Apex Reimbursement Specialists: Helping Dental Collective Members Get Paid What They Deserve

Dental insurance continues to be one of the biggest pressure points for today’s dental practices. Rising overhead, flat reimbursement rates, denied claims, and confusing network structures all eat away at profitability—often without dentists even realizing how much revenue is being left on the table.

That’s exactly why Dental Collective partners with Apex Reimbursement Specialists.

In Episode 4 of the Dental Collective Podcast, we sat down with Harold Gornbein, Co-Founder of Apex Reimbursement Specialists, to talk about how Apex helps dental practices improve insurance reimbursement, optimize network participation, and strengthen their overall revenue cycle.

From “the Insurance Side” to Advocating for Dentists

Apex Reimbursement Specialists was founded in 2012 by industry veterans who saw firsthand how dental insurance works—from the inside.

Harold Gornbein spent more than 25 years working within major dental insurance organizations, including UnitedHealth Group, Ameritas, Pacificare, and United Concordia. That experience gave him a deep understanding of how payer contracts are built, how fee schedules are set, and where negotiation opportunities actually exist.

What started as a simple request from a periodontist frustrated with stagnant fees turned into a nationwide solution.

Today, Apex has worked with 4,500+ dental practices across the country, helping them improve reimbursement through smarter contracting, data-driven negotiations, credentialing support, and revenue cycle management.

What Apex Reimbursement Specialists Does for Dental Practices

Apex focuses on one core mission:
helping dental practices build better, more profitable relationships with insurance companies.

Their services include:

PPO Fee Schedule Negotiation

Most dental practices don’t realize that insurance reimbursement is often negotiable—or that their neighbor down the street may be paid more for the exact same procedure.

Apex negotiates directly with dental insurance carriers to improve reimbursement rates, typically delivering:

• 6–8% increases on direct contracts
  
  
• Double-digit improvements on certain third-party or umbrella networks
  
  

Network & Contract Optimization

Sometimes the biggest opportunity isn’t a rate increase—it’s how a practice is contracted.

Apex analyzes:

• Which networks a practice is actually contracted under
  
  
• Whether better-paying networks are available with minimal patient disruption
  
  
• Opportunities to switch networks for significant reimbursement gains
  
  

In some cases, this approach has resulted in 50–60% increases on specific payer relationships.

Credentialing & Insurance Management

Whether it’s a new associate, startup, acquisition, or expansion, Apex manages the entire credentialing process—ensuring providers are properly enrolled and paid correctly from day one.

Dental Billing & Revenue Cycle Support

Apex also offers dental billing and revenue cycle management services, helping practices reduce denials, improve collections, and streamline insurance workflows.

UCR (Usual, Customary & Reasonable) Fee Analysis

Many practices set their cash fees once and never revisit them.

Apex performs market-based UCR analyses to ensure:

• Fee-for-service patients are charged competitive, market-aligned rates
  
  
• Practices aren’t undercharging for common procedures
  
  
• Insurance negotiations are supported by accurate fee benchmarks
  
  

For many practices, this alone can unlock $20,000+ in additional annual revenue.

Why This Matters for Dental Collective Members

Dental Collective exists to give independent practices collective leverage—and Apex fits perfectly into that mission.

As a Dental Collective partner, Apex provides members with:

• Exclusive discounted pricing (approximately 15% savings compared to standard Apex fees)
  
  
• Predictable, flat-fee pricing for small and mid-sized practices
  
  
• The ability to spread costs over 12 months with no interest
  
  
• Proven ROI—often 5x to 10x return on investment
  
  

Most Dental Collective members begin seeing reimbursement improvements within 3–5 months, with gains compounding year after year.

Why Practices Struggle to Do This on Their Own

While many offices try to negotiate insurance contracts internally, most hit the same roadblocks:

• Not knowing who to negotiate with at the insurance company
  
  
• Lack of market-wide fee data
  
  
• Limited time and competing priorities
  
  
• No leverage or established payer relationships
  
  

Apex brings years of payer relationships, national benchmarking data, and negotiation expertise that individual practices simply don’t have access to on their own.

The Bottom Line

Dental insurance isn’t going away—but poor reimbursement doesn’t have to be the cost of participation.

Through its partnership with Dental Collective, Apex Reimbursement Specialists helps practices:

• Increase insurance reimbursement
  
  
• Optimize payer networks
  
  
• Improve cash flow
  
  
• Reduce administrative headaches
  
  
• Strengthen long-term profitability
  
  

If you’re a Dental Collective member and haven’t reviewed your insurance contracts in the last two years, there’s a strong chance you’re leaving money on the table.

Apex exists to help you get it back.

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