The world of dental billing is ever-evolving and never stagnant. Whether we’re talking about new code sets, insurance requirements, or state limitations on collecting patient balances, these gears are moving parts of your revenue cycle management. Got questions? Great news, we’re here to answer all your burning questions about dental billing, why it’s essential, and how it’s evolving.
Dental revenue cycle management
The dental billing processes are crucial to a healthy dental practice revenue cycle management. The kicker is that they require consistency, from initial insurance verification to eventual dental claim reimbursement to collecting copayments from patients, and everything in between. But did you know that these processes affect more than your dental practice revenue? They can directly affect the level of trust your patients have in your dental practice team.
How healthy is your dental practice revenue cycle? Take our 100% FREE Revenue Health Assessment!
Dental Office Managers
Dental Office Managers are the lifeblood of a dental practice. They keep operations running smoothly, work hard to meet goals, and keep the practice running at full speed. But what happens when all of those plates are nearly impossible to keep spinning? Patients expect a dental practice to take ownership of all of the dental billing processes, so missing anyone can cause distrust and dissatisfaction.
Dental practice owners
As a dental practice owner, you have your eye on the prize: dental practice profitability. But how do you get there? On top of having updated facilities and technology, a good location, and friendly staff, you will find yourself with empty chairs if your dental billing processes aren’t consistent.
Missing any of the important steps causes a ripple effect of chaos:
- Inaccurate treatment plan presentation
- Inaccurate copayments collected at the time of service
- Balances owed after dental claim reimbursement
- Poor social media reviews
- Low word-of-mouth referrals
- Increased no-shows
If your dental practice is struggling with patient retention or acquisition, we recommend that you look at the dental billing processes within your revenue cycle management to see what can be improved. 
Why do you need dental billing expertise on your team? Because dental billing processes are crucial to the health of your dental practice revenue cycle health, whether you participate with dental insurance or not. A healthy dental practice revenue cycle means profitability. So what is dental billing? Click here to read our blog that answers that question. Below you can find more information and answers to frequently asked questions.
Is dental billing hard?
The short answer? Yes. Dental billing and coding is a complicated process that requires experience, along with the right resources for support. Successful dental practices understand that dental billing is a team sport that requires knowledge and attention to detail from every dental practice team member.
Want to increase your dental billing knowledge? CLICK HERE
Why is dental billing important?
Since this is such an integral part of dental practice revenue cycle management, it is vital that a dental billing specialist completely understands the scope and details of the dental billing process. We include more information in our blog: What is dental billing?
What does the dental billing process include?
The dental billing process includes every aspect of sending an accurate dental claim for the completed treatment to an insurance carrier for reimbursement (per the patient’s insurance plan). This starts with attaching the correct CDT codes to the claim that match the services rendered. Before payment is received from the insurance carrier — or patient — there are many more steps that include clinical documentation, potentially appealing the claim, sending it to the patient’s medical first, and more.
What are all the dental billing processes? CLICK HERE to find out.
Perfecting the dental billing process
Looking to perfect your dental billing processes? Have you considered outsourcing your dental billing? eAssist Dental Solutions is the nation’s largest platform for dental billing and patient billing services. Our platform specialists have over 10,000 collective hours of dental insurance experience, so you know that your processes are being streamlined by knowledgeable remote teammates.
Outsourcing your dental billing also takes all of the tedious dental billing processes off of your in-house team, freeing them up to:
- Answer the phone promptly
- Return patient phone calls
- Greet patients properly
- Create memorable patient experiences
- Give thorough treatment plan presentations
- Create relationships with patients that increase loyalty and referrals
What codes are used for dental billing?
The most recent dental claim form is the ADA 2019 claim form, which requires valid CDT (Current Dental Terminology) codes for adjudication.
Is dental billing the same as medical billing?
Dental billing and medical billing have similar processes, but not exact. There are many instances, however, where medical billing knowledge could be extremely useful in the dental billing processes. For example, when a dental claim needs to be sent to the patient’s medical insurance plan per their dental insurance plan requirements.
Here is a list of the standard code sets used by medical and dental insurance plans in the adjudication of claims:
- CDT (Current Dental Terminology) — used to report dental procedures
- CPT® (Current Procedural Terminology) — used to report procedures to medical payors
- HCPCS (Healthcare Common Procedure Coding System) — used to report medical services, equipment, and supplies
- ICD-10-CM (International Classification of Diseases, 10th revision, Clinical Modification) — communicates information about a patient’s condition and the necessity for the procedure reported
- ICD-10-PCS (International Classification of Diseases, 10th revision, Procedure Coding System) — used only by hospitals to report inpatient procedures
- ICD-11-CM (International Classification of Diseases, 11th revision, Clinical Modification) — next version of the ICD physician diagnosis coding system
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Dental medical cross coding
Dentists and their teams are familiar with CDT codes reported to dental insurance plans. These codes communicate the dental procedure performed, but it becomes challenging when dental procedures need to be reported to a medical insurance plan.
The ICD-10-CM code set is currently used to communicate the patient’s condition and medical necessity for the dental procedure reported. All medical plans require at least one diagnosis code on the medical claim form.
Some dental insurance plans are, or will soon be, requiring diagnosis codes on dental claims. Is your dental practice ready?
Why outsource dental billing?
The answer is simple: because you deserve peace of mind. This is eAssist’s core purpose, which is achieved through transparency, accountability, achieving our brand promises, and increasing dental practice revenue.
Is eAssist a scam?
Actually, eAssist Dental Solutions is the nation’s largest and most award-winning platform for dental billing and patient billing services. With a full suite of front desk solutions and a consistent track record of progress, you can finally achieve the peace of mind that comes with a healthy, consistent revenue cycle.
Here’s what you can expect with eAssist’s Dental Billing platform:
- Collect 100% of what’s rightfully owed
- Submit clean claims for payment within 1 business day
- Post all payments to patient ledgers within 1 business day
- Follow up at least every 10 business days on all claims that hit 30+ days in aging
- Our achievable goal is to get your over 90-day insurance aging near ZERO (and keep it there)
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