Our Dental Billing Process involves a very detailed steps that consist of all the below
• Collect patient details (name, DOB, insurance ID, group number).
• Verify insurance eligibility (active coverage, benefits, waiting periods, annual maximums).
• Confirm if the plan covers the planned procedure (e.g., preventive vs. major restorative).
•Dental Procedures (CDT Codes) – Use current Current Dental Terminology (CDT) codes (e.g., D0120 for periodic exam, D1110 for prophylaxis).
• Diagnosis Codes (ICD-10) – Some insurers require ICD-10 codes (e.g., K02.9 for dental caries).
• Clinical Notes – Document treatment necessity (e.g., X-rays, perio charts for scaling).
•Paper Claims – Submit via ADA Dental Claim Form (2019 version).
• Electronic Claims (EDI) – Faster processing via dental billing software (e.g., Dentrix, Eaglesoft, Open Dental).
• Attachments – Include X-rays, narratives, or perio charts if required.
Our Dental Billing Process involves a very detailed steps that consist of all the below
• Insurance Review – Payer checks for errors, coverage, and medical necessity.
• Explanation of Benefits (EOB) – Details approved amounts, adjustments, and patient responsibility.
• Payment Posting – Record payments and write-offs in the practice management system.
• Bill the patient for uncovered amounts (deductibles, copays, non-covered services).
• Set up payment plans if needed.
• Denial Management – Appeal denied claims with additional documentation.
• Denials – Incorrect CDT codes, missing tooth numbers, or lack of pre-authorization.
• Timely Filing Limits – Most insurers require claims within 90–180 days.
• Coordination of Benefits (COB) – Handling primary vs. secondary insurance.
• Eligibility Issue which needs Insurance Verificaton prior to service to avoid surprises.
