Ep 27: Dental Claim Timely Filing Limitations - The Easiest Money You Will Ever Lose

Ep 27: Dental Claim Timely Filing Limitations - The Easiest Money You Will Ever Lose

In the wild world of Dental Billing, here is one reason for dental claim denials that makes us irrationally angry every time we see it. Not because it's complicated. Not because insurance did something sneaky. But because it's 100% preventable. Timely filing. (nooooooooooo) The denial that basically says: “You did the work… but you waited too long to tell us about it.” (which suuuuuuuucks) Which means the treatment was completed, the claim existed, the revenue was earned… …and then the deadline passed. Money gone. In Episode 27 of The Truth Decay Podcast, Sara Baker and LaRae McMullen break down one of the easiest revenue leaks in dentistry — and why so many offices still fall into it. Because timely filing isn’t really about insurance rules. It’s about SYSTEMS. (Baby, spoiler alert: it's always about systems.) When claims sit for weeks… When rejected claims aren’t monitored… When no one checks the unsent claims report… That’s when deadlines quietly pass and thousands of dollars disappear. poof In this episode we cover: • What timely filing actually means • Why deadlines vary wildly between carriers • Why in-network offices can lose 100% of the revenue • Why out-of-network offices face brutal patient conversations • And the simple systems that make timely filing denials almost impossible Insurance companies already have plenty of reasons to deny claims... In dental billing, we got 99 problems every day. Don't let timely filing issues be one of them. 🎧 Episode 27 is live now on all podcast platforms 📺 Watch on YouTube → https://www.youtube.com/watch?v=L7YDo_fI7Y4 [https://www.youtube.com/watch?v=L7YDo_fI7Y4] 📩 Questions? Email us at hello@thetruthdecaypodcast.com [hello@thetruthdecaypodcast.com] 🌐 Learn more at sddentalsolutions.com [http://sddentalsolutions.com]

Ep 26: Old Fees, Bad Estimates: When Your Fee Schedule Is Stuck in the Past

My dental billing brochachos, let us paint a very real picture, we in the biz see every single day: You post an insurance payment from a carrier you’re in-network with… and it’s higher than what you estimated. Sounds like a win! Woohoo! Until you realize: • There’s now a credit sitting on the patient’s account. • You under-collected at the time of service. • Your estimate was wrong. • Your reporting is about to look reeeeal messy. Here’s what actually happened. Your fee schedule in the PMS was outdated. In Episode 26 of The Truth Decay Podcast, Sara Baker and LaRae McMullen pull back the curtain on a quiet systems issue that distorts estimates, inflates adjustments, and makes your numbers unreliable. Because consider this: Insurance does not calculate payment off whatever fee happens to be in your software. It calculates payment off the contracted allowed amount tied to your agreement. So if your practice management system is using old contracted fees — or submitting UCR, which Sara has a beef with, come fight her — your estimates are built on the wrong foundation from the start. Which means: You’re collecting the wrong patient portion. You’re adjusting production later. And you’re making financial decisions based on numbers that were never accurate to begin with. (agh!) In this episode, we break down: • Why outdated PPO fees create credits and under-collections • How bad fee data quietly wrecks your reporting • What to check inside your PMS immediately • Why fee schedules are legal contract terms — not suggestions • And how (yes) you can negotiate them If your adjustments feel high or your estimates feel off, this might be why. Come take a listen! 🎧 Episode 26 is live on all major platforms 📺 Watch on YouTube → https://www.youtube.com/watch?v=JzIJV7yFY9g [https://www.youtube.com/watch?v=JzIJV7yFY9g] 📩 Questions? Email us at hello@thetruthdecaypodcast.com [hello@thetruthdecaypodcast.com] 🌐 Learn more at sddentalsolutions.com [http://sddentalsolutions.com]

Ep 25: Care Vs. Coverage - Stop Letting Dental Insurance Run Your Financial Conversations

What up, my fellow enamel enthusiasts! Riddle me this: What’s one of the biggest collection killers hiding in plain sight inside dental offices? It’s not insurance. It’s not patients. It’s how you start the conversation. See, the minute you lead treatment planning with, “Let’s see what your insurance covers…” —You’ve handed control of the narrative to a third party. You’ve shifted the value of the doctor’s diagnosis from clinical necessity --> a benefits summary. And when the claim doesn’t pay? Now the patient is confused. Now they’re questioning the diagnosis. Now your statements are getting ghosted. Because somewhere along the way, you accidentally taught them that coverage equals necessity. In this episode of The Truth Decay Podcast, Sara Baker and LaRae McMullen break down the difference between a Care-First Communication Approach and a Coverage-First Communication Approach—and why that distinction directly impacts your ability to collect. If your financial conversations start with benefits instead of health, you’re quietly devaluing treatment before the patient ever says yes. You’ll learn: • Why leading with insurance creates distrust when claims get denied • How coverage-first language makes treatment sound optional • What care-centered communication actually sounds like • Why “we’ll see what insurance says” kills your leverage • How conviction (not clinical expertise) builds patient trust • Why offices that lead with care collect faster and with fewer complaints Sara and LaRae also address the fear of “scaring patients off” by talking about money upfront—and why avoiding the conversation creates far more damage than having it. Because here’s the truth: Patients don’t leave over cost. They leave over confusion. So let's clear up that confusion, bay-bees! <3 Listen today and let us know what you think. ⸻ 🎧 Available on all major podcast platforms 📺 Watch the full episode on YouTube → https://www.youtube.com/watch?v=ZyInp6t_vxo [https://www.youtube.com/watch?v=ZyInp6t_vxo] 📩 Questions? Email us at hello@thetruthdecaypodcast.com 🌐 Learn more at sddentalsolutions.com

Ep 24: X-Ray Vision - Billing Dental Radiographs (for Full Payment!)

Okay, dental billing friendos: You took 4 bitewings and six PA X-rays, billed them correctly, and still got denied because insurance saw it and went, ‘oh hey, process those bad boys as an FMX.’ We've all seen it before - that math ain't mathing, yet that's what happens. Because if you're not paying attention to how those images are billed, bundled, processed, and frequency-limited, you could be accidentally triggering denials, flirting with write-offs, and surprise patient balances—just for trying to get clear, diagnostic pictures! How dare you! In this episode of The Truth Decay Podcast, Sara Baker and LaRae McMullen unpack the (potentially) messy issue of dental X-ray billing: what makes an FMX an FMX, when bitewings and PAs get bundled (whether you like it or not), and how a few smart tweaks to your billing workflow can save you cash, claims, and chaos. They'll break down: * Why billing multiple X-rays often get processed as a D0210 (FMX) * How frequency limitations turn potential benefits into a denied claim * Why you should never bill insurance "just to see if they'll pay" * The carrier math behind X-ray bundling (and how to work with it) * How to ethically bill individual images without triggering FMX processing * When and how to talk to patients about potential out-of-pocket portions You’ll also get a deep dive into: * The difference between diagnostic needs and benefit policies * Why X-rays deserve to be valued (and paid for!) * Scripts and tips for leading a care-centered financial conversation If your front desk is tired of surprise denials, your ledger is full of FMX write-offs, or you’re just ready to take control of how X-rays get submitted and paid—this one is for you. 🎧 Available on all major podcast platforms 📺 Watch the full episode on YouTube → https://www.youtube.com/watch?v=KPrf3KP0jKY [https://www.youtube.com/watch?v=KPrf3KP0jKY] 📩 Questions? hello@thetruthdecaypodcast.com [hello@thetruthdecaypodcast.com] 🌐 Learn more at sddentalsolutions.com #DentalBilling #FMXConfusion #DentalInsurance #DentalPracticeManagement #TruthDecayPodcast #RevenueCycleManagement #DentalClaims #BillingTips

Ep 23: Scaling the System - When SRPs are Necessary But Not Covered

“Wait — My Dental Insurance Didn't Cover It?” 😬 (SRPs, Denials, and the Conversation You Forgot to Have) For those SRPs, you thought you did everything right. Diagnosed the periodontal disease. Treatment planned SRPs (appropriately) and explained the necessity. "We'll send this to your insurance." Provided great care to your patient. And then… 💣 The claim got denied. The patient got big mad. And your front desk is stuck holding the billing grenade. Sound familiar? That’s because scaling and root planing (SRP) lives in a weird gray zone: ✅ Absolutely clinically necessary. ❌ Often doesn't meet criteria for insurance coverage. In this episode of The Truth Decay Podcast, Sara Baker and LaRae McMullen break down the messy overlap between clinical care and coverage criteria—and how to stop the chaos before it starts. Because here’s the truth: SRPs are absolutely essential to treating periodontal disease. But when you center the conversation around what insurance “might” pay—instead of what the patient needs—you set yourself (and your team) up for frustration. 🎧 You’ll Learn: * Why SRPs get denied even when treatment is spot-on * The most common insurance criteria for SRP approval (and how to document them) * What to say before the appointment to set clear expectations * The difference between care-centered and coverage-centered language * How one missing detail in your charting can cost you the claim * When to appeal—and when to skip the fight * Why “surprise billing” is really a systems problem, not a patient one Listen now and learn how to protect your team, your treatment plans, and your bottom line—one clean claim at a time. 🎧 Available on all podcast platforms 📺 Watch the Full Episode on YouTube: https://www.youtube.com/watch?v=DIJvdeFtq1U 📥 Download Your Free Resource: “SRP Billing Playbook: Scripting Ideas, Charting Tips + What the Carriers Usually Require” → thetruthdecaypodcast.com [http://thetruthdecaypodcast.com] 📩 Want us to tackle your burning billing questions? Email: hello@thetruthdecaypodcast.com [hello@thetruthdecaypodcast.com] More tools + training: sddentalsolutions.com [http://sddentalsolutions.com] #TruthDecayPodcast #DentalBilling #SRP #PerioBilling #DentalInsurance #CleanClaims #PatientPortions #BillingTransparency #PrivatePracticeTips #RevenueCycle