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wrong.• Your reporting is about to look reeeeal messy.Here’s what actually happened.Your fee schedule in the PMS was outdated.In Episode 26 of The Truth Decay Podcast, Sara Baker and LaRae McMullen pull back the curtain on a quiet systems issue that distorts estimates, inflates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 (agh!)In this episode, we break down:• Why outdated PPO fees create credits and under-collections• How bad fee data quietly wrecks your reporting• What to check inside your PMS immediately• Why fee schedules are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 themIf 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📩 Questions? Email us at [email protected]🌐 Learn more at sddentalsolutions.com