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Stay ahead of insurance reimbursement trends with Limoli & Associates.
Do Any of These Scenarios Hit Home?
Office
In Our Practice…
- We take way too many plans.
- We take no plans.
- Patients don’t stay with us if their plan changes.
- We have available chair time.
Our Existing Patients…
- Accept only the treatment that is covered by their plan.
- Expect us to know exactly what their plan is going to pay.
- Hold us accountable when something goes not as planned.
- Come in only once or maybe twice then disappear.
Our New Patients…
- Want to know if we are part of their insurance.
- Expect to have their teeth cleaned on the first visit.
- Only want x-rays if the insurance pays for them.
- Are emotionally driven by their insurance benefits.
Team
Our Administrative Support Team…
- Spends hours on the phone chasing down benefit information.
- Feels the need to tell patients everything about their plan.
- Wants stock narratives to satisfy requests for additional information.
- Keeps the doctor owners away from the daily EOBs.
- Has and wants nothing to do with the clinical team.
Our Clinical Support Team…
- Thinks auto-notes are the solution to everything.
- Wants the doctor to stop talking and simply run on time.
- Tells the patient that insurance is not part of what they do.
- Has and wants nothing to do with the administrative team.
Doctor/Owner
Our Doctors…
- Want to do more dentistry.
- Want to get paid for what they do.
- Want to get paid now.
- Want the insurance to not be such a big deal.
And As The Owners…
- Have to keep everybody happy.
- Hear that the administrative team wants another employee.
- Knows that the clinical team wants another employee.
- Fears that the hygienists want more time with new patients.
- Realizes the actual cost of doing business.
- Frustrated that dentistry is not the team’s top priority.
Here's Your Solution...
Click here to view the simple four-part action plan that I have helped implement in thousands of offices.
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Tom Limoli is the prevailing expert on proper coding and administration of dental insurance benefit claims, with over 30 years of experience. Limoli & Associates has, over the past quarter century, assisted dental offices in streamlining the insurance reimbursement process and ahead of reimbursement trends.
Tom’s no-nonsense approach to the management of third-party reimbursement has been implemented in thousands of dental practices across the United States and Puerto Rico.
Let Tom help you in simplifying and streamlining the challenges associated with all the various forms and formats of dental reimbursement.
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Limoli’s Original Dental Insurance Today – Blog
Radiographic Frequency: It’s Not Simply About the Calendar
How often does your office update radiographs? Is it based upon specific, doctor-diagnosed patient need or their individual benefit plan limitation? Do patients question radiographic frequency to the extent that they only want them if paid for by their insurance? Now here is the kicker — do you write off the fee if the plan doesn’t pay?
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It Can’t Be An “Interim Provisional Temporary” — So What Is It?
Insurance companies and plan administrators usually do not separately reimburse for temporary prosthetics or restorations, particularly if the overall completed procedure is in any way cosmetic in nature or considered to be non-covered. Provisionals and interims are another story. Let’s take a minute and draw a clearer distinction between the use of these terms…
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The Problem with Crowns and Buildups — Again
Not so long ago, the claim payment parameter for a crown was pretty simple. The “dump to pay” rate for these claims were rarely if ever questioned. Crowns were easy to treatment plan and they were a vital part of the overall cornerstone to dental office profitability. Those were the good old days of yesteryear and the rules have definitely changed.
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Insurance Management Is Easy If You Start at the Beginning
It is imperative that we as dental professionals, both clinical and administrative, have a sequential process by which the entire team can follow. All too often I find offices that have slipped out of focus by attempting to hold themselves out as being all-knowing as well as all-doing when it comes to the patient’s benefit plan.
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Punitive Damages Found Against Dentist Who Hiked Value of Practice Before Sale
(Yours truly worked on this case for over three years and provided expert testimony on behalf of the Plaintiff.)
A Cook County jury has awarded more than $500,000 to an Oak Park dentist who bought another dentist’s practice, then later learned that dentist defrauded patients and their insurance companies and inflated his revenue.
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Prophy vs Perio Maintenance: It’s what you DID — NOT who or where it was done
It is a sad state of affairs when I see procedure coding taken completely out of context for the betterment of one’s own political agenda or simple lack of knowledge. So is the case with the age-old discussion of “When does perio maintenance become a prophylaxis?” Believe me when I say it has nothing to do with simply the calendar or GPS. What’s the solution?
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