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Monday, July 29, 2013

Re: Re: [ACEsthetics] Insurance puzzle - your guidance and experiences..on biling combination or large cases to dental insurance

yes agree unless the dentist can get their fees or close to it and specialists usually have better luck with that.

Shahin Safarian DMD, MBA, LVIF | Irresistible Smiles
Carmel Valley/Del Mar 858.755.8993 | Chula Vista/Eastlake 619.656.6785
WEBSITE | FACEBOOK | LINKEDIN | YOUTUBE | THEBATTLEGUARD



-----Original Message-----
From: drmaclee@gmail.com
To: safariandmd
Cc: ARUN NAYYAR ; acesthetics
Sent: Mon, Jul 29, 2013 2:58 am
Subject: Re: [ACEsthetics] Insurance puzzle - your guidance and experiences..on biling combination or large cases to dental insurance

Shahin, that is the purpose of my post.  Get off insurance if you are doing big restorative.  

Mac


On Mon, Jul 29, 2013 at 8:26 AM, <safariandmd@aim.com> wrote:
Mac if you are under contract then you have to follow the guidelines given by the plan. If you are not contracted then you can use your fees and still submit to insurance plan. 

Arun the best your friend can do at this point is to call the plan and ask all these questions. Each plan for each patient is different depending on the contract the employer has with the insurance plan in this case Delta. Within the plan there are certain restrictions that needs to be understood and there is no general rule. Some plans will allow for higher fees for specialists. 

Hope this helps. 

Shahin Safarian DMD, MBA, LVIF | Irresistible Smiles
Carmel Valley/Del Mar 858.755.8993 | Chula Vista/Eastlake 619.656.6785
WEBSITE | FACEBOOK | LINKEDIN | YOUTUBE | THEBATTLEGUARD



-----Original Message-----
From: Mchenry Lee <drmaclee@gmail.com>
To: ARUN NAYYAR <arunnayyardmd@gmail.com>
Cc: Ace <ACEsthetics@googlegroups.com>
Sent: Mon, Jul 29, 2013 05:41 AM
Subject: Re: [ACEsthetics] Insurance puzzle - your guidance and experiences..on biling combination or large cases to dental insurance


I wrote an article about something like this a few years ago:



On Mon, Jul 29, 2013 at 7:29 AM, Mchenry Lee <drmaclee@gmail.com> wrote:
Its not the insurance because being a prostodontist and dental BENIFITS, they simply don't go together.  It is about him or her building their reputation of helping other dentists as a specialist.  Oil and water!!!!!!!!

It is also about marketing to  the public and a dentist for those who know they are really in trouble and are looking for answers.

Long road and until then great verbal skills for patient that insurance is only a coupon and is meant to deal with complicated issues.


On Sun, Jul 28, 2013 at 9:40 PM, ARUN NAYYAR <arunnayyardmd@gmail.com> wrote:
 Hello All

I am mentoring a young Prosthodontist and he is hitting a wall with his fees.

He says he is signed with Delta Dental and another Dental Ins co.

His dilemma is that he is doing large combination cases or FMX

Several or most of you see this routinely and have a lot of wise counsel.

I am totally failing on this issue since I have no experience.

SO how does a fee for service practice survive until it builds a referral pool??

For example he has a patient with a $900 per crown fee and a 3000 limit??

But his fee for 22 units is 44K   this includes removing crs, buildups interim restorations, post op and finally restorations.  A 6 month plan
________________________

What will the ins co say to him if he charges $900 + 300 per unit for lab fee

How do YOU handle such a complex multiple appointment tx.

Doe sthe ins co control ALL charges once you are under contract

Do they have special fees for a Prosthodontist.

Anyone know of and use insurancesolutions.com

If you wish to email me privately with actual examles,  I will greatly appreciate this

Thank you

Arun 

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Dr. Mac Lee
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Want to learn more about communicating with patients?
Cell 361-781-2134

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