The Dental Billing Survival Guide

Billing may be broken — but you’re not.

In this on-demand session, Wisdom’s team of dental billing experts walk you through practical strategies to take control of your billing process, reduce stress, and get paid faster.

Here’s what you’ll learn:

• How to document claims that insurers actually approve
• The most common attachment mistakes and how to avoid them
• Simple scripts for confident, clear time-of-service collections
• A proven follow-up system to keep insurance claims moving
• Ways to align your whole team so nothing slips through the cracks

Whether you’re running the front desk solo or managing a full office, this webinar gives you tools and systems you can start using right away.

Want to dive deeper? Download our Dental Billing Cheat Sheets eBook for more tips and tools.

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Webinar Q&A Recap

 Who has a PMS that actually pulls this information correctly?

Honestly, no PMS (Dentrix, EagleSoft, Open Dental, Curve, etc.) does this perfectly out of the box. Accuracy comes from consistency over time. It takes about six months of intentional effort—getting thorough benefit breakdowns, attaching the right fee schedules, and most importantly, posting payments carefully including updating payment tables.

When you notice your estimate doesn’t match the EOB, pause and dig in.

Sometimes it’s just a deductible or waiting period, but sometimes the wrong fee schedule is attached, the benefits are outdated, or exclusions weren’t entered. Updating payment tables when posting will improve accuracy not just for one patient, but for every patient on that group plan. Garbage in, garbage out—so accuracy depends on how detailed you are with setup and posting. Over time, with consistent posting and updates, you can get ~90% accuracy in estimates .

How do you check the clearinghouse for rejections?

It depends on which clearinghouse you use, but every system has a rejected claims section you should be checking daily (at minimum weekly).

• In Dentrix eClaims, go into the Insurance Manager and look for “Rejected.” 
• In DentalXChange, there’s also a rejected section.
• In Vyne, look for a “rejected” section in your portal.
• Always work rejected claims immediately—correct them, resubmit if possible, or route them by fax if electronic isn’t working.
  
  

Don’t just wait for reports. Get into the clearinghouse dashboard itself. If you don’t have access, call your software support and get login credentials. This is where you’ll catch claims that never actually made it to the insurance company.

With insurance companies “borrowing” fee schedules, how do you track the right one?

You’re already doing the right thing by verifying at the start of the year, but plans can (and do) switch fee schedules mid-year without notice.

Here’s what I recommend:

• Keep doing annual full benefit breakdowns.
• Add an eligibility check 1–2 days before each visit to confirm coverage, deductibles, and sometimes even the current fee schedule (portals may list it).
• Communicate clearly with patients: let them know estimates are just that—estimates. Always explain that estimates are not guarantees. If the payer changes schedules mid-year, be transparent with patients that it’s out of your control.
  This mix of verification + communication keeps trust intact .

It’s about balancing accuracy with transparency. Even with the best systems, perfection is impossible with dental insurance—but you can get 90% there, and the last 10% is about patient communication

What’s the best way to handle claims that require attachments or don’t accept electronic submission?

• Fax first: Faster than mail, provides proof of transmission. Ask these companies if they have a fax-line for claims
• Portals: Use payer portals whenever possible for secure and trackable uploads. 
• Mail only if necessary: Some small union or local plans still require mailed claims, but this should be a last resort. A lot of clearing houses will mail claims for you with the right payer ID attached, but attachments will not process through. These are ones you must mail with the attachments. 
• Documentation: Save all attachments, appeals, and fax confirmations in the patient’s record so you can easily re-send if the payer “loses” them.

How do you support offices with no insurance experience at all?

A good outsourced billing team (like Wisdom) functions as an extension of the office by:

• Handling verifications, claims, follow-ups, appeals, and billing.
• Providing expert guidance so teams understand what’s happening with your billing  without being overwhelmed.
• Our website offers free scripts, protocols, and systems so even a team with zero prior insurance knowledge can start running smoothly. 

We allow your team to be patient and customer-service focused, while our dental billing experts deal with the insurance and collections. Essentially, they remove the burden while giving the office confidence and clarity they need for communication. Our regular meetings help align our teams each week so there is no lack in communication, transparency, and trust.

What do I do if medical is primary (OON) but dental secondary is in-network?

Best Practices:

1. Bill medical first – Even if the practice is out-of-network, medical insurance must receive and process the claim before dental can coordinate benefits.
2. Submit dental as secondary – Once medical issues an EOB (often showing denial or reduced payment for OON), submit that along with your dental claim. Dental will process as secondary, applying their in-network coverage rules.
3. Set clear patient expectations –
   
   • Let the patient know up front that medical is out-of-network and may not cover anything.
   • Explain that the dental insurance will still process as secondary once medical responds, but estimates are not guarantees.
   • Use a signed treatment plan or financial consent that shows the estimated patient portion, based primarily on dental benefits.
4. Collect appropriately – Collect the patient’s estimated responsibility at the time of service based on the dental estimate, not the medical side. This avoids long delays in collection.
5. Communicate in writing – Include language such as: “Your medical insurance is considered primary, but is out-of-network. We are estimating your portion today based on your dental insurance. If either plan processes differently than expected, you may receive a statement later.”

Key Takeaway: Always respect coordination of benefits rules (bill medical first), but base your collections and patient communication around the in-network dental secondary. This keeps cash flow moving and prevents patient frustration.

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