Apex Reimbursement
Specialists:
Putting Money in
Dentists’ Pockets and
Saving Them Hours
of Time
By Hillel Kuttler
Dentists
take pride in patients’ pearly smiles – and Apex Reimbursement Specialists
prides itself on the smiles it brings to dentists.
After
all, why wouldn’t a dentist be
thrilled when he or she receives an additional eight to 12 percent in insurance
reimbursement for the same procedure? That’s the typical range of increases
Apex secures for its dental clients. Apex has achieved increases as high as 50 percent.
Apex
provides key services – services that work. Best of all for dentists in both
solo and group practices is this: The reimbursement services are a no-risk,
all-reward proposition.
Apex
accomplishes great returns for its clients through hard work, a deep knowledge
of the industry, and building trust with dental practices and insurance
companies alike. Apex researches the rates, the local and regional markets and
the practices. From a position of strength, Apex negotiates with insurance
companies to obtain higher reimbursement rates for its dental clients.
In
addition to handling reimbursement-related planning, Apex’s portfolio of
services includes:
*
Licensure: Consider a dentist’s state license that must be kept current.
Now consider the steps involved in renewing that person’s license. Then
multiply the time spent by the number of dentists in the practice, all with
different license-renewal dates. Add to that DEA certificates, malpractice
policies and other regulatory documentation that must be kept current – the
huge logistical undertaking can be overwhelming, involving countless hours
spent by practices’ staff. Those staff members could spend that time far more
productively in servicing patients. Apex frees you to do that.
*
Credentialing: Consider the staff hours spent in enrollment and
re-enrollment with an insurance company. Now consider the rules of that
company. Then consider the number of insurance companies and their different
rules. That’s a lot for your business manager to juggle. Apex frees you from
that obligation, too.
What
Apex asks dentists is this: Do you want to spend more of your time on paperwork
or on patients in the chair?
Apex’s
team has an insider’s perspective of how the carriers build and retain their
networks.
Apex’s
co-founders, Joseph Lefkowitz and Gavi Cohn, aren’t trained in root canals,
bridges and plaque, but they bring to dentistry what practitioners don’t: strong
business backgrounds. For Lefkowitz, that means years of negotiating on behalf
of large-institutional clients. Cohn has an M.B.A. and success in starting
companies.
Serendipity
brought them together to form Apex in 2013. A relative who’s a periodontist
complained about his reimbursement rates. Two other relatives who work in the
insurance business explained that negotiation with insurance companies is
possible, even effective. Lefkowitz and Cohn ran a test case, and verified that
statement.
They
haven’t looked back, and now – from its base in Maryland – Apex represents
clients in 18 states.
For
dentists, Apex’s expertise means higher revenue. Apex negotiated a projected $1 million increase in annual revenue
for a large multi-state group practice based in Florida. All told, Apex manages
approximately $200 million in clients’ portfolios.
For
insurance companies, Apex is a welcome relief, too. Often, dentists and other
medical practitioners view insurance companies as adversaries that dictate
terms and reimbursement rates. One might expect, then, that insurance companies
would view Apex as an adversary, too. Apex, after all, advocates for its
clients’ best interests.
They’re
correct in understanding that Apex always puts clients first. But the
relationship between Apex and insurance companies is not adversarial – far from
it. In fact, the relationship is cooperative. That is because insurance
companies have a vested interest in retaining dentists in their networks.
Remember: Insurance companies are only as strong as their networks. Dentists
leaving hurts the companies’ bottom line – and dentists leave when they feel
neglected or taken advantage of, like when reimbursements are driven too low.
One representative
at an insurance carrier recently told Apex that Apex is excellent at what it
does because “you care, and you strive to do a complete job.” When the
insurance carrier tried to manage the process on its own, she said, the
proverbial ball often got dropped.
“We
always say to the insurance company: What can we do together to keep this
dentist happy?” Lefkowitz explained. “Insurance companies have retention teams
to keep providers in-network. If the fees are too low, the dentists can’t
survive and will leave.”
Just
as Apex saves dentists untold time, it does so for the insurers. Apex
represents more than 300 group and solo practices. You think an insurance
company meeting with one point of contact isn’t more efficient than its meeting
with 300?
“I
would like to show the dentists why the insurance companies see the value in
our working on their behalf. In the case of credentialing, for example, their
time savings comes in our already knowing what forms are required,” Cohn said.
He
added: “It’s a win for the dental provider because they’ve now made more money.
It’s a win for the insurance company because it helps their network retention.
And both make us happy because we successfully filled the needs of the industry
as a whole.
“We
are the bridge between the two. We’re allowing the process to work more
smoothly.”
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