Medical Billing

What Exactly is Dental Billing? Knowing How Dental Billing Works

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“Decode the Challenging Process of Dental Billing to Maintain a Seamless Financial Flow with the Meticulous Assistance of Dental Billing Services”

It is common to think that medical billing is different from dental billing. Where the crux of the dental branch is distinct from other branches of medicine, its billing is not. The fundamental concept of dental and medical billing is the same.

In the case of dental billing, there is a need to perform coding procedures with precision. This way receiving payments by the medium of claims becomes easy. However, even if the process is straightforward, understanding it thoroughly is vital for its successful accomplishment.

As a Dentist, hoping for your practice to be successful in terms of finances is justifiable. And billing systems are made to achieve the same. But there is a catch to it. That is to concentrate on the process to prevent errors and attain a high level of accuracy. Another way is to partner with a dental billing company to improve and uplift your financial health.

Dental billing services understand the needs of the clients so that collections elevate, and the future becomes sound.

In no way should a dentist encounter revenue leakages and loss. For this, there are certain things to keep in mind for a significant improvement in dental billing. Once you acknowledge the basic requirements of dental billing, administrative activities get effortless.

This blog is a roadmap of dental billing. It will take you through all the vital actions that lead to the maximization of reimbursement. By the end of this blog, you will get some major answers to questions like what dental billing is and how it works.

Let's begin with:

Describing Dental Billing

Dental billing is a process of generating revenue by converting data to billing claims and submitting the same. It is carried out with the aim of receiving adequate collections for rendered services. The process of dental billing is extensive and involves several steps. Every step serves the purpose of enhancing the bottom line of the practice.

The Dental Billing Process

The process of dental billing initiates with the arrival of a patient in the dental facility and ends with reimbursement. The steps are focused on revenue generation which is possible only by maintaining consistency and precision.

The steps in the medical billing process:

Collection of Patient Information

The collection of information happens prior to a patient’s visit to the healthcare facility. At the time of scheduling the initial appointment, the patient shares certain information about himself for the purpose of recording.

Usually, this conversation happens over a phone call where various information is exchanged. The data that is collected includes name, phone number, address, email address, contact preferences, date of birth, name of the subscriber’s employer or insurance plan, insurance carrier, carrier’s provider phone number, and insurance ID number.

Verification of Insurance Coverage

After the collection of information, the next step is verification. This step involves verification and cross-checking of the collected information with the insurance company. The purpose of this step is to get all the relevant details regarding the patient’s insurance benefits and coverage. The billers log into the insurance portal to attain all the valuable data and move further in the process.

Data Recording of Dental Treatment

During the treatment process, all the information related to it must be recorded. Keeping account of all the necessary details is essential to associate codes with them. This documentation of clinical notes of the treatment is for the purpose of claim filing.

Additionally, this information is subject to review before converting it into electronic data. The best course of action is to verify what's being recorded every day at the end of the day to prevent inaccuracy of information.

Submission of Claims and Tracking

Once all the information is collected, it's time to submit the insurance claims. First and foremost is attributing the codes to the type of treatment. This is vital for claim filing and its accuracy is important for avoiding denials.

The claims include all the codes for rendered procedures in the case of dental billing. It also includes other information such as insurance information, patient information, and clinical attachments (x-rays, periodontal charts, narratives, primary EOBs, intraoral photos, etc.).

Reconciliation of Claims

In case of claim denials, or it has been 30 days and still you have not received your revenue, then this step comes into action. In this step, you collect all the data regarding pending dues and outstanding claims. After that, you contact the insurance company to identify the areas of errors to carry on with the appeal procedure. The appeal procedure involves rectification of mistakes and then resubmission of claims to recover the outstanding amount. This step is also referred to as denial management and follow-up. This step is mandatory to increase the rate of collections and decrease the rate of overheads.

Collection of Revenue

In dental billing, there are two ways of collection. The first way is the collection of the entire amount from the insurance company. The second way is the collection of charges from the insurance company only up to the insurance benefits. The rest of the charges are paid by the patient.

If you choose the latter, it enables collection even before the patient leaves the dental office. You can also make a request for your revenue via email. In a different situation, you can get reimbursed according to the insurance completely. Either way collection of revenue is crucial to maintain the financial health of the practice.

Payment Posting

This step is useful after you have already received your payment and it has been deposited in your bank account. Payment posting is the process of updating your practice management software. This is for proper documentation and recording of all the activities in the process. With this step, you have come to the end of the process. This is essential to keep track of the cash flow and maintain accuracy.

Account Aging and Collections Report

When you reach this step, the process of dental billing is already complete. However, this step helps in overlooking the entire process and finding the drawbacks to correct them in the future. This way you will have a complete view of the entire process. You have a dual view of the net production and net collection along with outstanding account and insurance aging reports.

Now you know all about the dental billing process from start to end. Knowing all the steps will upgrade your process as it eliminates confusion and enhances understanding.

You can get a more streamlined method of flowing through the steps with the help of a medical billing company.

From here we will move toward the specifics of the coding.

The Concept of Dental Billing Coding

Obtaining the accuracy of dental codes is essential to reach a successful financial posture. For this, there is a need for expertise in two things: CDT and ICD-10-CM procedure codes. A failure to maintain the accuracy of these codes can lead to significant revenue loss.

CDT and ICD are the most commonly used codes in dental billing.

CDT: Current Dental Terminology

These codes are for the documentation of dental treatment to the patients. Specific CDT codes are attributed to different procedures. These codes serve as references in the claims to attain revenue from the insurance company.

CDT codes start with the letter “D” and are followed by 4 numbers.

These codes change on a regular basis. Every year there is an update in CDT that stresses the need to stay current and not miss any details. It is essential for compliance as well as for ensuring timely reimbursement.

According to HIPAA, these codes must be used in all situations whether you are an in-network or out-of-network dental care provider. Usually, these codes are a part of the dental practice software, however, there is a need to allocate them accurately.

ICD-10-CM: Internal Classification of Diseases, Tenth Revision, Clinical Modification

ICD-10-CM codes are similar to CDT but have slight differences. These codes are also for recording and documenting dental procedures. ICD codes fall under the category of CMS (Centers for Medicare and Medicaid Services). It is CMS that updates these codes annually.

Even though these codes are updated annually the date of their implementation is different. CDT codes are updated with effect from January 1st and ICD-10-CM codes are updated with effect from October 1st each year.

Medical Billing for Dental Treatment

As we discussed earlier in this blog, medical billing for dental treatment is different from medical billing for other branches of medicine. The main reason behind this is the coding for dental procedures.

The dental services that fall under the category of insurance claim filing are:

  • Oral surgery
  • Trauma (broken tooth, broken teeth, broken jaw)
  • Pathology (when the dentist performs biopsies needed to check for diseases inside of teeth, gums, and around the mouth)
  • Obstructive Sleep Apnea

Dental billing services are well-versed with the codes for these procedures. Their expertise drives profit-making results by preventing errors and optimizing the process.

Overcome Dental Billing with these Tips

The process of dental billing can be overwhelming. Not only this, but administrative burdens can also lead to stress and anxiety. With a few tips, you can overcome the challenges of Dental Billing and make your practice more profitable. The tips are:

Focus on Efficiency

Efficiency is the answer to most of the errors in dental billing. Appropriate and accurate execution in a timely manner can boost the bottom line of the practice. A systematic approach to every step of dental billing is good for the financial health of your practice. Therefore, it is essential to focus on efficiency.

Keep a Check on Cost

Claim processing can be expensive and can raise operational costs. The central principle of improving billing could be distorted if the cost incurred in the process is more than expected. There are some uncontrollable factors such as changing policies and regulations but other than that you can keep a check on the costs.

By streamlining the process, you can achieve the target of minimal operational costs with improved performance.

Stay Current

The landscape of medicine is ever-evolving, not staying current with changes now and then can lead to revenue loss. Specifics such as dental policies, regulations, and coding guidelines are crucial for the practice. As a result, updating is like preparing for success in every situation of medical billing.

Outsource Dental Billing Services

The best option of all the tips is partnering up with a dental billing company. You can also opt for a medical billing company that offers services for dental practice as well. Professional partners have substantial experience in dealing with the administrative process. They offer an array of solutions along with custom services for individual clients. Hence, it is reasonable to outsource dental billing services.


Unify Healthcare Services is the best medical billing company in USA. With a medical billing specialist team with expertise in the dental field. Our dental billing services are designed to tackle every issue with precision. Apart from that, our billers and coders are equipped with CDT and ICD-10 codes.

Unify Healthcare is a reliable medical billing company that offers a wide range of dental billing services as well.

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