Chairside Connection: Insurance benefits and getting paid for what you do

Oct. 20, 2023
Want to get paid for what you do? Who doesn't? Dr. Dominque Fufidio explains clinical claim reviewers, and why dentists should contact them.

Nothing bothers Dominque Fufidio, DDS, FAGD, and Philips KOL, more than seeing dentists denied payment for what they do. When she was in private practice, she would gather with her team to go over denied claims, and then she'd call insurance companies and explain why treatments were necessary.

That’s when she learned about peer-to-peer review, where she could speak with a clinical claim reviewer, who would explain why some things were denied. Dr. Fufidio would then have the opportunity to explain cases to the reviewers and why certain treatments were performed. The reviewers would then help her get paid for her production.

Most dentists have no idea there’s a fellow dentist they can reach out to to explain why they should be paid for denied treatment. Dr. Fufidio certainly didn't, and she was so appreciative and fascinated with the service that she educated herself extensively to be able to help other dentists get paid, and she became a clinical claim reviewer. 

She explains the responsibilities of clinical claim reviewers and shares ideas on how dentists can guarantee payment more regularly, and with fewer headaches, for the necessary treatments they perform. Much of it comes down to clinical documentation.

Hear Dominque's and my discussion here, and watch your incomes rise!

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