Negociating Higher Fees

Is it possible to get a higher fee schedule from an insurance company than their standard PPO fees? If so how do I go about it?

Usually not. Why? PPO schedules are published to both doctors and patients. If a patient were to receive say, a crown, from Dr X who had negociated a higher benefit, that additional money would have to come from either A - the patient, who could perceive this plan as a bait and switch or B - the insurance company, who base their premiums on anticipated payment based on the fee schedule. In addition, if area doctors were aware that another was receiving a higher benefit, they would also want an increase.

For more information on practice management and dealing with dental insurance in your office, CLICK HERE. or EMAIL US BY CLICKING HERE

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Get paid by insurance companies faster.

Wherever we lecture throughout the country, offices are constantly asking us how they can get paid faster by insurance companies. The best answer for all situations is : File your claims electronically.

What are some advantages:

1) The claims are checked for mistakes along the submission process and you are notifed usually within 48 hours when you can immediately correct and refile. Not 3-4 weeks later.

2) Some companies can notify you of a patient's eligibility in real time.

3) You are notified when the insurance company receives the claims. The clearing house will give you a tracking number for your claim as soon as it arrives (Usually 24-48 hours after submission).

4) You actually save money in mailing and manual claim preparation costs.

5) Companies will accept electronic attachments: no more sending in hard copy x-rays or periodontal charting.

For more information, including a calculator that lets you determine how much you'll save, based on the number of claims you submit, contact NDEDIC (National Dental EDI Council) by CLICKING HERE.

For more information on practice management and dealing with dental insurance in your office, CLICK HERE. or EMAIL US BY CLICKING HERE

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE

Are you coding your dental claims correctly?

Probably one of the most frustrating things we find when assisting dentists with their dental insurance problems is the fact that many offices do not code their procedures correctly. And because of this, they are sometimes missing out on potential benefits and possibly mis-reporting work performed. Are you aware of the difference between a multi-surface restoration and a crown-buildup and when each should be used? How about the difference between types of exams? Were you aware that CDT-2005 has a procedure code that can be used for Valplast partials?

Make sure the insurance coordinator (and the doctor) understand the nuances of the different codes. Take courses (or contact us) for information on correct coding.

Because if you're not coding correctly, you may not be getting paid correctly.

For more information on practice management and dealing with dental insurance in your office, CLICK HERE. or EMAIL US BY CLICKING HERE

If you would like to post a subject and start a discussion, EMAIL US BY CLICKING HERE