Dental billing, handled with care
Where dental billing gets difficult
The issues we see most often, and the ones that quietly cost practices the most.
Frequency limits and annual maximums
Dental plans often cap cleanings, X-rays and dollar amounts per year, and patients are not always aware of their remaining benefit.
Missing attachments
Crowns, periodontal treatment and other services commonly need X-rays, charting or narratives before a plan will pay.
Medical plan opportunities
Services such as treatment after trauma or certain oral surgery may be billable to medical insurance, but only with medical coding and documentation.
Coordination between plans
Patients with two dental plans, or with both dental and medical coverage, need careful coordination of benefits.
How we handle them
Detailed benefit breakdowns
We verify frequencies, waiting periods, maximums and history so your team can present accurate treatment estimates.
Complete claims the first time
We attach the images, periodontal charting and narratives each plan expects for the procedures being billed.
Medical cross-coding review
We identify services that may qualify under the medical plan and prepare CPT and ICD-10 coded claims when appropriate.
Follow-up on pending claims
We work outstanding dental claims and pre-determinations regularly so they do not sit unanswered.
Coding notes
General guidance only. Code sets update every year and payer policies vary, so we check current rules on every claim.
- CDT, not CPT
- Dental procedures are reported with CDT codes maintained by the American Dental Association, usually on the ADA dental claim form. CDT is updated every year.
- Medical-dental cross-coding
- Some services, such as care after accidental injury, certain oral surgery, biopsies or oral appliances for sleep apnea, may be billed to medical insurance using CPT, HCPCS and ICD-10 codes on a CMS-1500 form.
- Diagnosis codes on dental claims
- Dental claims now have space for diagnosis codes, and some plans require them. Medical claims always require a supporting ICD-10 diagnosis.
Dental billing questions
Get a free dental revenue audit
Send us a recent aging report and a sample of denials. We’ll show you what we’d fix first.