Here’s How We Enhance Your Dental Practice Revenue:
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Across the U.S., dental practices lose an estimated 8–10% of annual revenue due to preventable billing issues. For a solo provider grossing $1 million, this translates to $80,000–$100,000 in uncollected revenue funds that could otherwise support staff expansion or invest in modern clinical equipment. For larger, multi-location groups collecting $5 million, these gaps can reach up to half a million dollars annually.
These financial losses often stem from avoidable errors: inaccurate coding, outdated payer guidelines, overlooked pre-authorizations, and delayed claim follow-ups. In many cases, a single denied implant, crown, or extraction code can quietly impact cash flow for weeks or even months. The solution lies in partnering with specialized dental medical billing services. These experts ensure accurate CDT, CPT, and diagnostic coding from the outset, drastically improving first-pass acceptance rates. Their automated eligibility verification tools catch coverage issues before treatment, giving patients clear estimates and keeping your revenue predictable. Real-time billing dashboards offer complete visibility into claims, reimbursements, and payer trends without adding administrative burden.
Are CDT codes, eligibility calls, and 90-day A/R cycles pulling focus from patient care? Medcare MSO removes that burden with end-to-end dental billing services built for precision and speed. Our certified dental billing experts, trained under American Dental Association (ADA) standards, apply accurate CDT, CPT, and ICD-10 codes, while AI-driven scrubbing ensures clean claims from the start.
We secure pre-authorizations before treatment begins, eliminating coverage surprises. When denials occur, our rapid-response team resolves them within hours. From ERA posting to A/R follow-ups, we accelerate collections and reduce delays. Patient billing is handled with care, transparency, and HIPAA compliance. With real-time dashboards tracking your production, collections, and payer trends, Medcare MSO’s dental billing services help your practice stay focused on outcomes, not overdue claims.
Medcare MSO provides the best and most comprehensive dental billing services for small and large dental practices. Our dental revenue cycle management services include:
Enrollment with dental PPOs, HMOs, Medicaid, and Medicare Advantage plans, plus ongoing revalidation tracking.
Accurate capture of intake details to ensure correct payer matching & clean claim setup for accurate dental insurance billing.
Real-time checks of dental insurance verification, coverage limits, waiting periods, & frequency clauses before treatment starts.
Submission of clinical notes, radiographs, and narratives to secure approvals for high-cost procedures.
Precise translation of clinical services and diagnoses to meet payer requirements and medical-necessity rules.
Automated edits and payer-specific rule checks to achieve first-pass acceptance rates above 88%.
Seamless transmission through clearinghouses, including cross-coding for oral-surgery claims to medical insurers.
ERA/EOB posting, contractual adjustment mapping, and daily deposit balancing to spot variances quickly.
Root-cause analysis, corrective resubmissions, and formal appeals executed within timely-filing windows.
Systematic outreach on 30-, 60-, and 90-day aging buckets to reduce outstanding balances.
HIPAA-compliant statements, balance explanations, and payment-plan coordination to improve patient billing & collections.
Real-time KPIs: production, collections, net collection rate, and denial trends, all delivered without extra software hassle.
When outsourcing dental billing services, a provider’s foremost concerns center on meeting state-specific compliance requirements and safeguarding patient data. That’s why Medcare MSO’s compliance and data security are engineered into every workflow we manage. Our dental revenue cycle platform is HIPAA-certified and housed in SOC 2 Type II audited data centers with 256-bit encryption, multi-factor authentication, and role-based access controls. Dedicated compliance officers continuously monitor CMS, OIG, and state regulations, updating protocols the moment rules change. All our staff complete annual HIPAA, PCI-DSS, and phishing-resilience training, and every claim passes through automated audit trails for full traceability. From secure SFTP document exchange to real-time intrusion detection, we safeguard PHI and protect your practice against fines, breaches, and reputational damage, so you can focus on patient care.
We handle all aspects of cancer care billing so you can focus on treating patients. Our expert team manages everything from insurance approvals to payment collection, ensuring your practice gets paid faster and more efficiently.
Expert coordination between dental and medical insurance for oral surgery, periodontal, and TMJ treatments.
Seamless billing across orthodontic, implant, and prosthodontic treatment sequences with proper phase timing.
Strategic coding and documentation to maximize insurance coverage for aesthetic procedures with medical necessity.
Advanced tracking of insurance limitations and waiting periods to maximize preventive treatment reimbursements.
Specialized billing for EPSDT programs, school-based services, and age-specific preventive protocols.
Complex medical insurance billing for extractions, grafts, and surgical procedures with hospital coordination.
Long-term treatment billing with insurance benefit optimization and family payment coordination strategies.
Expert management of active treatment to maintenance transitions with proper interval coding and documentation.
Comprehensive billing across implant placement, restoration, and maintenance phases with proper revenue recognition.
Specialized billing for conscious sedation and general anesthesia with medical insurance coordination and documentation.
Coordinated billing for crown and bridge work with laboratory fees and delivery timing optimization.
Strategic coding and timing for urgent dental care to maximize insurance benefits and patient satisfaction.
Dental procedures carry intricate coding rules, so we staff only seasoned specialists who excel in dental billing and coding, such as:
CDT Range: D0100–D0999
Description: Exams, x-rays, diagnostics
ICD-10 Codes: Z01.20, K00–K14
ICD-10 Description: Dental exams, Tooth development disorders
CDT Range: D1000–D1999
Description: Cleanings, fluoride, sealants
ICD-10 Codes: Z00.00, K05.0
ICD-10 Description: Routine exam · Gingivitis
CDT Range: D2000–D2999
Description: Fillings, crowns, veneers
ICD-10 Codes: K02.3, K08.1
ICD-10 Description: Caries · Tooth loss
CDT Range: D3000–D3999
Description: Root canals, pulpotomy
ICD-10 Codes: K04.0–K04.9
ICD-10 Description: Pulpitis · Periapical abscess
CDT Range: D4000–D4999
Description: SRP, perio surgery, maintenance
ICD-10 Codes: K05.3, K05.6
ICD-10 Description: Chronic periodontitis · Other perio disease
CDT Range: D5000–D5899
Description: Dentures, relines
ICD-10 Codes: K08.1–K08.5
ICD-10 Description: Edentulism · Tooth loss (trauma/causes)
CDT Range: D5900–D5999
Description: Facial/jaw prostheses
ICD-10 Codes: Q67.4, K02.0
ICD-10 Description: Jaw deformities · Facial anomalies
CDT Range: D6000–D6199
Description: Implant placement & upkeep
ICD-10 Codes: Z96.5, K08.1
ICD-10 Description: Implants present · Partial edentulism
CDT Range: D6200–D6999
Description: Bridges, fixed crowns
ICD-10 Codes: K08.40, K08.402
ICD-10 Description: Partial edentulism (upper/lower)
CDT Range: D7000–D7999
Description: Extractions, grafts, TMJ
ICD-10 Codes: S02.x, K10.x
ICD-10 Description: Jaw fractures · Cysts/tumors
CDT Range: D8000–D8999
Description: Braces, aligners, retainers
ICD-10 Codes: K07.1–K07.4, M26.3
ICD-10 Description: Malocclusion · Jaw anomalies
CDT Range: D9000–D9999
Description: Anesthesia, consults, ER
ICD-10 Codes: Z51.81, R68.2, T81.4
ICD-10 Description: Pre/Post-op care · Complications
Maximus medical billing and coding software brings every step of dental revenue cycle management into one secure, AI-driven workspace. It’s a cloud platform that scrubs CDT and CPT codes in real-time, flags missing data, and files clean claims to every major payer within minutes. Maximus’ built-in eligibility checks warn front-desk teams of coverage gaps before treatment starts, while smart rules push first-pass acceptance rates above 90 percent. It’s A/R dashboards update nightly to show unbilled, current, and aged balances, helping you act before revenue slips away. Maximus also operates on HIPAA-certified servers and generates clear, weekly KPI reports automatically for easy performance tracking. So, it provides comprehensive dental billing solutions to simplify your billing operations.
Chief Operating Officer, MAKO MEDICAL LABORATORIES
Chief Executive Officer, CARE NOW CLINIC
Chief Operations Officer, ION DIAGNOSTICS
Co-Founder, AW Care
Our platform seamlessly integrates with over 50+ dental EHR systems, and our certified billing and coding team is proficient in every one of them.
Dental providers spend around 50 hours weekly providing patient care, and such a busy schedule compromises their dental revenue cycle management. That’s why leaks like expired provider credentials, out-of-date fee schedules, and forgotten secondary claims drain revenue long before denial letters ever arrive. Missed timely-filing windows, unbilled sedation modifiers, and PPO write-offs based on outdated reimbursement tables quietly strip thousands from each month’s production. Our complimentary Dental Billing Health Check follows every dollar from chairside charting to final patient receipt, uncovering leaks buried in eligibility files, narrative attachments, and inactive A/R worklists. You receive a clear roadmap that lists recoverable balances, priority fixes, and preventive safeguards tailored to your software. Stop silent losses before they snowball!
Are you a dental medical billing company looking to expand into dentistry without hiring new staff? Medcare MSO offers white-label dental billing services that plug seamlessly into your existing workflows. Our dental billing experts handle full-cycle dental medical billing from insurance verification and CDT coding to claim submission, denial management, and patient collections for you. By choosing our dental billing solutions, you outsource dental billing to a proven billing company that already supports remote dental billing companies nationwide. We integrate with dental billing software, deliver detailed dental insurance billing reports, and give you scalable, affordable dental billing outsourcing that protects margins.
State-by-state billing regulations and strict, timely-filing limits are where generic medical billing vendors most often stumble. We solve that risk by assigning billers and coders who are fully trained in your state’s specific rules, shielding your practice from preventable denials, fines, and compliance penalties. We serve all 50 states:
Get the latest insights about the dental healthcare industry and keep your practice one step ahead of the competition.
Dental billing begins with verifying a patient’s insurance benefits and capturing accurate clinical details in the electronic dental record. Your team (or an outsourced dental billing company) assigns the correct CDT and, if needed, CPT or ICD-10 codes, then submits a claim electronically to the payer. The claim is adjudicated, any denials are appealed, and approved payments are posted. Finally, remaining patient balances are billed and collected, and month-end reports track production, collections, and accounts receivable aging.
Outsourcing shifts labor-intensive tasks, coding, claim submission, follow-up, denial management, and patient statements, to specialists who handle them all day, every day. Practices gain higher first-pass approval rates, faster cash flow, and lower overhead because they no longer need to hire, train, or retain in-house billing staff. Outsourcing also keeps you compliant with ever-changing payer rules and frees clinical staff to focus on patient care instead of paperwork.
Most dental billing companies charge either a percentage of monthly collections or a flat fee per claim. Percentages typically range from 4% to 10% of monies collected, depending on claim volume, specialty complexity, and the scope of services (e.g., insurance verification, patient billing, detailed A/R work). Per-claim pricing can run from $4 to $8 for straightforward submissions and higher for claims that require extensive follow-up. Always confirm whether costs include denial appeals, comprehensive reporting, and credentialing support.
We deliver a turnkey solution: insurance verification, CDT/CPT/ICD-10 coding, electronic claim submission, real-time claim scrubbing, denial analysis and appeal, A/R follow-up, patient statements, payment-plan management, monthly KPI reporting, credentialing, and seamless integration with 40+ EHR/PM systems. One contract covers the entire revenue cycle.
A huge team of AAPC-certified specialists focuses exclusively on dentistry. They master the full CDT code set, plus CDT-to-CPT cross-walks for oral surgery, and stay current with ADA, payer, and state updates through mandatory quarterly training.
Yes. We are enrolled with all major commercial PPO/HMO networks, regional Medicaid plans, Medicare Advantage, and specialty carriers. Dedicated payer liaisons maintain up-to-date rules and fee schedules, ensuring clean claims regardless of the insurer mix in your practice.
Medcare MSO operates on HITRUST- and SOC 2-certified, HIPAA-compliant infrastructure with 256-bit encryption, MFA, role-based access, and continuous intrusion monitoring. Staff complete annual HIPAA, PCI-DSS, and phishing-resilience training, and every transaction is fully audited.
We produce branded e-statements and paper bills, offer an online payment portal, manage courtesy reminder calls, and set up interest-free payment plans when needed. Our early-out program recovers balances while preserving patient satisfaction and keeping delinquent accounts below 5%.
We use a straightforward, percentage-of-collections model: you pay a small, agreed-upon percentage of the revenue we actually collect on your behalf. That single fee covers claims submission, eligibility checks, denial appeals, patient statements, and monthly reporting, no setup charges, portal fees, or surprise add-ons.
Get faster payments, fewer denials, and higher collections with our expert dental billing team handling your revenue cycle.
A member of our team will get in touch with you in 12 hours.
800-640-6409
