Dental billing and revenue cycle, 50-state coverage.

What good dental billing execution looks like.

The operating discipline we install on every dental billing engagement.

1. ADA code (CDT) vs medical code (CPT) crossover billingyour state dental practices billing medical insurance for medically-necessary dental services (TMJ, sleep apnea oral appliance, oral cancer screening) need both CDT and CPT coding depth and crossover claim submission workflow.
2. Pre-treatment estimate workflowMajor dental work (crowns, implants, orthodontia) requires pre-treatment estimate submission and patient cost transparency. your state practices need efficient pre-D estimate cycles.
3. Insurance verification + benefits accumulator trackingDental benefits typically include annual maximum, deductible, frequency limits, waiting periods, and patient share by procedure type. Real-time benefits verification supports treatment planning.
4. In-network vs out-of-network billing strategyyour state dental practices often operate as fee-for-service with insurance assignment. Out-of-network claim filing on behalf of patients requires distinct workflow.
5. Medicaid dental program participationyour state your state Medicaid program dental coverage varies significantly. Pediatric coverage is universal under EPSDT; adult coverage is state-dependent. Eligible your state dental practices need your state Medicaid program workflow.
6. Implant + cosmetic case managementHigh-ticket implant and cosmetic cases require financing coordination, treatment plan acceptance tracking, and clean patient AR management.