Claims Review

"Claims Review"

Michael Fiorenza, DDS; Michael Weisenfeld, DDS; Marie Schweinebraten, DDS            Robert Rosenthal, DDS - Moderator

CE Credit hours: 2

Panelists will review claims for the very first time in various disciplines and discuss adjudication policies and other pertinent information.  The audience will be invited to participate in discussion of these claims with regard to CDT coding, comparison of treatment submitted to clinical standards of care, quality of diagnostics and share their opinions on proper claim handling.

Upon completion, attendees will be able to:

  • Understand the review process for dental claims
  • Understand CDT coding of dental claims
  • Learn proper clinical criteria for proper dental claim adjudication
MICHAEL FIORENZA, DDS received a BS degree in Biology from Fordham University in New York and  graduated from the Georgetown University School of Dentistry. He then completed a general practice residency at Flushing Hospital in Queens, New York before moving on to private practice. He is the current Dental Director of P&R Dental Strategies, LLC and is responsible for the clinical oversight of all P&R products and services including the day to day management of over sixty Dental Consultants across the country. With over 25 years of experience as a private practicing dentist and as the P&R Dental Director since 2002, he brings a unique experience and perspective when dealing with the various stakeholders in the dental industry.

MICHAEL WEISENFELD, DDS is a Past President of the AADC who spent 24 years in private practice in Michigan. In 1986 he joined the faculty at the University of Detroit Mercy School of Dentistry, and was appointed as Assistant Professor (Adjunct). In 1989 Dr. Weisenfeld became a consultant for a major insurance company for dental indemnity claims. In 1997, bringing his experience as a practitioner, Dr. Weisenfeld served as a Senior Claim Examiner and Expert Consultant for dental malpractice for an insurance company. There, he worked with company attorneys to develop defense strategies and risk management. Currently, he continues to consult with Dental Insurance Companies for claim review. Dr. Weisenfeld is past President and member of the Academy of General Dentistry, as well as member of the American Dental Association, and North Carolina Dental Association. He has received fellowship in the American College of Dentists, the International College of Dentists, Pierre Fouchard Academy as well as the Academy of General Dentistry.

MARIE C. SCHWEINEBRATEN, DMD graduated from the University of Pittsburgh School of Dental Medicine and spent four years in the Army Dental Corps prior to a periodontal residency at Emory University. She has been active in organized dentistry serving on numerous committees at the state and national level including the ADA Council on Dental Benefit Programs and the ADA Board of Trustees. Her present involvement includes serving as the American Academy of Periodontology’s Insurance Consultant, which includes representation on the Code Maintenance Committee, the Dental Quality Alliance, and the Standards Committee for Dental Informatics. She has also served on AAP task forces addressing classification of periodontal disease and comprehensive periodontal therapy. Marie resides in Duluth, Georgia with her husband, Chris McFarland, a prosthodontist, where she has a private practice limited to periodontics.