FAQ
Our mission is simple: to stop dental practices from “leaving money on the table.” We serve a national client base ranging from solo practitioners to large Dental Service Organizations (DSOs), helping them navigate the complexities of insurance reimbursements.
Does Apex Reimbursement Specialists provide PPO Fee Negotiations for dental practices?
Yes. Apex Reimbursement Specialists excel at PPO fee negotiations on behalf of their dental clients to strategically raise reimbursement rates with insurance companies. Apex has negotiated over $1B PPO revenue lifetime.
How is Apex Reimbursement Specialists different from other fee negotiation companies?
- Insider Expertise: Our leadership team includes industry veterans with over 30 years of experience in dental insurance, auditing, and clinical practice.
- Data-Driven Advocacy: We utilize a proprietary database of national fee schedules and market trends to provide practices with quantifiable leverage during negotiations.
- National Reach: Apex has negotiated over $1B of PPO revenue in most states, and worked with close to 5,000 dental practices.
Does Apex Reimbursement Specialists offer credentialing services?
- Yes. Apex Reimbursement Specialists has credentialed thousands of dental providers and have enrolled them with most insurance companies.
What kind of increase can I expect when using Apex Reimbursement Specialists?
On average, we have seen increases of 8%-12% on direct insurance contracts.
Do you focus on the codes that give us the most revenue?
We focus on your highest-utilized codes (like cleanings, exams, and crowns) so that even a small percentage increase translates to significant annual revenue. In one case, we secured percentage increases as high as 145% for a specific client!
Do you negotiate with third party networks?
We analyze whether you should be in a direct contract or accessed through a “leased” network (like a PPO umbrella).A practice can achieve double digit percentage increases, but it comes with risks as well that you need to analyze prior to making a decision.
What is a UCR?
UCR stands for Usual and Customary Fees. This is your practice cash fee schedule.
Can you determine if our UCR is set correctly?
Apex conducts a UCR Fee Analysis to ensure your office’s standard fees aren’t holding you back.If your office fees are set too low, insurance companies have no reason to offer you more. Apex helps you set your fees at the correct percentile for your specific zip code to create the necessary leverage for negotiations.
How long does the credentialing process take?
Anywhere from 30-90 days for direct contracts
How long does it take to negotiate PPO fees?
4 to 6 months
Does Apex help determine which insurance companies to term with?
Yes
How long does it take to get started? Is there a wait time?
No, once we have all the documents needed, we begin working on your behalf
Will the insurance companies raise my fees more since I haven’t negotiated in 5 years?
Not necessarily. Most carriers will increase incrementally
