10 THE ADA PRACTICAL GUIDE TO EXPERT BUSINESS STRATEGIES Discussion Questions 1. According to the chart by NADP, what is the most commonly accepted insurance plan? Why do you think this is the plan most people use? 2. What are the most commonly accepted insurance plans in your practice? 3. What is the difference between insured and self-funded plans? How can you tell whether a plan is insured or self-funded? 4. What are the main differences between a DHMO and a PPO? 5. Why do you think the ADA considers co-payment forgiveness unethical? What are some other issues with insurance that might be considered unethical? 6. Are denied claims an issue in your practice? What are some steps your practice can take to reduce the number of denied claims? What is the process when a claim is denied? 7. What’s your practice’s process for determining coordination of benefits? Who in your practice should you consult if you have a question about coordination of benefits? Where is the process documented? 8. What are some ways your practice can improve its staff training in insurance administration and coding? What is your preferred method of training — seminars, self-guided reading, watching a video, listening to a speaker, etc.? 9. A new patient has her first appointment at your practice. She presents her insurance information. You have never seen the plan, and are unfamiliar with how it works or what it covers. What do you do next? Is there a way the patient can still use the plan to pay for dental treatment in your practice? 10. Who is the practice resource for coding and insurance questions? What are some other resources you can use to research these questions?