The Navigating Dental Insurance Podcast

Wow where do we start. Darren is a rockstar and you will love this episode! Darren has spent a great deal of time studying human interaction and human behavior. With his experience, both academically and professionally, Darren has learned unique approaches to how dealing with the natural human tendencies when it comes to making purchase decisions. During this episode, Darren discusses several techniques designed to influence patients to focus first on their oral health while steering patients away from making treatment decisions based upon insurance coverage. This is a must listen episode so stop reading and start listening! To contact Darren visit his website: www.acceleratemypractice.com Send him an email: darren@acceleratemypractice.com Call him: 877-910-9960 To contact our hosts please email help@veritasdentalresources.com.

During this episode Jen discusses the stress that comes with insurance management and provides key tips on how to reduce those headaches. Jen is a professional and certified stress coach that has engaged in saving lives of those who are overburdened by the business or practice of dentistry. One of our hosts, Ben Tuinei, actually has a dentist friend who was saved by Jen’s efforts. Not only is Jen a professional when it comes to stress management, she also is a kick a$$ practice management coach. Ben has also seen Jen increase practice revenue by over $100 annually for mutual clients both Ben and Jen work with. Jen discuses some of her management tips in this episode as well. To contact Jen visit her website www.jenbutlerpartners.com or give her a call at 623-776-6715. You can also email her at jen@jenbutlerpartners.com. To contact our hosts please email help@veritasdentalresources.com.

When we say minor, he billed 3 million dollars and was found guilty of overbilling $17,000. To us, that’s a minor coding mistake that can be easily corrected and refunded to the right entities involved. However, he spent 3 years in prison, lost his dental license, then another 5 years of probation for a mistake we all make with coding. Dr Shelburne shares his experience in how his life was completely ruined by something we all overlook in dental offices. His message is a powerful one in that we all need to take a second look at how we do things in business. From documentation to higher coding standards, Dr. Shelburne sheds light on the true reality and liability of relaxed business standards, especially when it comes to dealing with patients who have insurance or other 3rd party payor support. To contact Dr. Shelburne you can email him at roy_shelburne@yahoo.com. His website is www.royshelburne.com. To contact our hosts please email help@veritasdentalresources.com.

Happy FunDay HumpDay! While this is not a dental insurance related episode, you gotta listen to this episode about the other evil industry that takes your money, the tax industry (or government for those of you in Tooele UT). We understand that talking about dental insurance can be depressing at times. So, we've decided to incorporate an extra episode each week dedicated to talking about something non-related to dental insurance. Please allow us to introduce yet another depressing topic: taxes! Our Guest today is Craig Cody. Craig S. Cody is a Certified Public Accountant, Certified Tax Coach, Business Owner and Former New York City Police Officer with 17 years experience on the Force. In addition to being a Certified Public Accountant for the past 17 years, he is also a Certified Tax Coach. As a Certified Tax Coach, Craig belongs to a select group of tax practitioners throughout the country who undergo extensive training and continued education on various tax planning techniques and strategies to become, as well as remain, certified. With this organization, Craig has co-authored an Amazon best seller book, Secrets of a Tax-Free Life and recently authored 10 Biggest Tax Mistakes That Cost Business Owners Thousands. During this episode Craig talks about ways to minimize your tax liablity by communicating with your CPA often and regularly. He emphasizes the need for a certified tax coach as a professional that can help you plan your business so you don't get caught writing off a ton of crap you shouldn't be writing off the gets you in trouble with the IRS. To request a copy of Cody’s book go to www.craigcodyandcompany.com/ppo or please contact him at craig@ccodycpa.com. His website is www.craigcodyandcompany.com. His office number is 516-869-4051. To contact our hosts please email help@veritasdentalresources.com.

Debbie Seidel-Bittke, RDH, BS is a dental consultant, coach, speaker and author. She is also CEO of Dental Hygiene Solutions, powered by Dental Practice Solutions. Debbie is a world-class leader in creating profitable hygiene departments. She is well-known as a former clinical assistant professor at USC in Los Angeles and a former hygiene department program director. Dentistry Today recognizes Debbie as a Leader in Dental Consulting. DENTISTRY TODAY considers her a top dental consultant for the past 16 yrs. The focus of Dental Practice Solutions is to create healthier, longer lives for your patients while supporting the practice to optimize their hygiene department. The team at Dental Practice Solutions, takes an integrative approach with your team to create an increase in your production and collections without working harder. When you continue to use the systems implemented, you will benefit from production that creates dividends year after year, for the life of your dental practice. Debbie is also a former Hygiene Program Director and clinical assistant professor for the dental hygiene program at USC in Los Angeles. Debbie is passionate about supporting dental teams to provide a profitable, patient-centered dental practice through improving systems and efficiencies in the dental hygiene department. To take advantate of Debbie’s $1000 value-add offer contact her at 949-351-8741 or at admin@dentalpracticesolutions.com. Visit her website www.dentalpracticesolutions.com for more details about Debbie. To contact the hosts please email help@veritasdentalresources.com.

This month Jordon wrote an article featured in Dentistry IQ regarding Self-Reliance. He approached it from the perspective of reducing dependence on insurance participation and becoming more self reliant on obtaining patients through effective means. As requested by many listeners, Ben provides a ProCare update and a prediction on what will happen to the PPO industry as the ProCare product penetrates the market. Ben has thrown his hat in as a ProCare supporter months ago by helping them acquire key contacts in the broker community which has and will drive an estimated 30 million patients to ProCare member practices. To contact our hosts please email them at help@veritasdentalresources.com.

Dr. Brady Frank is a fan favorite! He is an international lecturer who focuses on implant placement and transitions. He operates a successful practice in Medford Oregon and has a following of over 1000 practitioners who seek his advice on both placement of implants and dental transitions. His latest project has been finding ways to legally leverage strength in numbers to allow solo practitioners to fairly compete against corporate DSO's. He introduces a DSO concept for solo practitioners that allow the "small guys" to obtain the same negotiating leverage inherent with large DSO's. The main objective in creating a DSO model for solo practitioners is to alleviate the stress of running and operating a dental practice to allow dentists to focus on what they love most, dentistry. To learn more about Dr. Frank’s lectures and material visit his website: osteaready.com. To contact Dr. Frank directly email him at bradyfrank74@gmail.com. To contact our hosts, Jordon or Ben, email help@veritasdentalresources.com.

Hi folks, this Ben Tuinei and it's my pleasure to introduce today's topic. Today, I audited a client office and found over $150,000 money they should be collecting from insurance payments! I'm amazed at how many dental offices are leaving on the table when it comes to money they rightfully deserve, but insurance doesn't pay them. This is not negotiated revenue, or negotiating PPO fees, this is money lost resulting from under-coding to not being persistent in your appeals and simply not knowing where the problems are with insurance A/R. Today we interview Hilary Tien and she explains the insurance auditing process. When performing an insurance audit here is her checklist: Date-of-service Correct provider assigned Clinical notes match the ledger Ledger matches EOB that was processed Insurance was billed Date insurance payment was received EOB was scanned EOB entered into ledger correctly Correct adjustments were made Denial noted, correct action taken Other pending claims reviewed Family ledger reviewed Statement sent Hillary goes through her process of how to perform an insurance audit and how often you should be auditing your numbers. Major corporations audit their numbers regularly. Some as often as each month and in an effort to make sure they are collecting every penny they've earned from their clients. We highly recommend performing an insurance audit of your own, or having Hilary perform an audit, to help you find and capture insurance money that is not reaching you. To ask Hilary a question email her at hilary@proveerpm.com. To contact our hosts please email help@veritasdentalresources.com.

Melissa appeared on episode 44 and since then, we’ve been flooded with emails to have her come back on and answer a ton of questions. During this episode, Melissa covers 3 main areas: 1. Adequate dental insurance inquirey – Basically gathering all the right data necessary regarding the patients plan to include sub-id’s and all other pertinent patient information and benefits 2. Simultaneous use of Fee Schedules and Blue books (softdent), payment table (dentrix), coverage book (eaglesoft). 3. Pre-D’s save you time and money Melissa goes to answer quests questions about locator codes and coding recommendations. To contact Melissa with questions of your own please email her at melissa@dunhamdental.com To contact our hosts please email help@veritasdentalresources.com.

During this episode Jordan and Ben answer listener questions regarding UCR, discounts, and fake regulations circulating the industry. Ben believes that www.fairhealthconsumer.org is the best place to obtain the appropriate UCR standards for your area. Jordon discusses regulatory issues regarding membership programs. There are many fake regulations out there that people make up so do your homework. For questions about this episode please contact our hosts at help@veritasdentalresources.com.

Dr. David Eshom is a general dentist with twenty years of experience in the art and science of cosmetic dentistry. Dr. Eshom has his undergraduate degree in business and his Doctor of Dental Surgery from the University of Pacific School of Dentistry. He is constantly continuing his education so that he can provide the most advanced dentistry for his patients. In the past twenty years, he has taken more than 1,500 registered hours of continued education through the California Dental Association in endodontics, orthodontics, oral surgery and his passion, cosmetic dentistry. He has achieved category II laser certification from the Pacific Laser Institute, and is a graduate of the Seattle Institute of Advanced Studies, the Blatchford Coaching Program, and the Pride Institute Leadership Program. His studies have allowed him to incorporate lasers into his treatment modalities, making his procedures minimally invasive and reducing the need for needles. During this episode Dr Dave shares his unique experience in purchasing a practice that was heavily PPO driven, to a complete fee for service model. It took him about 3 years to exit all PPO participation agreements and 20 years after exiting the shackles of PPO contracts, Dr Dave continues success at a very high level. He credits his ability to enjoy a fee for service practice to great practice management training, and the use of extra-oral photographs. Dr Dave’s camera techniques have become increasingly popular over the years that he has published his training curriculum on these two websites: http://www.eshomdds.com/professional/ http://www.dentaltown.com/OnlineCE.aspx?action=DETAILS&cid=618 For questions regarding this episode or to contact our hosts please email help@veritasdentalresources.com

Melissa has spent the last 30 years working and perfecting a system to manage dental insurance within a dental office. She is the boss at her husbands dental practice in Virginia Beach running a 2.8 million dollar operation. Needless to say, she knows her stuff! During this episode Melissa shares her system on how to reduce time spent managing insurance functions and more time on patient care. She believes that data is key and the right data entered into the practice management program can save you time, a lot of time, on insurance administration. A few items she talks about include: * The power of pre-authorizations * Locator codes (we'll have her on again to elaborate more on this) * Techinques to better identify patient benefits according to specific employers and patient ranking within the employer * Dealing with downgrades * Reducing statements We were so blown away at the knowledge Melissa has to share that we are going to invite her for a second interview in the coming weeks. Melissa is also a professional practice management coach that is one of the best in the industry on helping doctors create a system to better manage dental insurance within the office. While she is not taking new clients at this time, keep her contacts as she will be expanding soon. Email Melissa at: melissa@dunhamdental.com To contact our hosts please email help@veritasdentalresources.com

Dr Craig Smith is a practicing general dentist in Highland Utah. He started an organization called www.DentalCENetwork.com in an effort to promote and publish continuing education courses all across the country. The intent is to provide a one stop shop to find CE no matter where you practice and no matter where you travel. During this episode Dr. Smith explains what the Dental CE Network is about, how you can participate as a seeker of CE, or how you can participate as a provider of CE. To contact Dr. Smith email info@dentalcenetwork.com or visit his website: www.dentalcenetwork.com. To contact our hosts please email help@veritasdentalresources.com.

Amy Deschamps has over 25 years in dentistry working in every aspect except as a doctor or hygienist. She was one of the top consultants at Mercer for a number of years. She's recently built a practice management consulting firm that focuses on 4 major metrics within the dental practice. Those being: 1. Facility 2. Team 3. Patient Base 4. Schedule During this episode Amy shares key insight on how your schedule should be better balanced by effectively analyzing and using your PPO numbers. According to Amy building a schedule is more than just having a balance of procedures. A profitable schedule factors in a balance with PPO fees. While profits is not the number one criteria in providing dental care, it does have a lot to do with protecting the financial integrity of quality care. To contact Amy send her an email at amy@d4metrics.com. Visit her website www.d4metrics.com To contact the hosts Ben or Jordon, send an email to help@veritasdentalresources.com

Mr. Ben Tuinei takes questions from guests regarding the following issues: 1. Incorrectly billing D2751 instead of D2740 for EMAX or Zirconia Crowns 2. Delta Dental trends nationwide – the elimination of the Premier contract 3. Can you discount patient co-payment? Or can you waive patient co-payments? 4. Protecting yourself against insurance abuse. Tips on obtaining an inexpensive and powerful legal retainer. 5. Eliminate your PPO fees and replace it with your UCR (Standard Fees/FFS) These each are hot and controversial topics. Ben shares his opinion regarding these matters but in no way is he offering legal advice. He is not an attorney but wants to open the dialogue on these issues so that we can make positive progress as a profession. To contact Ben or Jordan send an email to help@veritasdentalresources.com