Dental Revenue Cycle

Dental Billing Services for US Dental Practices

Most dental practices submit claims to dental insurance and stop.

Dental Billing Services for US Dental Practices
92%

First-Pass Dental Claim Rate

45%

Medical Revenue Recovered

$340K

Avg Annual Recovery

18 days

Avg Days in AR

Overview

Why Dental Practices Leave Revenue Uncollected

Most dental practices submit claims to dental insurance and stop. They never touch the medical insurance their patients already carry. Our dental billing services cover both payer systems so you collect every dollar you are owed.
Why Dental Practices Leave Revenue Uncollected
Challenges

Common Dental Billing Challenges We Solve

Dental practices lose revenue in two places: dental claim denials that never get worked, and medical insurance benefits that never get billed.

Dental Denials Sit Unworked

Staff submits claims, receives denials, and moves on. No structured follow-up means payers keep the money.

Medical Benefits Never Billed

Oral surgery, sleep apnea appliances, and trauma care qualify under medical insurance. Most practices never submit.

CDT Code Errors

The ADA updates CDT codes yearly. One outdated or mismatched code triggers automatic denial.

COB and Medicaid Errors

Wrong primary/secondary sequencing and state-specific Medicaid rules create take-backs and delays.

Services

Complete Dental Billing Services

End-to-end revenue cycle management across dental and medical payer systems.

Eligibility verification for dental AND medical benefits pre-visit

CDT and CPT coding review with annual ADA updates

Dental and medical claim submission within 24 hours

Denial management and structured appeals workflow

Predetermination and prior authorization handling

Cross-payer reporting with monthly revenue reviews

Coverage

Serving Dental Practices Nationwide

We support general dentists and specialty practices across all 50 states.

General and family dental practices

Oral and maxillofacial surgery groups

Periodontics, endodontics, and prosthodontics

DSO-backed multi-location dental groups

Guide

The Complete Guide to Dental Billing

Your dental practice bills half of what it earns.

Most dental practices submit claims to dental insurance and stop. They never touch the medical insurance their patients already carry. We fix that. Our dental billing services cover both payer systems so you collect every dollar you are owed.

The billing problems costing your practice money right now

In-house dental billing produces inconsistent results. Staff submit claims, get denials, and move on. No one follows up. No one audits. Revenue ages in your AR and disappears.

The second problem is less visible. Most dental practices never bill medical insurance for procedures that qualify under their patients’ medical benefits. Oral surgery, sleep apnea appliances, periodontal treatment tied to diabetes, trauma cases. These procedures generate medical insurance revenue. Your practice leaves it uncollected every month.

We built our dental billing service to solve both problems. We manage your complete claims workflow across dental and medical payers. We find the revenue your current process misses.

  • High denial rates with no structured follow-up Denials sit unworked. Insurance companies count on your inaction to avoid paying claims.
  • Medical insurance never billed for dental procedures Procedures like oral surgery and sleep apnea appliances qualify under medical benefits. Most practices never submit.
  • Coordination of benefits errors Wrong sequencing of primary and secondary claims produces payment delays and take-backs.
  • CDT codes outdated or incorrect The ADA updates CDT codes every year. One wrong code triggers an automatic denial.
  • Prior auth delays holding treatment Missing documentation on predetermination requests postpones procedures and slows cash flow.
  • Medicaid billing errors by state Medicaid dental rules differ in Texas, California, New York, and Florida. One billing team cannot know all four without specialty training.
  • AR over 90 days growing with no resolution Once a claim passes 90 days without follow-up, collection probability drops sharply.

A complete dental billing service across both payer systems

We manage your full revenue cycle from eligibility verification through payment posting. Our team handles dental insurance and medical insurance billing under one service agreement.

Patient Eligibility Verification

We verify dental and medical insurance benefits before every appointment. Your front desk stops chasing eligibility issues after treatment is complete.

CDT and CPT Coding

Our certified coders apply the correct CDT codes for dental claims and CPT codes when billing medical insurance for eligible procedures. No guesswork. No outdated codes.

Clean Claim Submission

We scrub every claim before it leaves the clearinghouse. We attach required narratives, radiographs, and documentation to prevent first-pass denials.

Dental and Medical Crossover Billing

We identify procedures that qualify under your patients’ medical insurance and submit to both payers correctly. This is the revenue most dental practices never collect.

Denial Management and Appeals

We work every denial with payer-specific appeal strategies. We track denial codes by payer and fix upstream errors that cause repeat rejections.

Prior Authorization

We submit predetermination requests with complete documentation for implants, bone grafts, orthodontics, and oral surgery. We track auth status and alert you before treatment.

Payment Posting and Reconciliation

We post all payments, apply adjustments correctly, and identify underpayments before you write them off. Every ERA and EOB is reconciled against your fee schedule.

Accounts Receivable Follow-Up

We contact payers on every unpaid claim at 30, 60, and 90 days. We escalate when needed. Your AR aging shrinks on a consistent schedule.

Credentialing and Enrollment

We credential your providers with dental PPO networks and medical payers. If you want to bill medical insurance for dental procedures, we get you enrolled first.

Other billing services bill dental insurance. We bill the whole picture.

The standard dental billing service submits your ADA claim form to Delta Dental and MetLife. That is one revenue stream. Your patients also carry medical insurance through Blue Cross, Aetna, UnitedHealthcare, or Cigna. Dozens of dental procedures qualify under those medical plans.

We submit to both payer systems using the correct form, the correct code set, and the correct documentation for each. The ADA dental claim form for dental payers. The CMS-1500 with CPT codes and ICD-10 diagnoses for medical payers. Same procedure. Two legitimate payment sources.

This is not a workaround. This is correct billing. Most dental practices never do it because their billing team only knows one side of the payer system. Ours knows both.

Oral Surgery Case

A patient needs a complicated extraction with documented infection. The dental plan pays as primary. The patient’s Blue Cross medical plan covers a portion as secondary under hospital/surgical benefits. A dental-only billing service submits once. We submit twice and collect from both.

Periodontics and Diabetes

A diabetic patient receives full-mouth periodontal treatment. Clinical documentation supports medical necessity. We code the dental claim with CDT codes and the medical claim with ICD-10 codes for diabetes with oral complications. Both claims pay. The patient’s out-of-pocket is reduced.

Dental Sleep Medicine

A dentist prescribes an oral appliance for sleep apnea. The claim belongs under the patient’s medical plan, not dental. We credential the provider with the relevant medical payers, submit using HCPCS codes, and recover revenue that was previously written off or never submitted.

Dental billing services for every practice type

We serve general dentistry practices, specialty groups, DSOs, and solo providers across all 50 US states.

General Dentistry

PPO billing, patient collections, and full AR management

Oral Surgery

Dental and medical crossover billing for surgical procedures

Periodontics

Systemic disease crossover billing and Medicaid periodontal claims

Dental Sleep Medicine

Medical insurance billing and credentialing for OAT providers

Pediatric Dentistry

Medicaid dental billing and CHIP claims in all participating states

Orthodontics

Predetermination workflows and installment billing management

Implants and Prosthodontics

Prior auth for implants, grafts, and reconstructive procedures

DSOs and Group Practices

Centralized billing for multi-location groups with standardized reporting

From enrollment to collections in five steps

Practice Onboarding

We audit your current billing setup, fee schedules, and AR. We identify gaps before we begin.

Eligibility and Benefits

We verify dental and medical benefits for your scheduled patients. Your team starts the day with clean insurance information.

Coding and Submission

We code charges using current CDT, CPT, and ICD-10 codes. We submit clean claims to all applicable payers.

Follow-Up and Denials

We follow up on all unpaid claims at 30, 60, and 90 days. We appeal denials with supporting documentation.

Reporting and Analysis

You receive weekly and monthly reports on collection rates, denial trends, AR aging, and payer performance.

What your practice looks like after 90 days

Denial Rate Reduction

A 4-provider general dentistry group in Texas reduced their denial rate from 22 percent to 7 percent within 6 months of transferring billing to our team.

Faster Payment

An oral surgery practice in Florida went from 52 days in AR to 31 days within 90 days of onboarding. Cash flow improved without changing payer mix.

Medical Revenue Recovered

A dental sleep medicine practice in Ohio collected over $87,000 in medical insurance revenue in their first year after we enrolled them with medical payers and began billing OAT claims correctly.

We work inside your existing systems

We integrate with every major dental practice management platform. You do not change your software. We work inside it.

What dental practices ask before they start

Find out what your practice is leaving on the table

Request a free billing audit. We review your current denial rate, AR aging, and billing workflow. We identify exactly where revenue is leaking and how to recover it.

Common Questions

Frequently Asked Questions About Dental Billing

What dental practice owners ask most about billing both payer systems.

Can dental practices bill medical insurance?

Yes. Procedures like oral surgery, sleep apnea appliances, TMJ treatment, and trauma care often qualify under a patient medical insurance. Medical benefits apply when there is a medical necessity component and the ICD-10 diagnosis supports the procedure.

What are the most common CDT code denials?

Denials cluster around D4341 (scaling and root planing) without periodontal charting, D2740 (crown) without narrative, D7140 (extraction) without radiographic evidence, and D9222/D9223 (deep sedation) with missing medical necessity documentation.

How does dental billing differ from medical billing?

Dental uses CDT codes (ADA-maintained) instead of CPT. Dental insurance has annual maximums, waiting periods, and frequency limits that medical insurance does not. Coordination of benefits between dental and medical plans follows different rules.

Do you handle Medicaid dental billing?

Yes. Our team bills Medicaid dental programs across all 50 states. Medicaid dental rules differ sharply by state (Texas, California, New York, Florida) and require specialty training on state-specific fee schedules and covered services.

What is a dental predetermination?

A predetermination is a non-binding estimate from the dental payer confirming coverage and estimated payment for a planned procedure. It prevents surprise denials on major procedures like crowns, bridges, implants, and orthodontics.

How quickly can you take over our dental billing?

Most dental practices transition within 3 to 4 weeks. We run parallel submissions in the first cycle, train your front desk on eligibility handoffs, and establish reporting cadence before assuming full workflow ownership.

Comparison

How We Compare on Dental Billing

Most dental billing services touch only dental claims. We bill both sides.

Criteria My Medical Bill Solution Typical Provider
Dental claim submission Within 24 hours of encounter 2 to 5 business days
Medical insurance billing Included for qualifying procedures Not offered
Denial appeal workflow Structured with appeal templates Ad-hoc or not performed
CDT code updates Annual ADA update applied Delayed or manual
State Medicaid expertise All 50 states supported Limited to 1 to 3 states

Ready to Collect What You Are Owed?

Get a free dental billing audit. We will show you where revenue is leaking across dental and medical payers.