Billing Practices among other things

#**100** 01-18-2004, 08:56 PM

No AV actually you don't have to kiss a..
More than $5K is 'grand theft'
Press charges, watch how fast you get paid.

On 18 Jan 2004 00:27:51 -0800, purple012345[at]yahoo.ca (Alexander Vasserman DDS., BS.) wrote:

- quote -

> Sometimes that is a huge risk.
> I have one patient that owes me $6000.00 it's been 2 years now.
> She played a game on my front office, she was a real "actress" to say the least.
> her credit is messed up, and her friends who happen to pay, are clients as well.
> Basically I have to kiss her _ss to even hope in recovering some of that.
>
>
>
>
>
>
>
> WB <no_one[at]nowhere.net> wrote in message news:<ls9i00lfr73re5iehd8jc0fkd01anjgk94[at]4ax.com> ...
> > On Fri, 16 Jan 2004 01:37:11 GMT, "Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote:
> >
> > > And how about if the insurance company mistakenly sends the check to the
> > > patient? Most are honest, but once in a while....
> > >
> > > > We've learned (to
> > > > our dismay) that we often never see the money if we bill the patient after
> > the
> > > > insurance pays.
> > > >
> > > > Steve
> >
> > Most patients will give the check to the office.
> > Those that don't win a trip ...
> >
> > ...to small claims court, that is.

--

"I can dance on the head of a pin as well"
-Yoshimo

#99 01-18-2004, 08:30 PM

On Sat, 17 Jan 2004 15:11:45 GMT, "Tony Bad" <SpamSpamSpam[at]bakedbeans.spam> wrote:

- quote -

>
> "Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote in message
> news:bfHNb.43470$I05.901248[at]twister.tampabay.rr.com...
> > And how about if the insurance company mistakenly sends the check to the
> > patient? Most are honest, but once in a while....
> >
>
> I have been sadly disappointed in this area. My experiences have been that most
> are not honest until prodded into honesty. I have had good, long standing
> patients pull this one..."oh, I didn't know I needed to send it to
> you".....grrrrrrrrrrrrrr
>
>
> T
>
Small claims court judgements are an excellent motivator.

Pay the doc, or go to jail. What would you choose ?
PS patient is responsible for court costs too.
--

"I can dance on the head of a pin as well"
-Yoshimo

#98 01-18-2004, 06:22 PM

If you could bill lab bills separately (they really should be separate
billings anyway), and bill for the extra cost of very expensive materials
used in some high end procedures, then I would say ,,,,, yes billing by the
hour would be more fair.

--
`~`~`~`~`~`~`~`~`~`~`~`~`~`~`~
Stephen Mancuso, D.D.S.
Troy, Michigan USA
=+=+=+=+=+=+=+=+=+=+=+=+=
..
"Alexander Vasserman DDS., BS." <purple012345[at]yahoo.ca> wrote in message
news:ed94472d.0401180013.58c0c105[at]posting.google.com...
- quote -

> You bill for your time/chair time.
> does it really matter if you do a 1 or 3 surface filling???
> the way things are now you could be doing an occlusal buccal pit
> that is two surfaces yet it may take you about the same amount of time
> to do.
> Lab costs can be added where needed. just like the MD's when they
> order blood tests, CAT scans, etc... that is a separate bill.
> It is just a different way of doing things. I'm sure it will drive
> insurance companies crazy if every dentist started to do this.
>
>
>
> "Dr. Steve" <drsteve[at]I.give.up.on.the.spam.com> wrote in message
news:<XveOb.31504$P%1.25091208[at]newssvr28.news.prodigy.com> ...
> > But,,,,,,,,, if we were to bill by the hour, the simple things would
cost
> > much more and the "high-end" things would cost much less. Is it fair to
> > have to bill a patient 2-3 times more for a one surface restoration or a
> > prophy to cover the overhead of the lab fees, materials, and equipment
for
> > C&B or implants?
> >
> > --
> > `~`~`~`~`~`~`~`~`~`~`~`~`~`~`~
> > Stephen Mancuso, D.D.S.
> > Troy, Michigan USA
> > =+=+=+=+=+=+=+=+=+=+=+=+=
> > .
> > "Alexander Vasserman DDS., BS." <purple012345[at]yahoo.ca> wrote in message
> > news:ed94472d.0401170148.2d2ea04c[at]posting.google.com...
> > > Sure they could care less if your accounts recievable goes through the
> > > roof.
> > > It is a tactic the insurance companies are using to weaken our
> > > practices so that we will sign up as providers or ("their employees")
> > > and work for less money.
> > > The [at]#&*###! ADA has made this too easy for the insurance companies by
> > > providing
> > > that option on the claim form as well as a signature line for us to
> > > sign.
> > > If you can stay your ground until the rest of us come to our senses it
> > > would help. Another option is to collect the patient portion upfront
> > > or any small balances such as under $300-400. you can also play it by
> > > ear, try to collect upfront if you see hesitation, then collect the
> > > patient portion. You should also make it clear to them of the fee. In
> > > my practice I always present any fee over $6000.00
> > >
> > > I really believe we need to do away with the coding system and just
> > > bill by the hour as lawyers and accountants. If you think about all
> > > the behavioural management we deal with, and have to settle for a flat
> > > fee its rediculous and unfair to cooperative patients.
> > >
> > >
> > > jgenecov[at]aol.comnojunk (Jeff Genecov) wrote in message
> > news:<20040116212658.22937.00000173[at]mb-m04.aol.com> ...
> > > > I tried for a long time to charge up front for services, provide a
> > "superbill"
> > > > to the patient, and let them collect the reimbursement. That way
THEY
> > could
> > > > keep track of how much the ins. co. paid, and how much more was
owed,
> > etc.
> > > >
> > > > However, so many other docs in my area (an affluent suburb of
Dallas)
> > had begun
> > > > to accept assignment, that we finally had to to compete.
> > > >
> > > > Accepting assignment is, as has been stated here, an interest free
loan
> > which
> > > > requires more staff time and overhead to service. So it makes our
fees
> > go up!
> > > > And I think it also leads to patients not knowing or caring what
their
> > benefit
> > > > is - they think the insurance company is the resonsible party, not
them!
> > And
> > > > if the insurance company doesn't pay all of the bill, then our fees
are
> > too
> > > > high.
> > > >
> > > > Unfortunately we most easily remember those who give us trouble. But
> > insurance
> > > > companies being involved in our business practices give us more
trouble
> > than
> > > > even the most troublesom patients!
> > > > Regards,
> > > >
> > > > Jeff Genecov, DDS, MSD, FICD
> > > > Diplomate, American Board of Orthodontics

#97 01-18-2004, 07:27 AM

Sometimes that is a huge risk.
I have one patient that owes me $6000.00 it's been 2 years now.
She played a game on my front office, she was a real "actress" to say the least.
her credit is messed up, and her friends who happen to pay, are clients as well.
Basically I have to kiss her _ss to even hope in recovering some of that.

WB <no_one[at]nowhere.net> wrote in message news:<ls9i00lfr73re5iehd8jc0fkd01anjgk94[at]4ax.com> ...
- quote -

> On Fri, 16 Jan 2004 01:37:11 GMT, "Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote:
>
> > And how about if the insurance company mistakenly sends the check to the
> > patient? Most are honest, but once in a while....
> >
> > > We've learned (to
> > > our dismay) that we often never see the money if we bill the patient after
> the
> > > insurance pays.
> > >
> > > Steve
>
> Most patients will give the check to the office.
> Those that don't win a trip ...
>
> ...to small claims court, that is.

#96 01-18-2004, 07:17 AM

Yep.
Patient communication is the key.

"Tony Bad" <SpamSpamSpam[at]bakedbeans.spam> wrote in message news:<arcOb.103855$G04.23600909[at]news4.srv.hcvlny.cv.net> ...
- quote -

> > ehtorg[at]hotmail.com (Stew) wrote in message
> news:<8dc5746a.0401091312.265a5a19[at]posting.google.com> ...
> > > My wife recently had a single tooth extracted by a D.M.D.
>
> > > Am I making too big of a deal about this or does this seem deceptive?
> > >
> > > Thanks for reading such a long post. Your thoughts are welcomed.
>
> I think the office could have handled it better. I have stopped referring
> patients to a few specialists who do things like this. I used to refer many
> people to an oral surgeon until he took on an associate who was a tad
> aggressive. Suddenly patients were coming back telling me that they had been
> given general anesthesia for procedures that were not usually done with such
> anesthesia. I learned that the use of the GA was an "automatic" with the new
> surgeon, and there was no discussion first. I wouldn't like to be treated this
> way.
>
> T

#95 01-18-2004, 07:13 AM

You bill for your time/chair time.
does it really matter if you do a 1 or 3 surface filling???
the way things are now you could be doing an occlusal buccal pit
that is two surfaces yet it may take you about the same amount of time
to do.
Lab costs can be added where needed. just like the MD's when they
order blood tests, CAT scans, etc... that is a separate bill.
It is just a different way of doing things. I'm sure it will drive
insurance companies crazy if every dentist started to do this.

"Dr. Steve" <drsteve[at]I.give.up.on.the.spam.com> wrote in message news:<XveOb.31504$P%1.25091208[at]newssvr28.news.prodigy.com> ...
- quote -

> But,,,,,,,,, if we were to bill by the hour, the simple things would cost
> much more and the "high-end" things would cost much less. Is it fair to
> have to bill a patient 2-3 times more for a one surface restoration or a
> prophy to cover the overhead of the lab fees, materials, and equipment for
> C&B or implants?
>
> --
> `~`~`~`~`~`~`~`~`~`~`~`~`~`~`~
> Stephen Mancuso, D.D.S.
> Troy, Michigan USA
> =+=+=+=+=+=+=+=+=+=+=+=+=
> .
> "Alexander Vasserman DDS., BS." <purple012345[at]yahoo.ca> wrote in message
> news:ed94472d.0401170148.2d2ea04c[at]posting.google.com...
> > Sure they could care less if your accounts recievable goes through the
> > roof.
> > It is a tactic the insurance companies are using to weaken our
> > practices so that we will sign up as providers or ("their employees")
> > and work for less money.
> > The [at]#&*###! ADA has made this too easy for the insurance companies by
> > providing
> > that option on the claim form as well as a signature line for us to
> > sign.
> > If you can stay your ground until the rest of us come to our senses it
> > would help. Another option is to collect the patient portion upfront
> > or any small balances such as under $300-400. you can also play it by
> > ear, try to collect upfront if you see hesitation, then collect the
> > patient portion. You should also make it clear to them of the fee. In
> > my practice I always present any fee over $6000.00
> >
> > I really believe we need to do away with the coding system and just
> > bill by the hour as lawyers and accountants. If you think about all
> > the behavioural management we deal with, and have to settle for a flat
> > fee its rediculous and unfair to cooperative patients.
> >
> >
> > jgenecov[at]aol.comnojunk (Jeff Genecov) wrote in message
> news:<20040116212658.22937.00000173[at]mb-m04.aol.com> ...
> > > I tried for a long time to charge up front for services, provide a
> "superbill"
> > > to the patient, and let them collect the reimbursement. That way THEY
> could
> > > keep track of how much the ins. co. paid, and how much more was owed,
> etc.
> > >
> > > However, so many other docs in my area (an affluent suburb of Dallas)
> had begun
> > > to accept assignment, that we finally had to to compete.
> > >
> > > Accepting assignment is, as has been stated here, an interest free loan
> which
> > > requires more staff time and overhead to service. So it makes our fees
> go up!
> > > And I think it also leads to patients not knowing or caring what their
> benefit
> > > is - they think the insurance company is the resonsible party, not them!
> And
> > > if the insurance company doesn't pay all of the bill, then our fees are
> too
> > > high.
> > >
> > > Unfortunately we most easily remember those who give us trouble. But
> insurance
> > > companies being involved in our business practices give us more trouble
> than
> > > even the most troublesom patients!
> > > Regards,
> > >
> > > Jeff Genecov, DDS, MSD, FICD
> > > Diplomate, American Board of Orthodontics

#94 01-17-2004, 04:50 PM

I had the opportunity to speak with a claims processor from a major
insurance carrier in a setting outside the dental office a while back. I
was told that they are trained to drop a few claims into the waste can out
of every stack of claims. That is one reason they were so hesitant to go to
electronic claims. No way to lose a claim if it goes into the computer
directly (without writing phony computer code). If you watch each carrier
carefully, (good software should let you do this), you will notice that
certain carriers will ask for more documentation during certain times of the
year or just during certain years. It is relative to the number of policies
they have been able to maintain premium payment on during that time. Once
the cash flow coming in slows down, they get very creative on slowing down
claims. I stopped accepting assignment of benefits from ONE carrier a few
years back because this problem persisted for 18 months.

--
`~`~`~`~`~`~`~`~`~`~`~`~`~`~`~
Stephen Mancuso, D.D.S.
Troy, Michigan USA
=+=+=+=+=+=+=+=+=+=+=+=+=
..
"Steven Fawks" <tuthjockey[at]earthlink.net> wrote in message
news:40095202.71010B7[at]earthlink.net...
- quote -

>
>
> I felt compelled to reply because this is one area that I totally agree
> with Alex <G> .
>
> In the past 24 years of practice (starting from 'scratch') I can relate
> my own experiences with dental insurance.
>
> In the "early years" having a new patient walk in the door with dental
> insurance was great news. I had $1,000 available to improve a patient's
> dental health with the patient paying $200-$500. This was in the time
> of $30 fillings and $200 crowns. Most cases never approached the
> $1,000, but it was there for those that needed a lot of work. One form
> was filled out and the check was sent back in a few weeks with few
problems.
>
> Now things have changed. Many patients still have $1,000 maximums on
> their insurance, but this is in the days of $150 fillings and $700
> crowns (higher in cities and on the coasts). A bridge or set of
> dentures puts things over the maximum. To top that off, the insco.
> wants more documentation of need, radiographs, often 'loses' the claim,
> and uses delaying tactics which postpones payment and eats up overhead
> for a person to deal with the insurance hassles.
>
> I've seriously considered going to 'cash & carry' operations instead of
> raising fees (though I'll probably chicken out).
>
> Fawks
>
>
> "Alexander Vasserman DDS., BS." wrote:
> >
> > Insurance companies pay faster to the patient (their client) than to
> > the dentist who they could care less about.
> > I'll tell you a story 2 years ago I had a major flood in the office
> > and the computer system was soaked. I did not have adequate backup. My
> > hygenist called for a data recovery guy. I explained that because this
> > is going through insurance, I needed him to wait until the claim was
> > settled. He agreed.
> > He took my computers extracted the data and then held my computers
> > hostage until the insurance's cheque cleared his bank.
> > We dentists let patients walk out the door with hope insurance
> > companies pay their portion and we do not have to collect the rest
> > from the patient.
> > Others in the business world do not treat us the same we have bills to
> > pay to and are not given the same priveleges as we do to our patients.
> > Did you know that a typical small dental office has an accounts
> > Recievable (money owed to the office) of over $80,000.00 do you think
> > it is fair for us to extend such credit which depreciates to $0.00
> > after 90 days (if we sell the office).
> > If we have 80 patients that owe us $1000.00 waiting for insurance to
> > clear there is you $80000.00.

#93 01-17-2004, 04:44 PM

But,,,,,,,,, if we were to bill by the hour, the simple things would cost
much more and the "high-end" things would cost much less. Is it fair to
have to bill a patient 2-3 times more for a one surface restoration or a
prophy to cover the overhead of the lab fees, materials, and equipment for
C&B or implants?

--
`~`~`~`~`~`~`~`~`~`~`~`~`~`~`~
Stephen Mancuso, D.D.S.
Troy, Michigan USA
=+=+=+=+=+=+=+=+=+=+=+=+=
..
"Alexander Vasserman DDS., BS." <purple012345[at]yahoo.ca> wrote in message
news:ed94472d.0401170148.2d2ea04c[at]posting.google.com...
- quote -

> Sure they could care less if your accounts recievable goes through the
> roof.
> It is a tactic the insurance companies are using to weaken our
> practices so that we will sign up as providers or ("their employees")
> and work for less money.
> The [at]#&*###! ADA has made this too easy for the insurance companies by
> providing
> that option on the claim form as well as a signature line for us to
> sign.
> If you can stay your ground until the rest of us come to our senses it
> would help. Another option is to collect the patient portion upfront
> or any small balances such as under $300-400. you can also play it by
> ear, try to collect upfront if you see hesitation, then collect the
> patient portion. You should also make it clear to them of the fee. In
> my practice I always present any fee over $6000.00
>
> I really believe we need to do away with the coding system and just
> bill by the hour as lawyers and accountants. If you think about all
> the behavioural management we deal with, and have to settle for a flat
> fee its rediculous and unfair to cooperative patients.
>
>
> jgenecov[at]aol.comnojunk (Jeff Genecov) wrote in message
news:<20040116212658.22937.00000173[at]mb-m04.aol.com> ...
> > I tried for a long time to charge up front for services, provide a
"superbill"
> > to the patient, and let them collect the reimbursement. That way THEY
could
> > keep track of how much the ins. co. paid, and how much more was owed,
etc.
> >
> > However, so many other docs in my area (an affluent suburb of Dallas)
had begun
> > to accept assignment, that we finally had to to compete.
> >
> > Accepting assignment is, as has been stated here, an interest free loan
which
> > requires more staff time and overhead to service. So it makes our fees
go up!
> > And I think it also leads to patients not knowing or caring what their
benefit
> > is - they think the insurance company is the resonsible party, not them!
And
> > if the insurance company doesn't pay all of the bill, then our fees are
too
> > high.
> >
> > Unfortunately we most easily remember those who give us trouble. But
insurance
> > companies being involved in our business practices give us more trouble
than
> > even the most troublesom patients!
> > Regards,
> >
> > Jeff Genecov, DDS, MSD, FICD
> > Diplomate, American Board of Orthodontics

#92 01-17-2004, 02:48 PM

I recall in the sixties, exactly ONE patient of mine ever did that. It
was so outrageous no one would dare do it.

Today ,,, all bets are off!

- quote -

> On Sat, 17 Jan 2004 15:11:45 GMT, "Tony Bad" <SpamSpamSpam[at]bakedbeans.spam> wrote:

>
> "Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote in message
> news:bfHNb.43470$I05.901248[at]twister.tampabay.rr.com...
> > And how about if the insurance company mistakenly sends the check to the
> > patient? Most are honest, but once in a while....
> >
>
> I have been sadly disappointed in this area. My experiences have been that most
> are not honest until prodded into honesty. I have had good, long standing
> patients pull this one..."oh, I didn't know I needed to send it to
> you".....grrrrrrrrrrrrrr
>
>
> T
>

--
Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

#91 01-17-2004, 02:31 PM

Gee, lets see what else we can agree on.

;-)
Fawks

"Alexander Vasserman DDS., BS." wrote:

- quote -

>
> I really believe we need to do away with the coding system and just
> bill by the hour as lawyers and accountants. If you think about all
> the behavioural management we deal with, and have to settle for a flat
> fee its rediculous and unfair to cooperative patients.
>

#90 01-17-2004, 02:26 PM

I felt compelled to reply because this is one area that I totally agree
with Alex <G> .

In the past 24 years of practice (starting from 'scratch') I can relate
my own experiences with dental insurance.

In the "early years" having a new patient walk in the door with dental
insurance was great news. I had $1,000 available to improve a patient's
dental health with the patient paying $200-$500. This was in the time
of $30 fillings and $200 crowns. Most cases never approached the
$1,000, but it was there for those that needed a lot of work. One form
was filled out and the check was sent back in a few weeks with few problems.

Now things have changed. Many patients still have $1,000 maximums on
their insurance, but this is in the days of $150 fillings and $700
crowns (higher in cities and on the coasts). A bridge or set of
dentures puts things over the maximum. To top that off, the insco.
wants more documentation of need, radiographs, often 'loses' the claim,
and uses delaying tactics which postpones payment and eats up overhead
for a person to deal with the insurance hassles.

I've seriously considered going to 'cash & carry' operations instead of
raising fees (though I'll probably chicken out).

Fawks

"Alexander Vasserman DDS., BS." wrote:
- quote -

>
> Insurance companies pay faster to the patient (their client) than to
> the dentist who they could care less about.
> I'll tell you a story 2 years ago I had a major flood in the office
> and the computer system was soaked. I did not have adequate backup. My
> hygenist called for a data recovery guy. I explained that because this
> is going through insurance, I needed him to wait until the claim was
> settled. He agreed.
> He took my computers extracted the data and then held my computers
> hostage until the insurance's cheque cleared his bank.
> We dentists let patients walk out the door with hope insurance
> companies pay their portion and we do not have to collect the rest
> from the patient.
> Others in the business world do not treat us the same we have bills to
> pay to and are not given the same priveleges as we do to our patients.
> Did you know that a typical small dental office has an accounts
> Recievable (money owed to the office) of over $80,000.00 do you think
> it is fair for us to extend such credit which depreciates to $0.00
> after 90 days (if we sell the office).
> If we have 80 patients that owe us $1000.00 waiting for insurance to
> clear there is you $80000.00.

#89 01-17-2004, 02:22 PM

- quote -

> ehtorg[at]hotmail.com (Stew) wrote in message
news:<8dc5746a.0401091312.265a5a19[at]posting.google.com> ...
> > My wife recently had a single tooth extracted by a D.M.D.
>
> > Am I making too big of a deal about this or does this seem deceptive?
> >
> > Thanks for reading such a long post. Your thoughts are welcomed.

I think the office could have handled it better. I have stopped referring
patients to a few specialists who do things like this. I used to refer many
people to an oral surgeon until he took on an associate who was a tad
aggressive. Suddenly patients were coming back telling me that they had been
given general anesthesia for procedures that were not usually done with such
anesthesia. I learned that the use of the GA was an "automatic" with the new
surgeon, and there was no discussion first. I wouldn't like to be treated this
way.

T

#88 01-17-2004, 02:11 PM

"Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote in message
news:bfHNb.43470$I05.901248[at]twister.tampabay.rr.com...
- quote -

> And how about if the insurance company mistakenly sends the check to the
> patient? Most are honest, but once in a while....
>

I have been sadly disappointed in this area. My experiences have been that most
are not honest until prodded into honesty. I have had good, long standing
patients pull this one..."oh, I didn't know I needed to send it to
you".....grrrrrrrrrrrrrr

T

#87 01-17-2004, 10:30 AM

Exactly! Our dependence on the insurance company comes from a lack of
"patient cash flow."

Now the ADA could have factored the invoices, with recourse against
the dentist in the event of non-payment!

Joel

On 17 Jan 2004 02:26:58 GMT, jgenecov[at]aol.comnojunk (Jeff Genecov)
wrote:

- quote -

> I tried for a long time to charge up front for services, provide a "superbill"
> to the patient, and let them collect the reimbursement. That way THEY could
> keep track of how much the ins. co. paid, and how much more was owed, etc.
>
> However, so many other docs in my area (an affluent suburb of Dallas) had begun
> to accept assignment, that we finally had to to compete.
>
> Accepting assignment is, as has been stated here, an interest free loan which
> requires more staff time and overhead to service. So it makes our fees go up!
> And I think it also leads to patients not knowing or caring what their benefit
> is - they think the insurance company is the resonsible party, not them! And
> if the insurance company doesn't pay all of the bill, then our fees are too
> high.
>
> Unfortunately we most easily remember those who give us trouble. But insurance
> companies being involved in our business practices give us more trouble than
> even the most troublesom patients!
> Regards,
>
> Jeff Genecov, DDS, MSD, FICD
> Diplomate, American Board of Orthodontics

--
Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

#86 01-17-2004, 10:28 AM

The analogy I like is that the restaurant owner SHOULD bill my
discount restaurant card, see how much they pay, and then send me a
bill for the balance in a month or two .... sure!

Joel

On 17 Jan 2004 02:37:33 -0800, purple012345[at]yahoo.ca (Alexander
Vasserman DDS., BS.) wrote:

- quote -

> He took my computers extracted the data and then held my computers
> hostage until the insurance's cheque cleared his bank.
> We dentists let patients walk out the door with hope insurance
> companies pay their portion and we do not have to collect the rest
> from the patient.

--
Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

#85 01-17-2004, 09:57 AM

Stew,
we understand your frustration but you are out numbered here and
believe me the grass on this side of the fence is not as green as you
think. you would not want to be in our shoes and we hope you
understand some of the things we deal with that force us to make this
change. Regardless of it you are rest assured that if you or your wife
needs urgent care we dentists literally break our backs to help and be
there for you when you need us the most. Your insurance company could
care less about you or your pocket book when it comes to premiums and
claims.

ehtorg[at]hotmail.com (Stew) wrote in message news:<8dc5746a.0401091312.265a5a19[at]posting.google.com> ...
- quote -

> My wife recently had a single tooth extracted by a D.M.D. The actual
> procedure went fine but there are several other things related to
> administrative aspect of the procedure that have frustrated me. I
> would like to put forth a couple of issues and get others' opinions on
> the matter.
>
> We were referred to the D.M.D by our family dentist (only been with
> him for about 1.5 years). During my wife's first visit to the D.M.D
> took a panoramic x-ray. Consequently the insurance billed us for this
> x-ray as our policy covers only 1 full mouth/panoramic x-ray every 3
> years. Our family dentist did a full mouth x-ray about 1.5 years ago
> on her first visit.
>
> My frustration stems from the fact that the D.M.D. took the 2nd x-ray
> without really considering our insurance coverage or asking if full
> mouth x-rays were available from our family dentist. I now understand
> that I must fully understand what coverage is provided but in all
> fairness, on the first visit my wife was whisked in the x-ray room and
> there wasn't much time to think or tell the D.M.D. to stop, let me go
> get our x-rays. And we did tell him that we were referred to him by
> our family dentist.
>
> Further frustration came once I learned that my wife was put
> completely under with general anesthesia and that this is not covered
> by our insurance if it is for the extraction of a single tooth. After
> an initial claim was denied by our insurance provider, I talked to the
> D.M.D's office and they put it through again. My insurance carrier
> finally paid. When speaking to the D.M.D's office at a later date
> they recognized that normally an insurance carrier will not cover
> general anesthesia when extracting a single tooth, meaning they
> admitted they were aware that our insurance would not cover that part
> of the procedure.
>
> So I guess my first issue is where does the responsibility lie. While
> I respect the D.M.D.'s option to suggest the best treatment for my
> wife, I think that cost must be considered as well as insurance
> coverage. Can the consumer really be completely aware of what is
> covered and what not is covered? And should the D.M.D. be performing a
> procedure without giving the patient other options knowing that the
> parts of the procedure may not be covered by insurance?
>
> My second frustration is related to billing practices of the D.M.D.
> and my family dentist.
>
> For example, when I am billed, I see the service performed, let's say
> Surface Filling and the charge of $150. Then I see a Pay/Adj column
> that says $72.80 and a remaining balance column that says $77.20.
> Now, the thing that bothers me is that the dentist knows that I do not
> still owe the remaining $77.20. In this case I owe $18.20 due to the
> following: the PDP fee is $91.00 and my insurance covers 80% of that
> or the $72.80 paid. I then owe the remaining 20% but of the $91 which
> is the maximum they can charge me for that specific procedure.
>
> My point is that on the dentist's bill, I find it very deceiving for
> the consumer to see a remaining balance of $77.20. This is incorrect
> and without having your insurance information in front of you, this
> incorrect amount could be paid by mistake.
>
> Am I making too big of a deal about this or does this seem deceptive?
>
> Thanks for reading such a long post. Your thoughts are welcomed.

#84 01-17-2004, 09:48 AM

And we are comparing (ethical patients in) dentistry to automotive repair.
My machanic is more ethical then some people who come to see the dentist.

"Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote in message news:<M%JNb.43709$I05.926336[at]twister.tampabay.rr.com> ...
- quote -

> Oh, that reminds me, I have one better than that! A patient came in for
> extensive work, but wanted to pay cash and get 2 copies of her receipt.
> Then she told the receptionist that she was going to send one copy to her
> insurance for reimbursement, then submit another to her employer because she
> had one of those plans.. whatever they're called... where you put pre-tax
> money in, but either "use it or lose it". So, she got paid back
> double!!!!!!
> Also, another who was divorced (and the insurance was in ex's name) and the
> check went to her ex-hubby. He certainly wasn't paying up!!!
>
> "Joel M. Eichen D.D.S." <joeleichen[at]yahoo.com> wrote in message
> news:jkke00ln3unu1eparc7anbnquumeu6o4vm[at]4ax.com...
> > That is the worst! The patient goes to the dentist and ends up MAKING
> > money!
> >
> >
> > On Fri, 16 Jan 2004 01:37:11 GMT, "Florida Hygienist"
> > <FloridaRDH[at]tampabay.rr.com> wrote:
> >
> > > And how about if the insurance company mistakenly sends the check to the
> > > patient? Most are honest, but once in a while....
> > >
> > > > We've learned (to
> > > > our dismay) that we often never see the money if we bill the patient
> after
> the
> > > > insurance pays.
> > > >
> > > > Steve
> > > >
> > > > >
> > > > >
> > > > > "Stew" <ehtorg[at]hotmail.com> wrote in message
> > > > > news:8dc5746a.0401120642.58b17a16[at]posting.google.com...
> > > > > > "rg" <jobahut[at]hotmail.com> wrote in message
> news:<8akMb.42752$WS1.28641[at]fe1.texas.rr.com> ...
> > > > > > > "Suresh Goel" <Gumsdoc[at]worldnet.att.net> wrote in message
> > > > > > > news:egjMb.4265$VS4.137324[at]bgtnsc04-news.ops.worldnet.att.net...
> > > > > > > >
> > > > > > > > "Stew" <ehtorg[at]hotmail.com> wrote in message
> > > > > > > > news:8dc5746a.0401111106.6915b52e[at]posting.google.com...
> > > > > > > >
> > > > > > > > > I guess in response to this, the question arises, why did he
> need a
> > > > > > > > > panoramic x-ray, or a full mouth x-ray when it was clear from
> the
> > > > > > > > > referring dentist which tooth needed treatment? My family
> dentist
> > > > > > > > > had sent information prior to our first visit. Even my
> family
> dentist
> > > > > > > > > didn't use a panoramic machine. Is this an excuse for the
> oral
> > > > > > > > > surgeon just to use a new toy?
> > > > > > > >
> > > > > > > > Panormic machines are not new toys. Taking a pan is about
> as
> exciting
> > > > > > > > as watching paint dry, possibly less so. Typically, teeth are
> not
> taken
> out
> > > > > > > > with recent radiographs. I know that I certainly try to avoid
> this.
> Things
> > > > > > > > change, and a 1.5 year old radiograph could be considered old
> news
> when
> it
> > > > > > > > comes to a hot tooth. Sometimes discomfort is difficult to
> localize,
> and
> a
> > > > > > > > radiograph can ensure that everyone is on the same page as to
> which
> tooth
> is
> > > > > > > > the "root" of the problem.
> > > > > > > > Be glad your OS took a pan as they may often show serious
> things
> that
> may
> go
> > > > > > > > undiagnosed for years.
> > > > > > > >
> > > > > > > > > I agree that it is my insurance policy. I have learned from
> this
> > > > > > > > > experience that I must be fully aware of what is covered and
> what is
> > > > > > > > > not covered and not leave it up to anyone else. Of course
> that
> will
> > > > > > > > > mean understanding exactly what the procedure will entail and
> how it
> > > > > > > > > may be classified for insurance purposes. I guess one thing
> that is
> > > > > > > > > frustrating is this. I have a very common, nationwide
> insurance
> > > > > > > > > carrier. As you state, "they usually have a good
> understanding
> as
> to
> > > > > > > > > what is covered and what is not". Why is it so difficult to
> share a
> > > > > > > > > little bit of their knowledge when they deal with this on a
> daily
> > > > > > > > > basis and I may have to deal with it once or twice in my
> lifetime?
> > > > > > > >
> > > > > > > > It is not a little bit of knowledge. You have to remember
> that
> there
> > > > > > > > are people in some offices that may spend HOURS every day
> dealing
> with
> > > > > > > > insurance information, and even they don't necessarily always
> know
> the
> > > > > > > > details. Insurance companies can change the rules anytime they
> want
> to.
> Do
> > > > > > > > you have any idea how often they will tell us that a claim was
> not
> > > > > > > > submitted, even though we have sent it in once, twice, or even
> three
> times.
> > > > > > > > If they do admit that a claim was sent, the radiographs may
> have
> been
> > > > > > > > discarded and resubmission is necessary. On top of all of
> this,
> it is
> the
> > > > > > > > patient's insurance. We submit insurance claims only as a
> curtesy -
> we
> are
> > > > > > > > not compensated for this procedure. It costs us time and money
> to
> submit
> > > > > > > > and fight for these claims, for your benefit. The private
> patients
> > > > > > > > ultimately pay for this with higher fees that subsidize your
> treatment.
> > > > > > > >
> > > > > > > > > Here is the part where you do not understand what I wrote.
> The
> > > > > > > > > remaining balance is not what it says. My insurance had paid
> already
> > > > > > > > > and the remaining balance included the insurance write-off or
> the
> > > > > > > > > difference between the plan rate and what the oral surgeon
> would
> want
> > > > > > > > > to charge for the service. Had I sent in the "remaining
> balance" I
> > > > > > > > > would have overpaid.
> > > > > > > >
> > > > > > > > Your portion of the fee, and in some offices, your entire
> fee,
> is
> due
> at
> > > > > > > > the time of service, not after an insurance company may or may
> not
> decide
> to
> > > > > > > > pay their portion. Why should the doctor give you an interest
> free
> loan?
> > > > > > > > We aren't banks. If you don't want a bill mailed to you, pay
> us
> the
> entire
> > > > > > > > PPO agreed upon fee, and deal directly with your insurance
> company
> to
> get
> > > > > > > > your payment - in the long run this will only help you as the
> office
> will
> be
> > > > > > > > spending less time working on your claim, and more time working
> on
> taking
> > > > > > > > care of you! If you overpay, doctors are happy to refund the
> extra,
> not a
> > > > > > > > big deal.
> > > > > > > >
> > > > > > > > This may all sound a little strong, but patients should
> realize
> that
> by
> > > > > > > > us performing insurance duties the following issues are
> involved;
> > > > > > > > 1. We are loaning the patient money until the
> insurance
> company
> > > > > > > > pays
> > > > > > > > 2. We are asking FFS patients to subsidize treatment
> for
> PPO/HMO
> > > > > > > > patients
> > > > > > > > 3. Our costs are incurred whether or not you and your
> insurance
> > > > > > > > company pay
> > > > > > > >
> > > > > > > > Lastly - our treatment cannot be based upon the insurance
> someone
> has.
> > > > > > > > It must be, and should be, to the best of our abilities,
> regardless of
> > > > > > > > insurance. If the insured individual feels that the insurance
> company's
> > > > > > > > profit is more important than their own health and they deny
> the
> right
> > > > > > > > thing, then there is a serious problem with going forward with
> treatment.
> > > > > > > >
> > > > > > > > Suresh
> > > > > > >
> > > > > > > Isn't it amazing how ignorant the general public is regarding
> their
> medical
> > > > > > > and dental insurance?
> > > > > > >
> > > > > > > Whose fault is this?
> > > > > > >
> > > > > > > Perhaps it is the fault of the buyer of the policy and the owner
> of
> the
> > > > > > > policy.
> > > > > > >
> > > > > > > It never ceases to amaze me that people do not understand that
> the
> "float"
> > > > > > > between service and billing and payment is in fact a form of a
> loan
> of
> > > > > > > money....without interest.
> > > > > > >
> > > > > > > Maybe they do understand this, and since it is to their advantage
> pretend to
> > > > > > > be dumb.
> > > > > > >
> > > > > > > rgdds
> > > > > >
> > > > > > If the "float" bothers you so much, may I suggest starting to
> educate
> > > > > > the general public then. Start with your own office. Demand
> payment
> > > > > > upfront for the service performed even if the patient has
> insurance.
> > > > > > Or if needs be, advise them of cost of financing, give them a
> > > > > > competitive rate of say 9.99% Annual APR for the amount outstanding
> > > > > > from the time of service until the time of payment. If you have a
> > > > > > million bucks outstanding for 30 days, that'll get you around 8,000
> a
> > > > > > month in finance charges. Not bad. But I highly doubt you would
> be
> > > > > > willing to do that. Ever since I've gone to the dentist, no
> dentist
> > > > > > has ever done this. No dentist has ever demanded payment upfront.
> > > > > > The only place I've heard of this happening is in some 3rd world
> > > > > > countries I've been to. Seriously, while it is to the advantage of
> > > > > > the consumer, in my experience it is all I have experienced. The
> very
> > > > > > practice of every dentist office I have ever visited has educated
> me
> > > > > > that this is how it is done. We received the service, and then you
> > > > > > collect from the insurance and the patient at a later date. Please
> > > > > > don't expect the general public to suddenly start offering to pay
> you
> > > > > > upfront. If you want, ask them to and see how they react. If you
> > > > > > offered it to me, I'd probably find another dentist.
> > > >
> > > > --
> > > > Mark & Steven Bornfeld DDS
> > > > Brooklyn, NY
> > > > 718-258-5001
> > > > http://www.dentaltwins.com
> > > >
> > > >
> > >
> >
> > --
> > Joel M. Eichen, .
> > Philadelphia PA
> >
> > DISCLAIMER FOLLOWS:
> >
> > *********
> >
> > Dental health-related material
> > is provided for information purposes
> > only and does not necessarily
> > represent endorsement by or an official
> > position of the SciMedDentistry gang
> > or any other official agency either
> > actual or fictitious or Steve Mancuso.
> >
> > Advice on the treatment or care
> > of an individual patient should
> > be obtained through consultation
> > with a dentist who has examined
> > that patient or is familiar with
> > that patient's dental history.
> >
> > STANDARD DISCLAIMER
> >

#83 01-17-2004, 09:44 AM

It's called a cafeteria plan

IRS 125

I had a similar experience patient wanted the reciept and swore she
was doing to get her work done next week even made an appointment.
she got the money I am still waiting for her to get in the chair it's
been 2 years now. Everytime we mention that she has to come in she
does not have the money and asks for another reciept.

"Florida Hygienist" <FloridaRDH[at]tampabay.rr.com> wrote in message news:<M%JNb.43709$I05.926336[at]twister.tampabay.rr.com> ...
- quote -

> Oh, that reminds me, I have one better than that! A patient came in for
> extensive work, but wanted to pay cash and get 2 copies of her receipt.
> Then she told the receptionist that she was going to send one copy to her
> insurance for reimbursement, then submit another to her employer because she
> had one of those plans.. whatever they're called... where you put pre-tax
> money in, but either "use it or lose it". So, she got paid back
> double!!!!!!
> Also, another who was divorced (and the insurance was in ex's name) and the
> check went to her ex-hubby. He certainly wasn't paying up!!!
>
> "Joel M. Eichen D.D.S." <joeleichen[at]yahoo.com> wrote in message
> news:jkke00ln3unu1eparc7anbnquumeu6o4vm[at]4ax.com...
> > That is the worst! The patient goes to the dentist and ends up MAKING
> > money!
> >
> >
> > On Fri, 16 Jan 2004 01:37:11 GMT, "Florida Hygienist"
> > <FloridaRDH[at]tampabay.rr.com> wrote:
> >
> > > And how about if the insurance company mistakenly sends the check to the
> > > patient? Most are honest, but once in a while....
> > >
> > > > We've learned (to
> > > > our dismay) that we often never see the money if we bill the patient
> after
> the
> > > > insurance pays.
> > > >
> > > > Steve
> > > >
> > > > >
> > > > >
> > > > > "Stew" <ehtorg[at]hotmail.com> wrote in message
> > > > > news:8dc5746a.0401120642.58b17a16[at]posting.google.com...
> > > > > > "rg" <jobahut[at]hotmail.com> wrote in message
> news:<8akMb.42752$WS1.28641[at]fe1.texas.rr.com> ...
> > > > > > > "Suresh Goel" <Gumsdoc[at]worldnet.att.net> wrote in message
> > > > > > > news:egjMb.4265$VS4.137324[at]bgtnsc04-news.ops.worldnet.att.net...
> > > > > > > >
> > > > > > > > "Stew" <ehtorg[at]hotmail.com> wrote in message
> > > > > > > > news:8dc5746a.0401111106.6915b52e[at]posting.google.com...
> > > > > > > >
> > > > > > > > > I guess in response to this, the question arises, why did he
> need a
> > > > > > > > > panoramic x-ray, or a full mouth x-ray when it was clear from
> the
> > > > > > > > > referring dentist which tooth needed treatment? My family
> dentist
> > > > > > > > > had sent information prior to our first visit. Even my
> family
> dentist
> > > > > > > > > didn't use a panoramic machine. Is this an excuse for the
> oral
> > > > > > > > > surgeon just to use a new toy?
> > > > > > > >
> > > > > > > > Panormic machines are not new toys. Taking a pan is about
> as
> exciting
> > > > > > > > as watching paint dry, possibly less so. Typically, teeth are
> not
> taken
> out
> > > > > > > > with recent radiographs. I know that I certainly try to avoid
> this.
> Things
> > > > > > > > change, and a 1.5 year old radiograph could be considered old
> news
> when
> it
> > > > > > > > comes to a hot tooth. Sometimes discomfort is difficult to
> localize,
> and
> a
> > > > > > > > radiograph can ensure that everyone is on the same page as to
> which
> tooth
> is
> > > > > > > > the "root" of the problem.
> > > > > > > > Be glad your OS took a pan as they may often show serious
> things
> that
> may
> go
> > > > > > > > undiagnosed for years.
> > > > > > > >
> > > > > > > > > I agree that it is my insurance policy. I have learned from
> this
> > > > > > > > > experience that I must be fully aware of what is covered and
> what is
> > > > > > > > > not covered and not leave it up to anyone else. Of course
> that
> will
> > > > > > > > > mean understanding exactly what the procedure will entail and
> how it
> > > > > > > > > may be classified for insurance purposes. I guess one thing
> that is
> > > > > > > > > frustrating is this. I have a very common, nationwide
> insurance
> > > > > > > > > carrier. As you state, "they usually have a good
> understanding
> as
> to
> > > > > > > > > what is covered and what is not". Why is it so difficult to
> share a
> > > > > > > > > little bit of their knowledge when they deal with this on a
> daily
> > > > > > > > > basis and I may have to deal with it once or twice in my
> lifetime?
> > > > > > > >
> > > > > > > > It is not a little bit of knowledge. You have to remember
> that
> there
> > > > > > > > are people in some offices that may spend HOURS every day
> dealing
> with
> > > > > > > > insurance information, and even they don't necessarily always
> know
> the
> > > > > > > > details. Insurance companies can change the rules anytime they
> want
> to.
> Do
> > > > > > > > you have any idea how often they will tell us that a claim was
> not
> > > > > > > > submitted, even though we have sent it in once, twice, or even
> three
> times.
> > > > > > > > If they do admit that a claim was sent, the radiographs may
> have
> been
> > > > > > > > discarded and resubmission is necessary. On top of all of
> this,
> it is
> the
> > > > > > > > patient's insurance. We submit insurance claims only as a
> curtesy -
> we
> are
> > > > > > > > not compensated for this procedure. It costs us time and money
> to
> submit
> > > > > > > > and fight for these claims, for your benefit. The private
> patients
> > > > > > > > ultimately pay for this with higher fees that subsidize your
> treatment.
> > > > > > > >
> > > > > > > > > Here is the part where you do not understand what I wrote.
> The
> > > > > > > > > remaining balance is not what it says. My insurance had paid
> already
> > > > > > > > > and the remaining balance included the insurance write-off or
> the
> > > > > > > > > difference between the plan rate and what the oral surgeon
> would
> want
> > > > > > > > > to charge for the service. Had I sent in the "remaining
> balance" I
> > > > > > > > > would have overpaid.
> > > > > > > >
> > > > > > > > Your portion of the fee, and in some offices, your entire
> fee,
> is
> due
> at
> > > > > > > > the time of service, not after an insurance company may or may
> not
> decide
> to
> > > > > > > > pay their portion. Why should the doctor give you an interest
> free
> loan?
> > > > > > > > We aren't banks. If you don't want a bill mailed to you, pay
> us
> the
> entire
> > > > > > > > PPO agreed upon fee, and deal directly with your insurance
> company
> to
> get
> > > > > > > > your payment - in the long run this will only help you as the
> office
> will
> be
> > > > > > > > spending less time working on your claim, and more time working
> on
> taking
> > > > > > > > care of you! If you overpay, doctors are happy to refund the
> extra,
> not a
> > > > > > > > big deal.
> > > > > > > >
> > > > > > > > This may all sound a little strong, but patients should
> realize
> that
> by
> > > > > > > > us performing insurance duties the following issues are
> involved;
> > > > > > > > 1. We are loaning the patient money until the
> insurance
> company
> > > > > > > > pays
> > > > > > > > 2. We are asking FFS patients to subsidize treatment
> for
> PPO/HMO
> > > > > > > > patients
> > > > > > > > 3. Our costs are incurred whether or not you and your
> insurance
> > > > > > > > company pay
> > > > > > > >
> > > > > > > > Lastly - our treatment cannot be based upon the insurance
> someone
> has.
> > > > > > > > It must be, and should be, to the best of our abilities,
> regardless of
> > > > > > > > insurance. If the insured individual feels that the insurance
> company's
> > > > > > > > profit is more important than their own health and they deny
> the
> right
> > > > > > > > thing, then there is a serious problem with going forward with
> treatment.
> > > > > > > >
> > > > > > > > Suresh
> > > > > > >
> > > > > > > Isn't it amazing how ignorant the general public is regarding
> their
> medical
> > > > > > > and dental insurance?
> > > > > > >
> > > > > > > Whose fault is this?
> > > > > > >
> > > > > > > Perhaps it is the fault of the buyer of the policy and the owner
> of
> the
> > > > > > > policy.
> > > > > > >
> > > > > > > It never ceases to amaze me that people do not understand that
> the
> "float"
> > > > > > > between service and billing and payment is in fact a form of a
> loan
> of
> > > > > > > money....without interest.
> > > > > > >
> > > > > > > Maybe they do understand this, and since it is to their advantage
> pretend to
> > > > > > > be dumb.
> > > > > > >
> > > > > > > rgdds
> > > > > >
> > > > > > If the "float" bothers you so much, may I suggest starting to
> educate
> > > > > > the general public then. Start with your own office. Demand
> payment
> > > > > > upfront for the service performed even if the patient has
> insurance.
> > > > > > Or if needs be, advise them of cost of financing, give them a
> > > > > > competitive rate of say 9.99% Annual APR for the amount outstanding
> > > > > > from the time of service until the time of payment. If you have a
> > > > > > million bucks outstanding for 30 days, that'll get you around 8,000
> a
> > > > > > month in finance charges. Not bad. But I highly doubt you would
> be
> > > > > > willing to do that. Ever since I've gone to the dentist, no
> dentist
> > > > > > has ever done this. No dentist has ever demanded payment upfront.
> > > > > > The only place I've heard of this happening is in some 3rd world
> > > > > > countries I've been to. Seriously, while it is to the advantage of
> > > > > > the consumer, in my experience it is all I have experienced. The
> very
> > > > > > practice of every dentist office I have ever visited has educated
> me
> > > > > > that this is how it is done. We received the service, and then you
> > > > > > collect from the insurance and the patient at a later date. Please
> > > > > > don't expect the general public to suddenly start offering to pay
> you
> > > > > > upfront. If you want, ask them to and see how they react. If you
> > > > > > offered it to me, I'd probably find another dentist.
> > > >
> > > > --
> > > > Mark & Steven Bornfeld DDS
> > > > Brooklyn, NY
> > > > 718-258-5001
> > > > http://www.dentaltwins.com
> > > >
> > > >
> > >
> >
> > --
> > Joel M. Eichen, .
> > Philadelphia PA
> >
> > DISCLAIMER FOLLOWS:
> >
> > *********
> >
> > Dental health-related material
> > is provided for information purposes
> > only and does not necessarily
> > represent endorsement by or an official
> > position of the SciMedDentistry gang
> > or any other official agency either
> > actual or fictitious or Steve Mancuso.
> >
> > Advice on the treatment or care
> > of an individual patient should
> > be obtained through consultation
> > with a dentist who has examined
> > that patient or is familiar with
> > that patient's dental history.
> >
> > STANDARD DISCLAIMER
> >

#82 01-17-2004, 09:37 AM

ehtorg[at]hotmail.com (Stew) wrote in message news:<8dc5746a.0401130659.17915f3a[at]posting.google.com> ...
- quote -

> "Suresh Goel" <Gumsdoc[at]worldnet.att.net> wrote in message news:<E2LMb.9291$VS4.302164[at]bgtnsc04-news.ops.worldnet.att.net> ...
> > "Stew" <ehtorg[at]hotmail.com> wrote in message
> > news:8dc5746a.0401120642.58b17a16[at]posting.google.com...
> > > "rg" <jobahut[at]hotmail.com> wrote in message
> > news:<8akMb.42752$WS1.28641[at]fe1.texas.rr.com> ...
> >
> > > If the "float" bothers you so much, may I suggest starting to educate
> > > the general public then. Start with your own office. Demand payment
> > > upfront for the service performed even if the patient has insurance.
> >
> > Many offices are doing this, and more are doing so every day. Offices
> > which do not participate in discount plans, and some that do, may collect
> > payment upfront.
> >
> > > Or if needs be, advise them of cost of financing, give them a
> > > competitive rate of say 9.99% Annual APR for the amount outstanding
> > > from the time of service until the time of payment. If you have a
> > > million bucks outstanding for 30 days, that'll get you around 8,000 a
> > > month in finance charges. Not bad.
> >
> > We aren't banks. It isn't our job. Do you really want your dentist
> > worrying about financing you in house?
> No of course I don't. I was being completely sarcastic here. All I'm
> saying is before you start complaining about the float as rg did in
> his prior post, think about what the options are.... there aren't many
> that make sense. It seems to me that you will always have a float
> with the insurance companies. I really doubt that patients would be
> willing to pay the total amount upfront (including amounts paid by
> insurance). Sure, they'll probably pay upfront the portion they pay,
> but it seems silly to have the patient pay the full amount and then be
> refunded once the insurance comes through.

Insurance companies pay faster to the patient (their client) than to
the dentist who they could care less about.
I'll tell you a story 2 years ago I had a major flood in the office
and the computer system was soaked. I did not have adequate backup. My
hygenist called for a data recovery guy. I explained that because this
is going through insurance, I needed him to wait until the claim was
settled. He agreed.
He took my computers extracted the data and then held my computers
hostage until the insurance's cheque cleared his bank.
We dentists let patients walk out the door with hope insurance
companies pay their portion and we do not have to collect the rest
from the patient.
Others in the business world do not treat us the same we have bills to
pay to and are not given the same priveleges as we do to our patients.
Did you know that a typical small dental office has an accounts
Recievable (money owed to the office) of over $80,000.00 do you think
it is fair for us to extend such credit which depreciates to $0.00
after 90 days (if we sell the office).
If we have 80 patients that owe us $1000.00 waiting for insurance to
clear there is you $80000.00.

I think reimbursing the patient is a positive thing it is like found
money when the patient gets a cheque from their dentist.

- quote -

> > Why wouldn't you want your dentist
> > to be able to focus completely on your care, instead of running a small
> > bank? Besides, there are several companies that offer third party
> > financing. Your dentist will be happy to provide the forms for you.
>
>
> >
> > > that this is how it is done. We received the service, and then you
> > > collect from the insurance and the patient at a later date. Please
> >
> > I'll try this with my mechanic tomorrow and see how it goes.
> I really don't think you want to walk down the path of comparing
> dentistry to the auto repair industry. I can't think of a more
> unpleasant, sleezy industry than the auto repair industry. Extremely
> consumer unfriendly. Compare yourself to a medical doctor, not an
> auto-mechanic.

I'll compare my self to an ethical accountant.
All doctors are shmucks when it comes to business sense that is why
the industry is the way it is.

- quote -

> >
> > > don't expect the general public to suddenly start offering to pay you
> > > upfront. If you want, ask them to and see how they react. If you
> > > offered it to me, I'd probably find another dentist.
> >
> > I won't let you freeload off of patients that respect my time and
> > expertise. It is unfair to other patients. I still have to pay my office
> > bills, and can't tell them that "Sorry, rent's gonna be a little late, Stew
> > hasn't paid for that $30,000 full mouth restoration case yet." That's
> > another thing - if your insurance max is $1000, and your work is $2000, will
> > you at least pay me for the difference above and beyond the insurance, at
> > the time of service, or I owe you a loan for that too?
> I'm not trying to freeload. This is where you have completely lost
> me. Of course I don't expect to have 30,000 or even 1,000 of "free"
> money from a dentist's office. You seem to have gone completely out
> of the context of my original post. I'm not talking about people with
> no insurance. I'm talking about those that have insurance and rg
> seemed to suggest that you guys give out interest free money to the
> patient because you haven't been paid by the insurance company or the
> patient upfront. He seemed to suggest that the patient should pay for
> everything upfront, thus eliminating the float. All I was saying, is
> the float is there. For people with insurance, I think they expect the
> float. I've always had a float.

That is the problem and guess what the industry is changing.

I've never had service rendered for
- quote -

> more than an $1,000. My biggest payment (after insurance has paid) was
> this last one, which I have paid in full. It was just more than I
> thought it would be. Much more. Sure, if I was going to get some type
> of restorative work (which I have discussed with my family dentist), I
> would expect to pay either up front or finance it (third-party). I
> actually agree that if you guys are floating people with no insurance,
> you should at least be checking their credit or something. Insurance
> will at least guarantee you (in general) some payment.

not if you default on your policy. Or your insurance decides not to
pay for something. We never know 100% what the insurance would do.
I've had insurance companies who were supposed to send payment to me
accidently send it to the patient and the patient spends the money and
then I have to collect from him/her.

- quote -

>
> Please try to understand the context of my statements (I understand it
> might be difficult in a forum). But for you to label me as a
> freeloader that doesn't respect the dentist's time or expertise is
> quite harsh. I had a problem with an oral surgeon. The guy didn't
> communicate to me what the service and/or cost would be for the
> extraction of my wife's tooth.

I sympathize with you on this point.

My wallet ended up in shock afterwards.

not good.
- quote -

> I've already learned a great deal about from the experience and from
> other dentist's who have posted here. I've also seen that a couple of
> you are pretty damn defensive and seem to take things to the
> extreme....seriously, a $30,000 float to Stew for a full mouth
> restoration. If you're floating 30,000 to anybody, something is
> extremely wrong with your practic IMO.
> >
> > sg

This something is a lot common than you think.
At the end it should not matter if the patient gets reimbursed the
cost is known ahead of time and with proper communication can be
planned.
The whole goal is in any business is to keep the accounts recievable
in line
when we have bills to pay and have patients that owe us money in
excess of $80000, it is unfair to us and our families. What if we die
and the burden of collections goes onto our families???
Patients have been spoiled with this curtecy because we by nature try
to help our patients. It will take 30 days for a patient to get their
money back and everyone will be happy, there is no reason for us to
carry such a float and as businesses it is our job to minimize the
float.
BTW Some dental offices will offer 5% discount if you pay your portion
upfront and collect from your insurance.
That Stew is how serious this problem is.

#81 01-17-2004, 08:48 AM

Sure they could care less if your accounts recievable goes through the
roof.
It is a tactic the insurance companies are using to weaken our
practices so that we will sign up as providers or ("their employees")
and work for less money.
The [at]#&*###! ADA has made this too easy for the insurance companies by
providing
that option on the claim form as well as a signature line for us to
sign.
If you can stay your ground until the rest of us come to our senses it
would help. Another option is to collect the patient portion upfront
or any small balances such as under $300-400. you can also play it by
ear, try to collect upfront if you see hesitation, then collect the
patient portion. You should also make it clear to them of the fee. In
my practice I always present any fee over $6000.00

I really believe we need to do away with the coding system and just
bill by the hour as lawyers and accountants. If you think about all
the behavioural management we deal with, and have to settle for a flat
fee its rediculous and unfair to cooperative patients.

jgenecov[at]aol.comnojunk (Jeff Genecov) wrote in message news:<20040116212658.22937.00000173[at]mb-m04.aol.com> ...
- quote -

> I tried for a long time to charge up front for services, provide a "superbill"
> to the patient, and let them collect the reimbursement. That way THEY could
> keep track of how much the ins. co. paid, and how much more was owed, etc.
>
> However, so many other docs in my area (an affluent suburb of Dallas) had begun
> to accept assignment, that we finally had to to compete.
>
> Accepting assignment is, as has been stated here, an interest free loan which
> requires more staff time and overhead to service. So it makes our fees go up!
> And I think it also leads to patients not knowing or caring what their benefit
> is - they think the insurance company is the resonsible party, not them! And
> if the insurance company doesn't pay all of the bill, then our fees are too
> high.
>
> Unfortunately we most easily remember those who give us trouble. But insurance
> companies being involved in our business practices give us more trouble than
> even the most troublesom patients!
> Regards,
>
> Jeff Genecov, DDS, MSD, FICD
> Diplomate, American Board of Orthodontics

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