10 Dental Billing Tips to Help Streamline Your Practice

Do you feel your accounts receivable (AR) is out of control? Is your team struggling with claims follow up? Understanding dental billing and collection best practices can help you and your team establish an effective routine that improves the flow of payments to your practice, therefore creating a more robust, successful revenue cycle management process.

Additionally, patients may benefit when your team can explain details of their coverage, claims, payments and overall dental costs so they can prepare for the dental care ahead.

Below you will find dental billing and collections best practices to help streamline business operations while delivering a top patient experience.

1. Know Your Dental Billing Terms

Familiarize yourself with dental billing terms so you know what’s happening in your billing conversations, the best way to guide patients and staff through the healthcare billing process and how it works.

• Balance billing. If you are in-network with an insurance company, you agree as a participating dentist to accept the approved fee for a treatment, but you can bill the patient for the difference. Balance billing also occurs when you are out-of-network with an insurance company and bill the patient for services rendered.
• Clean claim. This refers to an error-free claim submission that is accurate and complete when submitted to an insurance company or payer. The documentation can be processed without being resubmitted or needing additional attention.
• Covered service. Every dental plan has services that are covered and others that are not covered. Discussing with a patient the cost of a non-covered expenses before the work starts is essential. Making the patient aware of any out-of-pocket costs is best practice.
• Explanation of benefits (EOB). An EOB is a document from a patient’s insurance company that details dental treatments and services paid for on their behalf. This document is not a bill or dental invoice.
• Fee schedule. The fee schedule is a predetermined, itemized list of charges for specific dental treatments. It helps you determine the appropriate cost for the dental treatments you provide. Some dental plans pay based on a set fee schedule that is a set dollar amount vs. the typical percentages.
• In-network vs. out-of-network. Make patients aware of the dental insurance companies your practice is in-network with (you are part of the insurer’s network and accept their preestablished costs for your services). For all other insurance companies, your practice is typically considered out-of-network (your practice does not participate in the patient’s insurance network).
• Pretreatment estimate. Before dental treatment starts, your billing department can submit a treatment plan to the patient’s insurance for review. This allows an estimate of benefits to be created so the patient can determine how to proceed and budget for their dental procedures. Be aware that a pretreatment estimate is not a guarantee of payment; the best practice is to make sure the patient is aware of that.

2. Brush Up on Dental Codes

Dental coding can get overwhelming, particularly for dentists who carry out multiple variations of similar tasks. The list of codes is long, and the alphanumeric combinations are plentiful.

Nevertheless, every dental practice should stay up to date with the correct Current Dental Terminology (CDT) codes, cross-codes and code changes to ensure that every dental procedure and dental visit is billed correctly. For example, bone graft at time of extraction is a different code than a bone graft placed at time of implant placement.

3. Outsource Healthcare Billing

If you don’t have a dental practice manager, in-house billing specialist or staff member who is experienced with efficiently handling healthcare billing, consider outsourcing to a dedicated healthcare billing professional or company. These services can help simplify the complex task of managing insurance claims, patient billing, coding and collections, freeing up your team to focus on patient care. You can also leverage dental-specific billing software to manage daily financial tasks and improve reimbursement efficiency.

4. Submit Clean Claims and Be Consistent with Follow-Up

When claims are incomplete, it’s as though they were not submitted at all. Make sure full documentation and accurate information are provided when submitting the initial claim. Check and double-check claim completion to avoid errors, which can lead to claim denials.

Even if you do everything just right when filing a dental insurance claim submission, denials can happen. It’s important to stay on top of these denials, resubmit claims as needed and appeal unfair claim denials.

You can improve claims submission and reduce the need for appeal by paying attention to filing deadlines, requesting claims only for covered services, providing appropriate documentation and using the correct and current dental codes. Revise carefully and resubmit claims quickly.

5. Obtain Pre-Authorizations for Dental Care

No one wants to deal with surprise bills when it comes to their dental costs. You can help patients avoid unexpected charges by keeping them informed. Give them an excellent patient financial experience by getting pre-authorization for treatment from insurance companies. This can be especially helpful for advanced treatments and costly services like dental implants, porcelain crowns, root canal therapy, nightguards and orthodontics. Some patients see the cost of a dental procedure and are comfortable saying yes immediately. Others need more time to consider their options and may want to see what’s possible financially.

6. Streamline Dental Billing Statements

It’s important for you and your patients to know exactly what payment amount is expected and when. Creating detailed but easy-to-understand dental invoices helps patients understand what they are responsible for financially. Crafting a payment schedule through an in-office payment system or third-party billing option can also help keep everyone on track.

7. Collect Timely Payments

A smart dental billing practice for any dental office to adopt is to collect payment on the day of service. Billing patients for copay, coinsurance or deductible totals after the fact delays payment and can sometimes result in non-payment or incompletion of other dental treatments.

8. Educate Your Dental Staff

Make sure your entire staff — not just your accountant, bookkeeper or office manager — is ready to assist with patients’ billing questions. When everyone in your office can offer some guidance, from hygienists to dental assistants, patients feel better about being tended to by a knowledgeable team they trust.

The goal, above all, is to help patients understand their out-of-pocket expenses and offer payment options, such as third-party financing. You can share and reinforce this information with patients throughout their journey with information posted on your website, announced on hold messages, displayed through office signage, included on invoices and billing inserts and promoted in other marketing materials.

9. Adopt the Best Billing Practices for Your Dental Office

Establishing a streamlined system of dental billing best practices can help your practice run smoothly. When you adopt methods for improving the claims process, offer convenient payment options and improve in-house knowledge of dental financials, it can help your practice work better for you, your team and your patients.

10. Weigh Internal vs. External Financing

An internal financing plan or patient membership plan can provide services for basic dental care like X-rays, teeth cleanings and oral cancer exams. This type of business practice takes a great deal of time to manage and stay in full compliance with all state and federal regulatory issues, which is why many dental offices prefer to outsource financing options as the better value for patient and practice.

For example, third-party financing solutions like CareCredit issue a credit card to help patients pay for health and wellness services, including dental care treatments, at providers in the CareCredit network. In fact, Synchrony's Dental Lifetime of Care study revealed that 58% of respondents would probably or definitely choose a payment option that provided predictable, set, equal payments without having to use their general purpose or retail credit cards.

By implementing dental billing and collections best practices, your practice can help improve financial performance, minimize stress and deliver a better experience for both your team and your patients.

A Dental Patient Financing Solution for Your Practice

Want to help more patients access the dental care they want or need? Consider offering the CareCredit credit card as a financing solution. CareCredit allows patients to pay for out-of-pocket dental care costs over time while helping enhance the payments process for your practice.

When you accept CareCredit, patients can see if they prequalify with no impact to their credit score, and those who apply, if approved, can take advantage of special financing on qualifying purchases.* Additionally, you will be paid directly within two business days.

Learn more about the CareCredit credit card as a dental patient financing solution or start the provider enrollment process by filling out this form.

Expert Reviewer

Colleen Huff, FAADOM

Colleen Huff, FAADOM, brings more than three decades of dental industry experience, evolving from a MetLife dental customer service rep to a nationally recognized dental insurance expert. Her career spans multi-location practice management, founding a dental study group for practice administrators launching a thriving consulting and speaking career. Known as the "Dental Insurance Coach," Huff helps practices streamline revenue cycle management. A sought-after expert, she’s featured at national conferences, study groups, and on leading podcasts. Her 2024 book, "A Mouthful of Insurance," and articles in top dental publications underscore her thought leadership. Named to the Top 25 Women in Dentistry in 2017, she continues to educate professionals through online courses.

Author Bio

Elizabeth Weiss is a freelance writer and editor with more than 20 years of experience in content development for dentistry, orthodontics and cosmetic dermatology. She focuses on making healthcare topics accessible to readers and contributes to many fields, from family and estate law to industrial services and landscape design.

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