The Navigating Dental Insurance Podcast

Latest Episodes:

49: DSO's for Solo Practitioners Create Huge Negotiating Leverage with Dr. Brady Frank Sep 14, 2017

Show notes

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.

48: The importance of internal insurance audits with Hilary Tien Sep 01, 2017

Show notes

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.

47: Part 2 of Reducing Time Spent on Insurance Administration with Melissa Dunham Aug 25, 2017

Show notes

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:

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
Simultaneous use of Fee Schedules and Blue books (softdent), payment table (dentrix), coverage book (eaglesoft).
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.

46: Ben and Jordon discuss the Power of UCR and Fake Regulations Aug 18, 2017

Show notes

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.

45: An Amazing Journey from PPO to Fee For Service by Dr. David Eshom Aug 11, 2017

Show notes

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

Episode 44: A Proven System to Reduce Time Spent on Insurance Administration with Melissa Dunham Aug 04, 2017

Show notes

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

Episode 43: The Dental CE Network - Where Travelers can find CE Jul 29, 2017

Show notes

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.

Episode 42: Creating a Schedule with insurance fees in mind with Amy Deschamps Jul 28, 2017

Show notes

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:

Facility
Team
Patient Base
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

Episode 41: Eliminate PPO Fee Schedules and Replace them with your UCR/Standard Fees/FFS Jul 21, 2017

Show notes

Mr. Ben Tuinei takes questions from guests regarding the following issues:

Incorrectly billing D2751 instead of D2740 for EMAX or Zirconia Crowns
Delta Dental trends nationwide – the elimination of the Premier contract
Can you discount patient co-payment? Or can you waive patient co-payments?
Protecting yourself against insurance abuse. Tips on obtaining an inexpensive and powerful legal retainer.
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

Episode 40: The Power of Humor with Dr. Howard Farran Jul 10, 2017

Show notes

While this is not an insurance related topic we felt that it was important for us to invite a friend and mentor, Dr Howard Farran to our show. During this episode Dr Farran talks about the power of using humor in your presentation. For those who have attended Dr Farran's live presentations you'll know he has a unique style of delivery that makes his lectures very fun and engaging.

Howard Farran, DDS MBA is a famous international lecturer on faster, easier, more efficient dentistry. He has captivated audiences around the world with his innovative, informational and entertaining style. In his seminar entitled, “The Virtues of Profitable Dentistry” he gets down to the nitty gritty details of running a thriving family practice. He can show any dental team how they too can achieve their dreams and goals.

Dr. Farran graduated from UMKC dental school in 1987. He earned his MBA from Arizona State University in 1999. He received his MAGD in 1998. He received his Diplomate in the International College of Oral Implantology in 1998.

Dr. Farran has received wide-range recognition, such as being named Alumni of the Year by the University of Missouri in 1997, Arizona Public Health Dentist of the Year Award in 1995 by the Arizona Office of Dental Health, and the Arizona Award in 1989 from the Arizona State Dental Association for outstanding contributions made to the profession of dentistry efforts to fluoridate the water of Phoenix.

Dr. Farran is the founder and publisher of Dentaltown Magazine, which is mailed to more than 120,000 dentists in 43 countries each month. Dr. Farran is also the founder Hygienetown.com, Orthotown.com and the flagship site, Dentaltown.com where more than 140,000 registered dental professionals share information with each other on a daily basis!

Dr. Farran is the author of several dental practice management articles and multiple video series. His experience ranges from all aspects of practice management, including business planning, operations and finance, to e-commerce business and Internet marketing.

Visit his personal website www.howardfarran.com. Please also check out his book “Uncomplicated Business” on Amazon found under the "book" section of his website.

For questions or suggestions please email our hosts at help@veritasdentalresources.com.

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