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:

• dental billing services

• CDT codes for dental billing

• dental revenue cycle management

• dental insurance verification

• claim submission for dental practices

• dental billing for oral surgery

• dental billing software integration

• patient billing for dentists

• dental coding and claims

• dental billing outsourcing

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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.

Let us handle your billing — so you can keep your patients smiling.

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Would you like the next article on Orthodontics, Sleep Apnea Appliances, Medical-Dental Billing Integration, or another specialty? Just send the topic and keywords!

Here is a 1000-word SEO-optimized article on Dermatology Billing Services for Progressive RCM, including a 1-line meta description.

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Title:
Expert Dermatology Billing Services to Maximize Reimbursements and Reduce Claim Denials

Meta Description (1 Line):
Streamline your dermatology practice with billing services tailored for accurate coding, faster payments, and complete compliance.

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Introduction: Navigating the Complexities of Dermatology Billing

Dermatology is a diverse and rapidly growing specialty covering medical, cosmetic, and surgical procedures. However, the revenue cycle for dermatology is often burdened by complex CPT coding, cosmetic-medical overlaps, modifier usage, and frequent claim rejections. In such an environment, dermatologists need more than a standard billing solution — they need specialized billing expertise.

At Progressive RCM, we offer dermatology-focused billing services that boost your revenue, reduce denials, and ensure full compliance with Medicare and private payer policies.

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Why Dermatology Billing Is Complex

Dermatology billing presents unique challenges that require specialized knowledge:

1. Diverse Procedure Types

Dermatologists perform both medically necessary treatments (e.g., biopsies, excisions, acne therapy) and elective/cosmetic procedures (e.g., Botox, fillers, laser resurfacing). Only the former are typically reimbursable by insurance.

2. Modifier Complexity

Many dermatology procedures require multiple modifiers (e.g., 25, 59, XS, XE, RT, LT) to indicate distinct services, laterality, or multiple body areas. Incorrect use results in denials.

3. Bundling and Global Periods

Some dermatology treatments are bundled or fall under global surgical packages. Billing within the global period requires use of modifier 24 or 79, depending on the scenario.

4. Cosmetic vs. Medical Billing

Documenting medical necessity is essential for insurance to cover services that may appear cosmetic, like removal of skin tags, warts, or benign lesions.

5. In-Office Pathology

Many dermatology offices also perform in-house pathology or use external labs. Properly billing both the technical and professional components is critical.

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Progressive RCM’s Dermatology Billing Services

Our dermatology billing services are customized to meet the clinical and financial demands of dermatology practices — whether you’re solo, part of a group, or hospital-based.

✅ Accurate Dermatology Coding

We specialize in CPT, ICD-10, and HCPCS coding for a wide range of dermatology procedures, including:

• 11102–11107 – Skin biopsy

• 11300–11313 – Shaving of lesions

• 11400–11446 – Excision of benign skin lesions

• 11600–11646 – Excision of malignant skin lesions

• 12001–13160 – Wound repair (simple to complex)

• 17000–17004 – Destruction of premalignant lesions

• 17110–17111 – Destruction of benign lesions

• 96910–96913 – Phototherapy

• 96372 – Therapeutic injections (e.g., Kenalog)

• J3301 – Drug code for triamcinolone

We ensure that codes are linked with appropriate diagnosis codes (ICD-10), indicating medical necessity.

✅ Modifier Accuracy & Compliance

Our coders apply modifiers accurately for:

• 25 – Separate E/M on same day as procedure

• 59/XS/XE – Distinct procedural services

• RT/LT – Right/left side

• 24/79 – For services within the global surgical period

We also ensure compliance with Medicare’s NCCI edits to prevent bundling issues.

✅ Prior Authorization Support

For services such as photodynamic therapy, laser treatments, biologics (like Dupixent), or Mohs surgery, we manage prior authorizations to avoid last-minute denials.

✅ Claim Submission & Reimbursement

We submit claims electronically within 24–48 hours, ensuring clean claims and quick reimbursements. Our systems integrate with EMA (Modernizing Medicine), AdvancedMD, eClinicalWorks, Kareo, and DrChrono.

✅ Denial Management & Appeals

Our dedicated A/R team tracks and resolves claim denials — whether it’s a coding issue, documentation problem, bundling error, or medical necessity denial. We also handle appeals with supporting clinical documentation.

✅ Cosmetic Procedure Management

We clearly separate insurance-covered procedures from cosmetic treatments, ensuring patients are billed correctly for elective services like:

• Botox/fillers

• Laser hair removal

• Chemical peels

• Microdermabrasion

• Cosmetic mole removal

We provide transparent self-pay estimates and manage payment collection upfront.

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Dermatology Specialties We Serve

We support a full range of dermatology practices:

• General Dermatology

• Mohs Surgery Centers

• Pediatric Dermatology

• Cosmetic Dermatology Clinics

• Dermatopathology Labs

• Dermatology Groups

• Hospital-based Dermatology

Each practice type requires a customized billing approach, which we adapt using specialty-specific workflows and software integration.

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Our Dermatology Billing Workflow

1. Patient Insurance Verification
   Confirm eligibility, coverage limits, and co-pay requirements.

2. Charge Entry & Coding
   Translate chart notes into accurate codes with proper modifiers.

3. Claims Submission
   Submit clean claims electronically with payer-specific guidelines.

4. Payment Posting
   Post and reconcile insurance payments, identify underpayments, and process adjustments.

5. Denial Resolution & Appeals
   Investigate rejections, fix coding/documentation issues, and submit timely appeals.

6. Patient Statements & Collections
   Send clear statements, provide online payment options, and handle patient billing inquiries professionally.

7. Monthly Reporting
   Receive reports on collections, denials, productivity, and insurance performance.

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Why Choose Progressive RCM for Dermatology Billing?

✅ Dermatology-Certified Coders
Our team understands skin anatomy, lesion types, and the proper use of CPT codes and modifiers.

✅ E/M & Procedure Same-Day Billing Expertise
We know how to code both an office visit (E/M) and procedure on the same day to maximize reimbursement without triggering denials.

✅ Global Period Management
Avoid denied follow-ups by billing with the correct modifier during global surgical periods.

✅ Compliant Cosmetic Billing Support
We ensure cosmetic services are billed correctly as non-covered with signed ABNs (Advance Beneficiary Notices) when required.

✅ Full Revenue Cycle Transparency
Track every stage of your billing process with detailed reports and performance dashboards.

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KPIs We Track for Dermatology Billing

• Clean claim submission rate

• Denial rate per procedure type

• First-pass resolution rate

• Average days in A/R

• Underpaid claim percentage

• Medical necessity denials

• Modifier error trends

• E/M + procedure same-day billing success

These metrics allow us to identify issues early and continuously improve your dermatology practice’s revenue performance.

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SEO Keywords Used:

• dermatology billing services

• CPT codes for dermatology

• skin lesion excision billing

• cosmetic dermatology billing

• dermatology coding and modifiers

• phototherapy billing codes

• dermatology medical necessity documentation

• Mohs surgery billing

• dermatopathology revenue cycle

• billing solutions for dermatologists

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Final Thoughts

Dermatology billing is a balancing act — between cosmetic and medical care, multiple codes and modifiers, and strict payer documentation demands. Every misstep can lead to claim denials, delayed payments, or compliance risks.

At Progressive RCM, we handle your dermatology billing with unmatched precision and care — so you can focus on providing exceptional skin care while we maximize your revenue.