Dental billing goes far beyond filing insurance claims — it requires deep understanding of CDT codes, dual insurance coordination, procedure narratives, and medical-dental cross-coding. With increasing payer scrutiny and complex patient plans, running a profitable dental practice depends heavily on an efficient billing system.

At Progressive RCM, we offer specialized dental billing services tailored to general dentists, orthodontists, oral surgeons, and specialty dental practices. Our goal is to reduce your billing workload, increase your insurance collections, and improve overall practice revenue.

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What Makes Dental Billing So Complicated?

Unlike general medical billing, dental billing requires a unique process with several layers of complexity:

1. Unique Code Set (CDT Codes)

Dental procedures are billed using CDT (Current Dental Terminology) codes issued by the ADA, not the CPT codes used in medical billing.

2. Frequent Need for Narratives & Attachments

Procedures like crowns, implants, and periodontal surgery require clinical notes, x-rays, perio charts, and detailed narratives for insurance approval.

3. Coordination of Benefits (COB)

Patients often have primary and secondary insurance (e.g., employer plan and spouse’s plan). Coordinating benefits and following COB rules is critical to avoid payment delays.

4. Annual Maximums, Deductibles & Frequency Limits

Many dental plans have yearly limits, procedure frequencies (e.g., 2 cleanings/year), and waiting periods. Billing must align with plan terms to avoid denials.

5. Medical-Dental Cross Coding

Some procedures (like sleep apnea appliances, jaw surgery, or trauma care) may be billable to medical insurance with proper CPT/ICD-10 conversion.

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Progressive RCM’s Dental Billing Services

We offer end-to-end dental revenue cycle management (RCM) — from insurance verification to claims submission, appeals, and patient billing.

✅ Accurate Coding Using CDT Codes

We assign proper CDT codes based on treatment plans and chart notes. Our coders handle:

• D0120 – Periodic oral exam

• D1110 – Adult prophylaxis

• D2740 – Crown, porcelain/ceramic

• D7210 – Surgical tooth extraction

• D4341/D4342 – Scaling and root planing

• D6010 – Implant placement

• D1999 – Unspecified preventive procedure

• D9946 – Sleep apnea appliance

• D9110 – Palliative treatment

We also guide practices in converting dental services to medical billing when applicable, using appropriate ICD-10 codes.

✅ Insurance Verification & Benefits Breakdown

Before treatment, we verify:

• Eligibility and active coverage

• Coverage percentages by procedure type

• Annual maximums and deductibles

• Frequency limitations and age restrictions

• Waiting periods

• Pre-authorization requirements

This helps prevent surprises for both the patient and the provider.

✅ Claim Submission with Attachments

We submit claims electronically (or by paper where needed), attaching:

• X-rays

• Intraoral images

• Periodontal charts

• Treatment notes

• Clinical narratives

Our billing software integrates with systems like Dentrix, Eaglesoft, Open Dental, Curve, and Carestream.

✅ Denial Management & Appeals

We monitor rejected or denied claims, determine the cause, and resubmit with corrected documentation. Common denial reasons include:

• Missing attachments

• Exceeded frequency limits

• Incorrect COB

• Insufficient documentation

• Coverage exclusions

We manage all appeals and follow-up with insurance companies to ensure you receive every dollar earned.

✅ Payment Posting & Reconciliation

All insurance and patient payments are posted daily. We reconcile them against EOBs and fee schedules to catch underpayments and adjustments.

✅ Patient Billing & Collections

We generate clear, professional statements and provide online payment portals. We also support payment plans, credit card processing, and soft collections.

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Specialties We Serve

Our dental billing services are designed for:

• General Dentists

• Pediatric Dentists

• Oral Surgeons

• Orthodontists

• Periodontists

• Prosthodontists

• Endodontists

• Sleep Dentistry Practices

• Implant Centers

Each specialty has unique billing codes and documentation needs — our team is trained to handle them all.

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Our Dental Billing Workflow

1. Insurance Verification
   Verify dental and medical insurance, including COB and frequency limits.

2. Treatment Plan Review & Coding
   Assign CDT codes and prepare for cross-coding if billing medical.

3. Claim Submission
   Submit claims electronically with attachments and narratives.

4. Payment Posting
   Post all payments (EFT, paper check, patient) and reconcile.

5. Denial Management & Appeals
   Analyze denials, reprocess claims, and send appeals when necessary.

6. Patient Billing & Follow-Up
   Send statements and follow up with patient billing inquiries and collections.

7. Monthly Reporting
   Deliver detailed reports on insurance aging, collection rates, adjustments, and rejected claims.

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Why Choose Progressive RCM for Dental Billing?

✅ Experienced Dental Coders
Our team is trained in CDT coding, narrative creation, and medical-dental cross-billing.

✅ Faster Reimbursements
We submit clean claims quickly and minimize rejections through pre-submission scrubbing.

✅ Full COB Handling
We coordinate with primary and secondary insurance to ensure full benefit utilization.

✅ Appeals Expertise
Our denial management team has a high success rate in reversing unjust denials with proper documentation.

✅ EHR & PMS Integration
We work with Dentrix, Open Dental, Carestream, SoftDent, Eaglesoft, and other leading platforms.

✅ Transparent Reporting
You receive detailed dashboards and monthly reports with performance metrics and financial summaries.

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Key Performance Indicators (KPIs) We Track

• First-pass claim acceptance rate

• Claim rejection/denial rate

• Average insurance collection time

• Claims pending due to COB or attachments

• Percentage of underpaid claims

• Days in A/R (Accounts Receivable)

• Outstanding patient balances

Tracking these metrics ensures financial health and billing efficiency.

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SEO Keywords Used:

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Final Thoughts

Dental billing is no longer just a back-office task — it’s a key driver of profitability and practice growth. With complex coding, insurance rules, and detailed documentation requirements, your billing must be handled with precision and speed.

Progressive RCM provides expert dental billing solutions that improve cash flow, reduce administrative burden, and ensure your practice runs smoothly — so you can focus on delivering outstanding patient care.