In this episode, Ben and Naren discuss the challenges dental practices face with insurance claim denials post-healthcare hack. They explore how government agencies, primarily state insurance commissioners, can intervene in appeals against insurance companies. They clarify that while agencies protect consumer rights, dentists can utilize them effectively through strategic advocacy. The conversation also touches on the complexities of ERISA laws governing self-funded plans and emphasizes proactive engagement with insurance commissioners after initial claim denials. They highlight success stories where dentists like Tessina have effectively used governmental support to overturn claim denials, stressing the importance of early and persistent advocacy.
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Time stamps
- 00:02:57 – We often hear that in some states, both the attorney general and the insurance commissioners get involved with appealing denied claims. Is this true?
- 00:04:51 – Do you have any case studies or recent examples of how dental offices have successfully used the government to represent patients?
- 00:06:45 – Can you use the government to address claims problems for self-funded dental plans?
- 00:09:08 – At what point during the appeal process do you advise doctors to initiate the review/complaint process with an insurance commissioner’s office?
- 00:13:38 – If any listener needs help in this area, who should they contact?
- 00:15:39 – What resources do you have for listeners who are interested in learning more about this topic?
Resources
