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The Dental Billing PodcastAuthor: Ericka Aguilar
Dental billing is not data entry. It's the difference between a practice that collects what it earned and one that writes it off and calls it the cost of doing business.The Dental Billing Podcast is hosted by Ericka Aguilar and Jen Lyman, RDH. Ericka has been a dental biller since 1998 and has taught billing in 31 states and Mexico. Jen came out of the operatory and now runs Lyman Revenue Solutions, handling both dental and medical billing. One of us knows exactly what the carrier is going to do with your claim. The other one knows what actually happened in that chair. You get both.Every week we break down denials, appeals, coding, and the carrier behavior nobody warns you about, in plain language, with real sources. We teach the law before the codes, because a code doesn't win an appeal. Knowing what that carrier is legally required to do wins the appeal.If you've ever been told you're "just the biller," this show is for you. Downloads in 114 countries and counting. Bring your coffee and your worst denial. Language: en Genres: Business, Careers, Entrepreneurship Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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When AI Denies Your Claim with Dr. Amberena Fairlee
Tuesday, 15 September, 2026
Most dentists know the insurance system is broken. Far fewer know what it actually takes to change it. Dr. Amberena Fairlee does, because she has been in the room in Salem and in Washington DC doing it.Jen sits down with Dr. Fairlee, a general dentist in Bend, Oregon, owner of Cascadia Family Dental, and the current president of the Oregon Dental Association, for a conversation about advocacy: what organized dentistry can realistically move, what it cannot, and why declining membership makes every one of those fights harder to win.If you have ever wondered whether a day away from the chair is worth it, or what your association is actually doing with your dues, this one answers both.In this episode:Why insurance is a coupon book and not a benefit, and how to explain that to patients without losing themHealthcare requires a diagnosis: the verbiage Dr. Fairlee gives her team when patients push back on exams and x-raysWhy membership is the lever, and why quitting the association because you have not seen change yet makes change less likelyWhat insurance reform legislation actually looks like: small incremental wins and closing loopholes, not raising annual maximums by decreeERISA self funded plans claiming they do not have to follow state insurance regulation, and why that is a focus in DCAI in claim adjudication: requiring disclosure when AI denies a claim, requiring human review without an appeal, and the patient privacy questions nobody has answeredThe one payer behavior she would outlaw tomorrow: diagnostic and preventive care no longer counting against the annual maximumJen's wish list for the ODA agenda: diagnosis codes across the board, and an end to the appeal cycle on unreasonable denialsThe dental assistant and hygiene workforce shortage, and how staffing gaps push private practices toward being boughtWhy she gives up clinical days: advocacy makes her a more compassionate clinicianLeadership without being loud: be at the table, and someone will amplify your voiceAbout our guestDr. Amberena Fairlee is a general dentist in Bend, Oregon and the owner of Cascadia Family Dental. She started in the profession as a dental assistant straight out of high school, earned her Bachelor of Science from Portland State and her dental degree from OHSU in 2017, and still holds an expanded dental assistant certificate from the Oregon Board of Dentistry.She is the current president of the Oregon Dental Association and the association's representative to the Oregon Board of Dentistry, including its Dental Assistant Workforce Shortage Advisory Committee. She also serves with the ADA's workforce ambassador group and an Oregon Health Authority healthcare workforce group.Dentists who want to get involved in Oregon can reach the Oregon Dental Association through its website, or contact executive director Barry Taylor, who can point you to the right place to start.Follow the practice on Instagram: @cascadiafamdentalSend us Fan Mail Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:https://dentiqhub-diagnosis-codes.vercel.app/Get your Dental Billing Toolkit Here:https://www.dentalbillingdoneright.com/the-dental-billing-toolkitDownload "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=headerSchedule a billing chat with Ericka:https://calendly.com/ericka-dentalbillingdoneright/30minEmail Ericka:ericka@dentalbillingdoneright.comEmail Jen:jen@dentalbillingdoneright.com
