Got questions? Send Ericka a Text! Pivotal moments often arrive unexpectedly. After years of helping dental practices decode insurance denials and maximize reimbursements, I've made a significant discovery that's reshaping our journey together. What began as technical discussions about coding and claims consistently opened doors to far deeper conversations about practice culture, team alignment, and leadership challenges. The highest-performing billing departments I've encountered share one ...
Got questions? Send Ericka a Text! Dental insurance companies often deny necessary treatment claims not because they should, but because they can—and we explore how to fight back effectively through appeals and regulatory complaints. • 59% of denied claims are upheld simply because no appeal is ever filed • Unreasonable denials occur when patients have benefits but claims are still denied • State insurance commissioners can investigate denials and prompt payment violations • Understanding th...
Got questions? Send Ericka a Text! The entrepreneurial journey can be isolating even when surrounded by loved ones who don't fully understand what we're building. Success looks different for entrepreneurs than those in traditional jobs, and the lack of understanding can create a divide between our business reality and personal relationships. • We often downplay our professional wins because they don't translate well to those outside our industry • Traditional security (401k, benefits) looks ...
Got questions? Send Ericka a Text! Are you leaving money on the table while your patients remain undertreated? After analyzing over 300 dental practices across the country, I discovered a shocking truth: the average dental practice with a full-time hygienist treats only 17% of the periodontal disease they diagnose. That means 83% of diagnosed disease goes completely untreated—a staggering gap between diagnosis and care. This episode dives deep into the "hidden opportunity" within your hygien...
Got questions? Send Ericka a Text! Dental insurance verification is stuck in the 1990s, but insurance companies have dramatically changed how they operate—leaving dentists with surprise balances, frustrated patients, and a mess of accounts receivable. In this eye-opening episode, I reveal how insurance carriers are secretly leasing networks behind the scenes and potentially pulling your practice into networks you never directly signed with. Drawing from a recent consultation where a practice...
Got questions? Send Ericka a Text! Insurance companies are using AI to evaluate dental x-rays, denying claims when specific landmarks aren't visible in the images. This shift means approximately 70% of claims are now processed through artificial intelligence systems that disqualify submissions based on technical deficiencies rather than subjective human review. • Poor quality x-rays with cone cuts or missing apexes give insurance companies legitimate reasons to deny payment • Clinical teams ...
Got questions? Send Ericka a Text! After rebranding my company and going solo without a business partner, I discovered I needed to get intentional about how I showed up, leading to 10x growth for Fortune Billing Solutions in just one year. • Tracked every minute of my day for two weeks to discover I was creating chaos for myself and my team • Implemented structured timeblocking for client meetings, discovery calls, team one-on-ones, podcast recording, and CEO strategy • Created a daily "mira...
Got questions? Send Ericka a Text! Artificial intelligence has quietly revolutionized how dental insurance claims are processed, and most dental offices don't even realize it. Today we pull back the curtain on Novo Dynamics and their Novo Health Dental AI system that's scrutinizing your x-rays, documentation, and billing patterns before a human reviewer ever sees your claim. The game has changed dramatically. Insurance companies have trained AI systems to review claims using very specific cr...
Got questions? Send Ericka a Text! Dental billing has undergone a dramatic transformation since the carefree days of the late 1990s. What was once a straightforward process—send a claim, get paid, move on—has evolved into a complex system demanding meticulous attention to detail and strict compliance measures. The reason? Insurance companies have woken up to the staggering $12.5 billion lost annually to dental fraud, and they're scrutinizing claims like never before. You don't need to be com...
Got questions? Send Ericka a Text! Uncover the critical connections between HIPAA compliance and dental billing practices in our episode featuring host Ericka Aguilar. Discover how safeguarding patient privacy extends beyond ethical boundaries to play a pivotal role in averting billing fraud in dental practices. We delve into the cutting-edge strategies employed by insurance companies, such as predictive analytics, to detect inconsistencies and initiate audits without relying on whistleblower...
Got questions? Send Ericka a Text! Tired of bureaucratic inefficiencies and missed technological opportunities? Join us as we analyze the healthcare workforce, dissecting the tough reality of supply and demand in medical residencies, with a special focus on the rising field of pediatric dentistry. We'll reflect on personal encounters with government red tape and ponder how the tech boom of the 90s could have spurred a much-needed modernization of government systems. We'll even speculate on ho...
Got questions? Send Ericka a Text! Legendary dental expert and Founder of Dental Town Howard Farran joins me, Ericka Aguilar, for a compelling exploration of the future of dentistry, challenging the conventional norms that govern the industry. We embark on a fascinating journey through Howard's personal story, from Kansas to Arizona, navigating the complex economic barriers and education demands that define the profession. Together, we unravel the financial intricacies of being a dentist, con...
Got questions? Send Ericka a Text! This episode focuses on the critical issue of managing credit balances in dental practices and the associated legal implications. Various state laws dictate how these balances should be handled, with non-compliance leading to potential fines, making it essential for dental offices to incorporate credit balance reports into their regular billing processes. • Overview of why credit balances are often ignored • Importance of credit balance reports in fin...
Got questions? Send Ericka a Text! The episode encapsulates a life-changing mastermind weekend experiences shared by three female entrepreneurs. They explore themes of accountability, personal growth, and overcoming mind trash, highlighting the necessity of supportive networks in elevating one’s entrepreneurial journey. • Erika reflects on her long-held dream of hosting a mastermind • Participants share breakthroughs and insights gained from their connection • Discussion ar...
Got questions? Send Ericka a Text! This episode highlights the essential components of a streamlined and effective daily workflow for dental billing professionals. Emphasizing critical reporting, compliance, and continuous education, we aim to empower new and experienced billers alike. • Overview of the Dental Billing Mastery Course • Importance of establishing a daily rhythm in billing • Running Procedures Not Attached and Claims Not Sent reports • Verifying clinical docum...
Got questions? Send Ericka a Text! Imagine transforming your career by launching a home-based dental billing business that aligns perfectly with your lifestyle and personal commitments. In this episode, I guide Esmeralda, a seasoned dental biller, through the exciting and challenging transition from working in a single dental practice to becoming an independent entrepreneur. We promise you’ll gain invaluable insights into how resilience, strategic planning, and a keen understanding of busines...
Got questions? Send Ericka a Text! Unlock the secrets to navigating the often-confusing world of dental billing with our latest episode, where we promise to make the coordination of benefits (COB) your new superpower. When a patient is juggling multiple insurance plans, determining the primary insurance can feel like solving a complex puzzle. We'll walk you through the essential rules and scenarios, including the role of the patient's employer's insurance, the birthday rule for dependent chil...
Got questions? Send Ericka a Text! Unlock the secrets of dental billing as we challenge the conventional wisdom surrounding Coordination of Benefits and reveal strategies that can revolutionize your practice's revenue flow. Ever wondered why patients with dual coverage often face billing confusion? We unravel these complexities and offer practical insights to enhance collections and maintain patient trust. This episode is essential listening for anyone looking to master the intricate insuranc...
Got questions? Send Ericka a Text! What if you could reignite your passion for your job and drastically improve patient outcomes at the same time? Tune in to hear the inspiring story of Trish, a dental hygienist who transformed her career from burnout to joy. Trish reveals her journey of mastering periodontal care, saliva testing, and insurance coding, and how these skills not only reignited her love for her work but also elevated the quality of care in her practice. Find out why chart preppi...
Got questions? Send Ericka a Text! What if everything you thought you knew about dental hygiene billing was wrong? Join us for an eye-opening discussion with Jen, a veteran hygienist turned billing expert, as she uncovers the hidden intricacies of dental billing and the imperative role of accurate documentation. From debunking myths like the impossibility of combining SRPs and prophylaxis to the critical need for detailed perio charting, Jen provides actionable insights that can revolutionize...