Dental billing
Dental billing,
without the denials.
Dental insurance is its own world: annual maximums, frequency limits, waiting periods and pre-determinations. We verify benefits in detail and file claims that hold up, so treatment plans turn into payments.
What makes it hard
Where dental revenue gets lost.
Benefit breakdowns
Annual maximums, deductibles, coinsurance by category and waiting periods decide what a patient owes. A basic eligibility check doesn't show them.
Frequency limits
Cleanings, X-rays and exams are limited per period. A service done too early is denied and becomes a patient balance.
Pre-determinations
Major treatment such as crowns, bridges or implants often needs a pre-determination with X-rays and narratives before you can quote the patient.
Medical cross-coding
Some dental procedures (oral surgery, sleep apnea appliances, trauma) can be billed to medical insurance with CPT and ICD-10 codes instead of CDT.
How we handle it
Checks built into every claim.
Our team and the GetMax platform apply these checks before claims go out, not after the denial comes back.
- Full benefit breakdowns before the appointment, not just active coverage
- Frequency history checked before services are scheduled
- Pre-determinations filed with attachments and followed up
- Medical cross-coding where the procedure qualifies
Frequently asked
Questions we hear a lot.
What is a pre-determination?
A request to the dental plan to estimate what it will pay for planned treatment before it is done. It is not a guarantee of payment, but it lets you quote the patient accurately.
Can dental procedures be billed to medical insurance?
Some can, such as certain oral surgery, trauma care and oral appliances for sleep apnea, when they are medically necessary and documented with medical codes.
Keep reading
Other specialties.
Specialty
Behavioral & mental health
Billing for therapists, psychiatrists and counseling groups: time-based psychotherapy codes, telehealth, authorizations and carve-out payers, handled.
Learn more →Specialty
Physical therapy
PT billing that gets timed units, the 8-minute rule, KX thresholds, plan-of-care certification and visit limits right, so therapy claims get paid.
Learn more →Specialty
Chiropractic
Chiropractic billing for Medicare and commercial plans: spinal manipulation codes, AT and GA modifiers, ABNs, documentation and visit limits handled.
Learn more →Let's look at your dental numbers.
Tell us your payer mix and your biggest headache. We will show you what we would change.