Apex Reimbursement Specialists

What Apex Reimbursement Specialists does

Apex Reimbursement Specialists is a dental-focused revenue cycle management and practice management consulting firm founded in 2012 and headquartered in Baltimore, Maryland. The company serves U.S. dental practices ranging from solo practitioners to large Dental Support Organizations (DSOs), offering services centered on PPO fee negotiation with insurance carriers, credentialing and recredentialing, insurance verification and outsourced dental billing, full revenue cycle management, and ancillary services including transition/acquisition/startup support, M&A clinical compliance diligence, web marketing, and practice growth consulting. The firm also jointly operates DC Practice 360°, a service division created with DC Dental that bundles adjacent operational services such as HIPAA/OSHA compliance, bookkeeping, IT, and patient communications.

The firm's core technology is a proprietary database of dental fee schedules and network contract information that it uses to benchmark client schedules, detect market trends, and inform negotiation strategy. Co-founders Joseph Lefkowitz (institutional negotiation background) and Gavi Cohn (MBA) lead a team of approximately 15 employees, supplemented by specialists including Harold Gornbein and Denise Ellis. Apex claims to have worked with nearly 5,000 dental practices cumulatively and currently represents more than 300 group and solo practices across 18-28 states, having negotiated over $1 billion in PPO revenue cumulatively and securing typical reimbursement increases of 7-12%, with individual cases reaching up to 50%.

Apex operates a sales-led, direct-engagement go-to-market, combining website and phone inquiries, field sales to enterprise groups and DSOs, and active participation at dental industry events (Breakaway, AADGP, Scaling Up). Its pricing is quote-based and performance-linked — a "no-risk, all-reward" structure where fees are contingent on successful PPO negotiation outcomes — and is delivered through multi-year consulting engagements rather than self-service or productized software. The firm is privately held with no disclosed external funding and no parent company.

Name

Apex Reimbursement Specialists

Legal name

Apex Reimbursement Specialists, Inc.

Website

https://apexreimbursement.com

Company type

Private

Founded year

2012

Operating status

Operating

Headcount range

11–50 employees

Short description

Apex Reimbursement Specialists is a Baltimore-based dental consulting firm that helps solo and DSO dental practices increase PPO reimbursement rates and streamline credentialing, billing, and revenue cycle management using a proprietary fee-schedule database and performance-based pricing model.

Ownership category

akta.pro rank

Product category

Dental Practice Revenue Cycle Management Consulting

NAICS

Other Scientific and Technical Consulting Services (54169), Offices of Dentists (62121)

SIC

Services-Management Consulting Services (8742)

akta.pro primary industry

Provider Network Administration & Contracting (PPO Network Management) (HLAEALAE)

akta.pro secondary industry

Regional/Multi-Region DSO Platforms (Aggregators) (HLABAKAK)

Keywords

• Dental revenue cycle management
• PPO fee negotiation
• Dental billing services
• Insurance credentialing
• Dental practice consulting

Headquarters

HQ city

Baltimore

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Marketing or Sales, Technology or R&D, Others

Revenue model

1. Revenue Cycle Management Consulting: Professional consulting services for dental practices encompassing fee negotiation, credentialing, insurance verification, dental billing, claims management, and revenue optimization. Services are delivered through multi-step analysis and ongoing client partnerships.
2. Performance-Based Fee Structure: Apex operates on a 'no-risk, all-reward' model where the company is only paid for successes. This performance-based approach aligns company incentives with client outcomes in PPO fee negotiations and credentialing services.

Pricing tiers

Go-to-market motion3 records

Distribution channels3 records

Marketing channels8 records

Core offering

Apex Reimbursement Specialists is a dental practice revenue cycle and practice management consulting firm serving solo practices through large Dental Support Organizations (DSOs). Its core offering centers on PPO portfolio management, including fee negotiation with insurance carriers, UCR fee schedule structuring, billing codes analysis, credentialing, and insurance verification/dental billing, delivered through a multi-step analysis methodology backed by a proprietary database of fee schedules and network information.

Product overview

Apex Reimbursement Specialists is a dental practice revenue cycle and practice management consulting firm offering a suite of integrated services for dental practices ranging from solo practices to large DSOs. The core offering centers on PPO Portfolio Management encompassing Revenue Optimization (fee negotiation, carrier analysis, UCR fee review, and coding analysis), Credentialing (provider enrollment and recredentialing), and Insurance Verification/Dental Billing. Additional services include Transition/Acquisition/Startup support, M&A Clinical Compliance advisory, Web Marketing, Merchant Services (via ERJ Solutions partnership), and Innovative Solutions for Accelerated Growth consulting. The company also operates DC Practice 360° as a joint venture with DC Dental offering expanded operational support services. Apex uses a proprietary fee schedule database and multi-step analysis methodology to help dental practices increase revenue through negotiated reimbursement rates, optimized network participation, and improved billing processes.

Differentiator

Problem solved

Functional benefit

Brands

• DC Practice 360°: A joint service division with DC Dental offering business services for dental practices including medical waste service, HIPAA/OSHA compliance, patient communication software, bookkeeping, virtual office assistance, direct mail marketing and IT support.

Products and services

• Revenue Optimization A multi-step analysis program that includes fee negotiation with insurance carriers, analyzing and optimizing carrier selection, reviewing and structuring internal office fee schedules (UCR), and conducting billing codes analysis to maximize financial and clinical benefits for dental practices.
• Credentialing Provider enrollment and recredentialing services with insurance networks, handling all paperwork and follow-up with individual carriers to ensure smooth in-network status for dental practices.
• Transition/Acquisition/Startup Services supporting dental practice purchases, sales, and new practice launches including PPO contract review, renegotiation opportunities, and operational transition planning.
• Insurance Verification/Dental Billing Outsourced dental billing and insurance verification services to reduce claim errors, improve collections, and minimize time spent by office staff on insurance-related tasks.
• Insurance RCM Process Revenue cycle management process services for dental practices to optimize the entire billing workflow from patient registration through claim submission and payment collection.
• M&A Clinical Compliance Data analysis and patient record review services to assess clinical performance during dental practice acquisitions, including policy and procedure development and implementation.
• Innovative Solutions for Accelerated Growth Personalized dental practice growth consulting including in-depth business analysis, process optimization, and financial management strategies.
• Web Marketing Digital marketing services for dental practices including website and online presence optimization.
• Merchant Services Credit card processing services for dental practices with PCI-certified point-to-point encryption and patented tokenization, offering an average 27% savings on processing fees, delivered via partnership with ERJ Solutions.
• DC Practice 360° A service division created in partnership with DC Dental offering medical waste service, HIPAA/OSHA compliance, patient communication software, bookkeeping, virtual office assistance, direct mail marketing, and IT support for dental practices.

Quantifiable outcome

• 7-12% average reimbursement rate increase across negotiated fee schedules
• +5 more outcomes

Named customers10 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Four partnerships are on record, tiered minor and core.

• Connection Dental / CignaminorOthers · 1 May 2017Connection Dental umbrella arrangement with Cigna ended effective May 1, 2017. Providers could no longer access Cigna patients through Connection Dental and needed to contract directly as Cigna Advantage providers to maintain in-network status with all Cigna patients.
• Principal Life Insurance CompanyminorOthers · 1 November 2016Principal Life Insurance Company leased UCCI's (United Concordia) network to fill areas with significant patient populations but difficult provider recruitment. This network leasing arrangement affects how dental practices are reimbursed when not directly contracted with Principal.
• United Concordia (UCCI)minorOthers · 1 November 2016United Concordia network leased by Principal Life Insurance Company. UCCI fee schedules are non-negotiable while Principal generally negotiates. Practices direct with UCCI and Principal may see different reimbursement outcomes.
• DC DentalcoreStrategic or Co-development Partner · 2 August 2016Apex partnered with DC Dental to form DC Practice 360°, a new service division managing dental practice business needs. The partnership expanded market presence and combined Apex's PPO negotiation, credentialing, and UCR fee analysis services with DC Dental's supplies and equipment offerings. Each month new services were folded in including medical waste, HIPAA/OSHA compliance, patient communication software, bookkeeping, virtual office assistance, direct mail marketing, and IT support.

Scale indicators10 records

Recent moves7 records

Expansion highlights5 records

Others

• Rectangle Health: Rectangle Health is a healthcare payments and practice management technology company serving dental and medical practices. They are adjacent to Apex through merchant services and front-office software, often partnering with or competing for the same practice relationships.

Emerging players

• Productive Dentist Academy: Productive Dentist Academy is a dental practice coaching and consulting firm focused on production, case acceptance, and growth. They target the same dental practice audience as Apex but compete on business coaching rather than PPO fee negotiation.
• MGE Management Experts: MGE Management Experts provides dental practice management consulting, coaching, and training focused on productivity and growth. They overlap with Apex on serving solo and group practices but emphasize practice operations rather than insurance negotiation.
• McGill & Hill Advisory: McGill & Hill Advisory provides consulting services for dental practice transitions, including operations and financial due diligence. They overlap with Apex on transition/acquisition advisory and serve similar DSO and group practice clients.

Broad incumbents

• Cain Watters & Associates: Cain Watters is an established dental practice management and financial consulting firm serving DSOs and group practices. They overlap with Apex on consulting to dental groups but offer a broader financial advisory portfolio rather than specializing in PPO negotiation.
• Henry Schein One: Henry Schein One is the technology and services arm of Henry Schein providing dental practice management software, patient engagement, and back-office solutions. As a broad incumbent, they compete for the same dental practice wallet with scalable technology rather than specialized consulting.
• Patterson Companies: Patterson Companies is a large dental and animal health distributor offering practice management software, equipment, and services. They overlap with Apex on serving dental practices through a much broader product portfolio including supplies, technology, and consulting.
• Bentson Clark & Copple: Bentson Clark & Copple is a long-standing dental practice consulting and brokerage firm specializing in practice transitions and valuation. They serve overlapping DSO and group practice clients with adjacent services like M&A advisory and operational consulting.

Direct peers

• DDS Negotiations: DDS Negotiations is a direct competitor providing dental insurance PPO fee negotiation and credentialing services. Their narrowly focused offering closely mirrors Apex's revenue optimization program for individual practices and DSOs.
• Unitas Dental: Unitas Dental is a direct competitor offering PPO negotiation, network analysis, and credentialing services to dental practices. Their acquisition of Makan Associates further consolidates the dental PPO negotiation space, directly competing with Apex's flagship service.

Market position

Strengths1 record

Weaknesses1 record

Competitive moat3 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/apexreimburse
• YouTubeyoutube.com/channel/UCX9L-qW1DFeZriMXvnOIhuA
• Facebookfacebook.com/apexreimbursement
• LinkedInlinkedin.com/company/apex-reimbursement-specialists

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Apex Reimbursement Specialists