Apex Reimbursement Specialists

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Apex Reimbursement Specialists

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Apex Reimbursement Specialists is a PPO Portfolio Management firm handling negotiation, credentialing, UCR Fee Analysis, and Coding services to dental groups and practices.

10/16/2026

Which of your codes would surprise you if you saw the gap?

Your fee schedule and what each payer pays are two different numbers. Compare contracted rates to UCR on your top 10 codes and the difference shows up code by code.

Same procedure. Same chair time. Same materials. A different price depending on who is paying.

Which code would surprise you most?

10/16/2026

From Denise Quintero Ellis, DMD Fridays:

It's today! At noon, we turn the mirror onto your schedule.

Here's what you'll leave with:
1. How to build a day on purpose, with no gaps and the right procedure mix.
2. How to turn your budget into a daily goal, and see if your schedule hits it.
3. How to run a weekly schedule audit, so nothing slips through.

DMD Fridays, Episode Two: The Schedule.
Today, 12 PM ET. Free.

Join here:
https://us06web.zoom.us/meeting/register/q91dDYGYSgu6x3q_1j82VA

See you there!

10/16/2026

Do you know what your top ten codes pay compared to what you charge?

Most owners can name their fees and not their contracted rates. Pull each payer's allowed amount and your UCR for your ten most-billed codes, then put them side by side. The gap on a single high-volume code often explains more than the whole fee schedule.

It takes about three minutes with your practice management report.

Which of your top ten codes have you never compared?

10/15/2026

Is your hygienist wage problem actually a PPO problem?

DrBicuspid has reported on practices at risk of losing hygienists. The usual fix is a raise. A raise has to be paid from somewhere, and if your reimbursement rates were signed years ago, the revenue line hasn't moved while the payroll line has.

Apex averages a 7 to 10 percent reimbursement increase across about 5,000 practices, and for many owners that increase is what pays for the raise.

When did your fee schedule last keep up with your payroll?

Get our free 7 tips guide to negotiating with insurance companies:
https://apexreimbursement.com/7-tips/

10/15/2026

If an auditor opened ten of your charts today, what would they find?

Federal healthcare fraud enforcement is stepping up and dental offices are on the radar, per DrBicuspid and Group Dentistry Now coverage. The five red flags are upcoding, downcoding patterns, unbundling, missing documentation, and waived copays.

Same team. Same patients. Same procedures. A different answer when someone checks the paperwork.

What would they find in yours?

10/15/2026

From Denise Quintero Ellis, DMD Fridays:

Tomorrow at noon! This one is for the whole team.

Front desk, you build the schedule.
Office managers, you review it every week.
Doctors, it's your business, so you should always know what's on the books.

My favorite habit for any practice: every Friday, the office manager and the doctor sit down and look at next week's schedule against the budget. Light days, heavy days, and every open spot you can still fill.

Episode Two: The Schedule. Is it running you, or are you running it?
Friday, October 16, 12 PM ET. Free.

Save your seat here:
https://us06web.zoom.us/meeting/register/q91dDYGYSgu6x3q_1j82VA

Tag your office manager below so they don't miss it.

10/15/2026

Would your charts hold up if an auditor opened them tomorrow?

Federal scrutiny of healthcare fraud is stepping up, and dental offices are now part of it, per recent DrBicuspid and Group Dentistry Now coverage. Five patterns draw attention: upcoding, downcoding patterns, unbundling, missing documentation, and waived copays.

Most practices find these during an audit instead of before one.

Which of these would an audit find in your charts?

10/14/2026

Do you have your own reimbursement data, or only the payer's?

A proposed antitrust class action has been filed against Delta Dental of Washington, per Becker's, and the complaint makes allegations about how reimbursements are set. Nothing has been decided, and Delta Dental may dispute the claims.

Whatever the courts conclude, the lesson for a practice is the same. A payer's fee schedule is a position, and your own records are the evidence you bring to answer it.

Do you have your own reimbursement data on file?

Get our free 7 tips guide to negotiating with insurance companies:
https://apexreimbursement.com/7-tips/

10/14/2026

From Denise Quintero Ellis, DMD Fridays:

Your schedule shows up in your Google reviews. Here's how.

Fillings all day. The instruments run out. Sterilization gets backed up. Patients sit in the waiting room. And patients who wait are not happy patients.

Fix the mix, and you fix the flow.

This Friday on DMD Fridays:
Episode Two: The Schedule. Is it running you, or are you running it?
Friday, October 16, 12 PM ET. Free.

Save your seat here:
https://us06web.zoom.us/meeting/register/q91dDYGYSgu6x3q_1j82VA

What backs up first in your office, the instruments or the patients? Tell me below.

10/14/2026

What gives a single practice leverage over a payer?

Heartland Dental added Foundation Dental Partners' 33 practices, per Becker's. For a payer, a group that size is 33 locations of claims and patients in one conversation. For an independent practice, the leverage has to come from somewhere else.

Same payer. Same fee schedule. Different weight behind the ask.

What gives your practice leverage?

Address

2835 Smith Avenue, Ste 201
Baltimore, MD
21209

Telephone

(410) 710-6005

Website

http://www.apexreimbursement.com/

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