Medicaid. Worth Another Look?
There are more than a dozen different ways to successfully, as well as profitably, provide the necessary compassionate services to the Medicaid population. Ask yourself: Is it worth another look?.…
Clowns to the Left of Me, Jokers to the Right. Here We Are…
Each and every facet of the American healthcare system has been stretched beyond any previous conceptual limitation. Never in modern history has such upheaval touched (now go wash your hands) every individual, community, and industry…
UPDATE: Even With Implants, It Can’t Be an “Interim, Provisional Temporary”
In this issue, we will discuss when it’s (in)appropriate to not send a claim on behalf of the patient and their insurance. The ONLY reason to not send a claim is because you are hiding something that brings you shame. There – I said it – now prove me wrong…
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?
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…
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.
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.
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.
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?
Getting the Doctor Back into Hygiene — It should not be this hard
Coming soon to a dental office near you are newly revised procedure codes and definitions for 2018. Will they make more problems or solutions? The management, reimbursement and subsequent coding of non-surgical periodontal care has, for years, been a nightmare for all segments of the dental profession. So what is the real problem and where is the hidden solution? You got it… Where is the dentist?