How much time are you or your staff spending on the phone or searching through PPO portals verifying eligibility? With the rise of network umbrellas and PPOs sharing their networks of dentists, your in-network participation can sometimes not be as straight … Read More
PPO Tips Blog
Provider Directory Verification Notices – Do NOT ignore these!
With the Affordable Healthcare Act, there is a growing trend for legislation requiring insurance companies be held accountable for accuracy in their directories listing in-network providers. Prior to deciding on a plan, enrollees can know, with confidence, which doctors are … Read More
Metlife EFT Requirements, Do You Have To Comply?
Many offices have received notices from MetLife that they MUST sign up for Electronic Funds Transfer. Click here to review additional information, including the exception that “some offices may not yet be equipped to handle this change and those who can’t … Read More
Aetna Dental Policy Changes Effective July 17, 2017
D4355 – Debridement, full mouth to enable comprehensive periodontal evaluation and diagnosis To align with the ADA descriptor of D4355, the following changes are being made to our claim processing policies: D4355 will be denied when performed on the same … Read More
Cigna PPO Re-Credentialing Changes, Don’t Get Terminated!
Cigna is sending electronic links for re-credentialing. A provider who works at more than one location may think he/she does not need to complete the re-credentialing if they recently submitted everything to be added to another location. However, Cigna will … Read More
Zelis Purchases Maverest Dental Network
Many of you have received letters announcing that Zelis (formerly Stratose) has acquired the Maverest Dental Network. If you are directly contracted with both companies, you will have the option to select either your existing Zelis/Stratose or Maverest fee … Read More
2017 Tricare and ADA Code Changes
Tricare Changes Instead of the military contracting its own providers, they lease providers through existing PPOs. United Concordia has been awarded the TRICARE Dental Plan (TDP) five year contract which will take effect May 1, 2017. MetLife had the contract … Read More
Why Discussing Your Fees With Other Dentists Is Illegal
Have you ever been told that you should not discuss your office fees or insurance reimbursements with other dentists? Have you ever wondered why? If so, below is a refresher on federal antitrust law that prohibits certain activities and the … Read More
Important Changes for Maverest Basic Providers
As of May 1st, 2016, Maverest is phasing out their Basic plan. As a result, claims submitted by Basic Only providers will not be processed with Maverest fees. The Basic plan previously allowed dentists to be contracted at 75% of … Read More
3 Tips for Keeping Your Fee Schedules Updated in Dentrix
Updating and using fee schedules as a contracted PPO provider can produce huge benefits to your patients and your practice. It can assist you in giving more accurate accounting of production, help your front office collect more accurately, and give … Read More