accurate. Never had a problem in the last five years
January 15, 2015
Delta Dental
Message Board
Views: 2075 | Replies: 21
Starting a new dental practice in July 2015. Has anyone used an insurance credentialing company? I have called Insurance Credentialing, Unitas Dental, Five Lakes and Unlock the PPO. Five Lakes and Unlock the PPO were by far the most expensive, and Insurance Credentialing was the cheapest. Five
May 30, 2017
Delta Dental
Message Board
Views: 332 | Replies: 11
additional insurance coverage with Medicaid. That might be different in your state. Especially having MA as secondary makes no sense to me. This does seem very confusing. in my mostly medicaid world, you take what the other insurance pays, and don't even bill medicaid since the amount is ALWAYS
September 30, 2014
Claims Processing
Message Board
Views: 1435 | Replies: 31
to push for separation. If there are some law firms already sniffing please post updates here. Tweet: Alberta midwives have better insurance coverage than dentists...just ask Amber Athwal's parents . Better liability and better legal coverage...says something about the dual role
April 27, 2020
Canada
Message Board
Views: 85 | Replies: 0
I have the option to purchase income protection insurance for my start-up office for a little over $5,000 a year. I haven't researched the stipulations of this much yet, but I apparently get 50% of my income if my property is damaged due to fire, flood, etc. How necessary is this in the initial
June 26, 2014
Dental Liability Insurance
Message Board
Views: 66 | Replies: 3
I have a patient with two insurances and the one listed as secondary at the moment is now going to become primary. How do I make the switch in the chart to reverse them? thanks, Jackie In our PMS- you just remove primary and secondary will move to primary. If they will still have secondary
July 19, 2017
Open Dental
Message Board
Views: 461 | Replies: 21
Last F I attended a conference sponsored by several dental insurance companies, managed care, university, and others. It was a conference on managing the oral-systemic link, with a call to integrate dentists and physicians. Below is a report, in part, that I provided for our members. Immediately
November 20, 2014
Dental Insurance for Dentists
Podcast
In this episode we talk about how to bypass insurance regulation via DPC (Direct Primary Care)laws for practices that offer dental membership programs. Before joining Parsons Behle, J.D. was in-house counsel for a large national energy company. He has extensive experience negotiating corporate
May 06, 2019
by Jordon Comstock
Message Board
Views: 250 | Replies: 3
Noob poster here. I am going to be leaving a current associateship and buying my own practice. I will be moving to a new state. I currently am affiliated with numerous insurance carriers that my associateship requires. At the end of this month, my desire is to minimize my participation
November 07, 2019
Practice Start-Up
Message Board
Views: 532 | Replies: 17
I have a PPO health insurance plan right now that is ok - deductible is $1500/$4500 (ind/family). I pay 100% of the premium for employee and dependents. Right now I have myself and 3 employees and their dependents on it. As you can imagine, it is getting out of control. Premium costs me $4k
September 11, 2014
Practice Management & Administrative Forum
Blog
Letter (editable version we supply to our clients to assist in educating patients on dental insurance: Dental insurance is a highly complex area that creates confusion for many dental patients. The complexities of dental insurance and the lack of sufficient information provided by some insurance
November 03, 2017
by Kevin Tighe
Message Board
Views: 131 | Replies: 0
of uncertainty. Most dentists see spending 2%+ on marketing as a great idea. But those who don't, will gladly accept the draconian tax imposed by insurance providers. Why is this small minority so counter-intuitive? Now I get it, an empty chair is bad. Regardless of who's in the chair, it behooves many
October 16, 2015
Marketing
Blog
retainer agreement - See template below(May vary in different states)which will allow your practice to bypass any insurance regulations in most states. This gives me and my team hope as our goal is to help as many dental practices as we can create, organize, grow and automate an in-house membership
February 15, 2018
by Jordon Comstock
Message Board
Views: 366 | Replies: 8
! Sounds like a jackass This idiot made 2 mistakes. 1. Paying the insurance company back for their screwup after his business closed. 2. Asking you to pay him because of his stupidity. If I had cojones, I would tell him to go f' himself, but in reality, I'd probably just ignore him.That is a big
September 07, 2018
Practice Acquisitions
Message Board
Views: 513 | Replies: 21
I recently met a financial advisor and he wanted me to get 3-4 mil worth of term insurance for myself and 1-2mil for my wife. Do I really need that much? We each have 250K in term and 100K in whole life. I know that is not close to what I need. The advisor wanted me to cancel both plans and buy
February 05, 2014
Personal Finance
Message Board
Views: 157 | Replies: 3
I know orthodontitc treatment is covered by certain private insurance and have treated patients with their funds allocated by their insurance. Are there any private insurances out there that pay for surgical procedures such as implant, gbr etc? Any idea would be appreciated. Implant placement
January 23, 2015
Claims Processing
Message Board
Views: 549 | Replies: 16
I started working with a local DSO on organization the east this past week, I completed my GPR in June 2019. My insurance credentialing packet was submitted to all 10 PPOs around end of May. To this date, I am only in network with 4 of the 10. 4 others have effective dates throughout August
August 26, 2019
Claims Processing
Message Board
Views: 6602 | Replies: 86
I think the death of insurance would be awesome. I don't see that they really contributed much to dentistry in the first place. Maybe 30 years ago 1000 dollars or 1500 per year of dental benefits was significant - which is how they lured everyone in -but that total benefit hasn't increased in 30
August 31, 2014
Practice Management & Administrative Forum
Message Board
Views: 128 | Replies: 0
I attended a CE course that turned into a dental insurance history lesson for me (young dentist who only knows of PPOs). It was suggested that the youth of dentistry attempt to fade from PPOs and instead offer an in house membership plan. I am just curious how many dentists do this and have had success and how many like the way things are at this time in history. Please select an option.
December 14, 2019
Ideas To Make Your Practice Grow
Blog
In our last post, we finished up our discussion of the various disability claim forms that must be submitted when you file your claim. In this post, we will begin our discussion of the insurance company's investigation into the merits of your claim. THE INVESTIGATION BEGINS Once the initial
October 09, 2015
by Karla Thompson
Message Board
Views: 103 | Replies: 4
under a different entity and everything would be separate. The only thing we would share would be dentists and waiting room. Is it possible to be out-of-network and in-network with that setup in the two different entities despite being in the same building? Is it legal? How would malpractice insurance
March 08, 2018
Legal Issues
Message Board
Views: 142 | Replies: 9
Building insurance is due again, and I wonder if I am over-insured. This is a stand-alone dental office owned by the dentist. It's a basic wood frame building, built for me 15 years ago, of similar construction to my house. It's in a city, has a fire hydrant and a fire station nearby. A real
January 09, 2017
Lease Terms and Negotiation
Message Board
Views: 1000 | Replies: 29
I have a client who is looking to outsource his dental insurance billing. He does not participate in any plans. He is expanding like crazy and has already hired a 3rd front desk person, so outsourcing insurance claims processing would allow him to continue to service the ever increasing patient
March 14, 2018
Front Office Discussion
Message Board
Views: 469 | Replies: 14
. Just another example of the way insurance companies will slowly take over dentistry like they did medicine. It will be awhile, but I think it will happen eventually. Just look at how many more practices are contracted with PPOs as compared to 15 or 20 years ago. I hate to say it... but more
February 02, 2016
Claims Processing
Message Board
Views: 58 | Replies: 1
Posting this on Dentrix topics.... I'm used to submitting electronic insurance claims multiple times a day, typically about 3 (mid-morning, lunch, and end of day) -- Dentrix support as suggested that we only submit one time per day. They didn't give a solid answer as to why... only that it can
November 15, 2016
Dentrix
Message Board
Views: 433 | Replies: 15
she never received any check although insurance company said they sent the checks 3 weeks ago. I don't know who to believe. Do I just mentally prepare to lose not only this claim money but the patient forever? It is pretty tempting to just cash the check and find new dentist... I am looking for some
November 05, 2014
Claims Processing
Message Board
Views: 312 | Replies: 10
I've got a patient who's PPO insurance is maxed out but still wants to get treatment completed. If we won't be billing insurance and/or their insurance essentially won't be covering these procedures are they then technically considered non-covered benefits and therefore I am able to charge UCR, etc
February 12, 2020
PPOs and HMOs
Message Board
Views: 320 | Replies: 1
Below is the letter I am sending to UC to go OON. Is there anything else I need to add? To Whom It May Concern: This letter is to notify you that I will no longer be participating as an in network provider with United Concordia. Regards, Also, what do you recommend adding to the letter to...
June 10, 2020
Going Out of Network
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