SUDOKU DENTAL INSURANCE

 

  • The Dental Insurer would rather send you a Sudoku Puzzle, instead of an Insurance Check. 
  • Getting the Answers for Their Sudoku Puzzle would be just as difficult as Extracting that Payment timely.

    • Dr. Lauren Friedman DDS offers you a brief Education into the puzzling world of Dental Insurance. 

     

     

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    $ 600

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    $  70

     

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    $ 600

     

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    $  70

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    $  40

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    $ 900

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    $ 400

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    $ 300

     

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    $    9

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    $  60

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    $ 400

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    $    7

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    Rules of Dental SUDOKU: 

    • Format is a 9x9 Grid.  9 3x3 Grids are within.  Format of a Dental Insurance Claim is broken down into Grids.
    • Dollar Numbers are the only valid Dental Sudoku entries.  Dental Claim Forms are processed using Numbers for Procedure Codes, Group#, Phone#, Address. 
    • Dollars Numbers represent Dental Fees for Professional Services Rendered in Claim Forms, and Estimates for Preauthorizations / Predeterminations.
    • Lower Dental Fees  are for Exams, X-Rays, Cleanings, White Porcelain Fillings, & Simpler Dental Procedures.
    • Higher Dental Fees are for Crowns, Bridges, Root Canals, & Specialty Dental Treatments.
    • Dental Implants are Not usually Paid by Dental Insurers, so they are Omitted from most Dental Sudoku Puzzles.
    • Dollars are rarely paid out, unless Insurance Claim is Resubmitted 2 or 3 times, & up to 9 times.
    • All Sudoku Rows & Columns use numbers 1 thru 9 + 0. 
    • All Dental Claim Forms use numbers 1 thru 9 + 0.
    • Each Number can appear Only Once in each Row, Column & Box.  Dental Claim Forms pay Only Once for each Procedure on each Tooth within a 2-5 year period (Frequency Limitation).
    • Dollar Signs ($) are only allowed on Dental Claim Forms in the Fees Column.
    • Totals of all Rows & Columns are the sum of 1 thru 9 =  45.  Total Payments preferred by the Insurers are $0.00.
    • Solve the Dental Sudoku Puzzle, & your Dentist will reward you when they finally Get Paid from the Insurer & you.

     

     

    Scoring of Dental SUDOKU: 

    • Rows represent the Dentist's Request for Payment from the Dental Insurance Company.
    • Columns represent the Dental Insurance Company's Adjustments, Discounts, Alternative Benefit Clauses, & Errors, in Adjudicating your Claim.
    • The Larger   Total Dollar Amount Number should be the Patient's Insurance Benefit Payment to the Dentist.
    • The Smaller Total Dollar Amount Number should be the Patient's Copayment due the Dentist.

     

     

    Continuing Education Units (CEU) for Dental SUDOKU: 

    • {1}  What Dental Procedure could possibly be only $7?
    • {2}  If the Dental Insurance Company Pays on the Columns, did the Patient go over their Yearly Maximum?
    • {3}  What would be the Patient's Copayment due to the Dentist?
    • {4}  Is the $9 Payment a Correct Amount; or did the Insurer Underpay, & you need to Resubmit?
    • {5}  Was that $900 for the Root Canal, or for the Porcelain Crown?  And, does the Patient pay the Basic 20% Copay, or the Major 50% Copay?
    • {6}  Is Sudoku Dental Insurance:  (A). Educational.     (B). Easier than Japanese Sudoku.     (C). More Interesting than Sudoku.     (D). More Frustrating than Sudoku.     (E). An Expensive Game to Play without the Expert Help I get from my Humor Dentist?

     

     

    • Any questions you have, & suggestions for Faster Insurance Claim Payments, can be e-Mailed to your Humor Dentist - Dr. LAUREN FRIEDMAN DDS at n6lrn@yahoo.com,
    • or call 1-800-801-8730