The reimbursement market is constantly shifting, and a new report is indicating that decreasing reimbursement rates are on the way. Now is the time to adjust your expectations for the coming year and explore how reimbursement negotiation could ensure that you end up on the better end of the rate adjustments. Experts Are Projecting Decreasing…
While medical insurance will not cover most routine dental procedures like fillings or cleanings, there are cases where procedure codes can be submitted to traditional medical insurance for reimbursement. It’s essential that your practice understands what codes are eligible, and in which situations you should bill to medical insurance instead of dental insurance. “Medically Necessary”…
The credentialing process presents unique challenges to dental practices and doctors who are currently in the process and not yet credentialed. How does the claim filing process work when you are waiting to receive credentials? Can you bill and collect payment for dentists who are currently waiting to receive insurance credentials? Here’s what your practice…
Every new year brings along with it changes to CDT codes, and 2019 is no different. This year, the Code Maintenance Committee reviewed a wide variety of codes related to new technologies, procedures and materials designed to improve oral health. In this blog, we are focusing on the notable CDT 2019 code changes every dental…
HIPAA compliance matters, whether you’re a private practice family physician or a dentist. As dental practices grow in size and collect patient information and payment data, the importance of HIPAA certification for every practice employee increases. Are you compliant? Are Dentists Subject to HIPAA? HIPAA rules for dental practices are applied to any office that…
The Dental Service Organization (DSO) market is rapidly growing, and it isn’t showing any signs of stopping! With over 15% of dental practices in the United States currently participating in a DSO and benefitting from behind-the-scenes administrative benefits, many dentists are feeling the squeeze. Outsourcing key tasks to a skilled specialist like APEX can keep…
Today’s changing insurance landscape places a number of unique demands on dental practices. With over 85% of dentists belonging to at least one PPO and working with insurance carriers, maintaining the relationship between the practice and the carrier is essential. Unfortunately for your practice, working with insurance carriers is not something you can “set and…
According to the American Dental Association, the average dentist participates in 6 dental plans, and PPOs make up over 80% of that dental plan market. With a myriad of benefits available to dentists who choose to participate in PPO insurance networks, it’s understandable that so many practices take part. Access to More Patients One of…
Did you know that many insurance carriers have tiered networks and multiple plan options? When working with insurance companies, it’s important to understand what your practice is signing up for and the nuances of tiered options. What Are Tiered Networks? Tiered networks are designed as cost-saving mechanisms for members. These networks allow carriers to maintain…
At APEX Reimbursement Specialists, we are proud to be a company centered around analyzing data to the benefit of our clients. As a data-driven company, we are committed to accurately evaluating the market and the fee portfolios of all of our clients to offer the right information for practices to make informed decisions. Why Does…
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