Dental billing errors don’t just waste time, they waste money. A single coding mistake or missed claim deadline can lead to denied reimbursements, lost revenue, and frustrated patients.
And with nearly 80% of dental bills containing inaccuracies, these slip-ups are far more common than most practices realize.
At Wisdom, we understand the complexities of dental billing. Our mission is to simplify this process, allowing you to focus on patient care while we catch dental billing errors before they cost you.
In this guide, we’ll break down the most expensive dental billing mistakes and how to avoid them, so your practice keeps more of the revenue it earns and spends less time chasing it.
1. Coding Errors
Coding errors are a major reason for lost revenue - and honestly, we understand how tricky coding can be. It’s one of the toughest parts of dental billing, and even the smallest mistake can feel frustrating.
Current Dental Terminology (CDT) codes are updated annually, and even small mistakes can lead to big problems.
Whether it’s assigning the wrong procedure code, misusing a modifier, or forgetting to update a deleted code, errors like these can result in denied claims, delayed payments, and compliance risks.
What’s worse is that repeated coding mistakes could be flagged as fraudulent billing, even if they’re unintentional.
How to Prevent Dental Coding Errors
Staying current with CDT and ICD-10-CM updates isn’t optional - it’s essential.
Here’s how to keep your coding airtight:
- Commit to ongoing training: Ensure your billing team is regularly trained on annual code updates and payer-specific coding guidelines.Use smart billing software: Platforms that auto-flag outdated or incorrect codes can help reduce human error before claims go out the door.
- Reference reliable sources: Reputable organizations like ADA offer training, cheat sheets, and certification programs.
- Audit your claims monthly: Spot-check submitted claims to identify coding trends, recurring errors, or training gaps.
By investing in your team’s coding knowledge and tools, you’re not just preventing denials, you’re maximizing collections, reducing audit risk, and safeguarding your reputation.
2. Inaccurate Patient Data
One of the top reasons dental claims get denied is due to inaccurate information submitted.
When details on an insurance claim don’t match what the insurer has on file, claims are often denied or delayed.
This not only slows down your reimbursement but also creates extra work to investigate, correct, and resubmit claims.
Insurance payments typically make up around 50% of a dental practice’s revenue, so ensuring smooth, accurate billing is critical to your financial health.
Why Accurate Data Matters
Data entry errors are among the easiest billing mistakes to avoid - yet they remain the number one cause of claim denials.
Clean, verified patient data is the foundation of efficient insurance billing and faster payment.
What Information to Collect (and Verify) Every Time
Even for returning patients, it’s essential to confirm and update key information at every visit because personal and insurance details can change frequently — and insurance coordination (especially with dual coverage) is a common area where errors occur.
Make it a habit to review:
- Home address and phone number
- Employment status (Have they switched jobs or retired since their last visit?)
- Insurance provider’s name
- Secondary insurance details (if applicable) — ensure primary and secondary coverage are correctly assigned
- Member ID
- Patient’s date of birth (if different from the insurance member)
- Employer name
- Group ID number
- Insurance company phone number (especially if you don’t have portal access)
To avoid errors and delays in billing, regularly update patient records and verify insurance information.
Collecting accurate data upfront is also the first essential step in verifying insurance eligibility (an important safeguard that we’ll cover next!).
Download our free, comprehensive guide: “The most common dental billing mistakes”, and how to resolve them” and start protecting your practice’s revenue today.
3. Skipping or Rushing Insurance Verification
One of the most overlooked, but absolutely essential steps in dental billing is insurance verification.
This is where you confirm a patient’s active coverage, eligibility, and benefits before treatment begins.
And yet, many practices either delay this process or don’t treat it with the attention it deserves.
We get it, verifying insurance isn’t the most exciting part of your day. It can feel repetitive, time-consuming, and easy to put off.
But here’s the truth: inaccurate or outdated insurance details are one of the most common causes of claim denials and payment delays.
Verifying coverage up front ensures you bill correctly, reduce rework, and avoid uncomfortable conversations with patients about unexpected costs.
Stop leaving money on the table. Download your free copy of “Exclusive Guide to Dental Billing Secrets” and discover how to boost collections to 98% and beyond.
Why Insurance Verification Matters
Insurance verification sets the tone for the entire dental billing process.
If coverage details are wrong - like an expired plan or incorrect member ID - you’re almost guaranteed a denial.
That means more admin time, longer A/R cycles, and potential frustration for both your team and your patients.
It also directly impacts how accurately you calculate patient out-of-pocket costs, which plays a major role in the patient experience.
How to Simplify Your Insurance Verification Process
To reduce billing issues and boost patient trust, make insurance verification a standard and proactive step in your workflow.
Here’s how to do it right:
- Start early: Collect insurance information several days before the scheduled appointment.
- Use smart tools: Digital forms and insurance verification software help you collect and store data quickly and securely.
- Confirm details twice: Verify insurance information by phone, and again during patient check-in.
- Break down benefits: For complex or high-value procedures, request a full benefits breakdown.
- Apply info to families: If multiple family members are seen, use the same verified data to avoid duplicating work.
- Check deductibles and maximums: Know the patient’s remaining benefits for the year so you can plan treatment accordingly.
4. Poor Claim Submission Processes
Filing dental claims late - or without a clear system - can cost your practice thousands in lost revenue.
Claim denials don’t just come from coding issues or incorrect patient info.
Missed deadlines and poor follow-up are just as damaging.
Why Timely Claim Submission Matters
Every insurance company has its own filing deadline.
Some allow 12 months. Others, like Medicaid, may give you just 90 days.
Waiting too long reduces your chances of getting paid — no matter how accurate the claim is.
Submit claims within 24–28 hours of the procedure. The sooner you file, the fewer errors and delays you’ll deal with.
Waiting days to create or batch a claim increases the risk of forgetting procedures, misreporting treatment, or missing submission entirely.
Build a Reliable Daily Claims Workflow
Here’s what an efficient claims process should include:
- Create and batch claims the same day the procedure is completed.
- Get provider approval on all claims before submission to confirm accuracy.
- Send claims to the clearinghouse by the next business day at the latest.
- Assign responsibility - someone on your team should be accountable for reviewing the full daily schedule and ensuring every patient has a claim created.
This simple daily routine prevents revenue leaks and ensures faster reimbursements.
5. Failing to Monitor Your Insurance Aging Report
Submitting claims is only half the battle.
The other half? Following up on unpaid claims.
If no one is monitoring your insurance aging report, you’re likely leaving money on the table.
Aged claims - especially those over 30 or 60 days - become harder to collect with every passing week.
How to Work Your Aging Report Effectively
You should be reviewing and working your insurance aging report at least once a week.
Here’s how to make it count:
1. Go line by line through the report.
2. Check claim status via the insurance portal, and call the payer if needed.
3. Add clear notes on all follow-up activity for every outstanding claim.
4. Designate a team member to own this process and catch claims that fall through the cracks.
The more consistently you follow up, the faster your practice gets paid.
Here’s a deeper look at how to manage dental insurance aging reports to improve cash flow.
6. Losing Revenue to Bundled Procedures
Insurance payers often use bundling to reduce reimbursement - combining multiple procedures under one code and paying less than if billed separately.
If your team doesn’t recognize when and how bundling applies, your practice could lose out on revenue without even realizing it.
What Is Bundling in Dental Billing?
Bundling happens when an insurer treats two or more separate procedures as one “comprehensive” procedure and reimburses based on that lower rate.
For example:
You perform a panoramic x-ray and bitewing x-rays - two distinct procedures with separate fees.
Instead of paying for both, the insurer may classify them as an FMX (full-mouth series) and reimburse you at the FMX rate, which is often lower than the total of the individual procedures.
If your total charge is $150 but the FMX rate is $125, that $25 difference becomes a write-off if you’re in-network.
How to Avoid Revenue Loss from Bundling
- Understand which procedures are commonly bundled and what your contracts allow.
- Review the latest CDT codes regularly. Some recent updates have unbundled procedures previously grouped together.
- Use correct, detailed CDT coding to justify why procedures should be billed separately.
- Include clear clinical documentation in your claim submission to support separate reimbursements.
Staying current on coding rules and payer policies gives your team the best chance at collecting what your practice truly earns.Understanding how procedures are bundled is just as critical as choosing the correct code.
7. Forgetting to Attach Required Documentation to Claims
Even if your insurance verification is solid and data entry is accurate, claims can still be denied if essential attachments are missing.
Supporting documentation - like x-rays, intraoral photos, and detailed clinical notes - proves to insurance companies why a procedure was necessary.
Failing to include these attachments is a common and costly error.
Without clear evidence, insurers are more likely to reject your claims, delaying or denying payment.
Worse, missing documentation can cause confusion or disputes with patients who may question the need for treatment if their insurance denies the claim.
To avoid this, always attach thorough documentation tailored to each procedure.
Remember, x-rays alone might not be enough - sometimes photos or detailed notes are crucial to justify treatment.
Providing comprehensive evidence not only reduces denials but also protects your practice from potential legal issues and helps maintain patient trust.
8. Not Giving Patients Accurate Cost Estimates
Accurately calculating what patients owe is a make-or-break part of dental billing.
If your estimate is too low, patients are surprised with unexpected balances.
If it's too high, they may delay or cancel treatment altogether.
The problem?
Out-of-pocket costs are affected by many variables - deductibles, annual maximums, downgrades, exclusions, and waiting periods.
Relying on guesswork or outdated plan information often leads to under-collection and frustrated patients.
How to Estimate Patient Costs More Accurately
- Start with verified benefits: Always confirm active coverage, deductible status, and remaining annual maximums.
- Watch out for limitations: Insurance may downgrade composite fillings, deny coverage due to frequency limits, or exclude certain procedures altogether.
- Don’t rely solely on pre-determinations: They can delay treatment and aren’t always accurate or approved the first time.
- Train your team: Make sure your staff understands how to interpret benefit breakdowns and calculate estimates using real-time data.
- Communicate clearly: Present costs transparently to patients so they know what to expect before they commit to treatment.
9. Skipping Pre-Authorizations
Some procedures - especially high-cost treatments - require pre-authorization from insurance companies before they’ll consider reimbursement.
If your office skips this step, the claim could be denied no matter how accurate your coding and documentation are.
How to Manage Pre-Authorizations Effectively
- Know what needs one: Identify which procedures frequently require pre-authorization (e.g., crowns, implants, sedation dentistry).
- Submit complete documentation: Include x-rays, intraoral photos, and clinical narratives to support the need for treatment.
- Use a tracking system: Whether in your practice management software or a spreadsheet, monitor pending pre-authorizations and follow up regularly.
- Set patient expectations: Let patients know when a pre-authorization is required, how long it may take, and what the next steps are.
- Don't delay treatment unnecessarily: When possible, use your insurance verification data to estimate costs if a pre-auth isn’t required.
10. Not Tracking and Analyzing Claim Denials
Submitting claims is only the first step. If denied claims aren’t tracked and resolved quickly, your practice risks losing revenue and wasting time on rework.
It’s not enough to just resubmit a denied claim - you need to know why it was denied in the first place and fix the root cause to prevent future issues.
How to Stay on Top of Denials
- Keep a denial log: Document every denied claim, including the payer, reason code, procedure, and resolution status.
- Spot trends: Track recurring issues — such as codes frequently denied, payers with high denial rates, or missing attachments.
- Fix the process, not just the claim: Use denial data to retrain your team, adjust workflows, or update your billing software rules.
- Appeal quickly: Don’t let denials sit. Refile corrected claims promptly with necessary documentation and notes.
- Review monthly: Make denial analysis a regular part of your billing workflow to catch issues early and reduce rework.
11. Billing for Services Not Rendered
Billing for procedures that were never performed is not just a mistake — it’s insurance fraud.
This includes submitting claims for services that were canceled, not completed, or never provided.
It’s one of the most serious dental billing violations and can lead to fines, audits, or criminal charges.
How to Avoid Billing for Services Not Rendered
- Maintain detailed clinical records for every treatment
- Only bill for procedures that were actually completed
- Have providers verify and approve all claims before submission
- Use billing software to track and match claims to complete appointments
Honest, accurate billing protects your practice from legal trouble and builds patient trust.
12. Duplicate Billing
Duplicate billing happens when the same procedure is billed more than once - either by accident or due to poor workflow.
Submitting multiple claims for the same service can result in insurance audits, denied payments, or legal consequences under the False Claims Act.
How to Prevent Duplicate Billing
- Audit claims before submission to avoid duplicates
- Use billing software that flags repeated entries
- Train your team to check for existing claims before resubmitting
- Ensure proper coordination between front office and billing staff
Stay organized and double-check claims to make sure each one goes out once, and only once.
13. Waiving Copayments or Deductibles
Waiving a patient’s copay or deductible may seem like a way to help, but it’s usually considered insurance fraud.
Most payer contracts require providers to collect the patient’s financial responsibility. Ignoring that can lead to penalties or accusations of false claims.
How to Handle Copays, Co-insurance Amounts, and Deductibles Correctly
- Always collect copays, co-insurance amounts, and deductibles unless there’s a documented hardship policy.
- Inform patients about their financial responsibility before treatment.
- Never advertise “no out-of-pocket costs” unless legally permitted.
- Follow your payer contracts and stay compliant with insurance rules.
Consistent, compliant billing keeps your practice out of legal trouble and ensures steady revenue.
Legal Risks of Dental Billing Errors
Billing mistakes aren’t just costly - they can also lead to serious legal consequences.
Common dental billing errors such as submitting claims for services not rendered, waiving copays, or duplicate billing can be flagged as insurance fraud.
This can result in audits, fines, penalties, or even loss of your participation in insurance networks.
To protect your practice, ensure all claims are accurate, supported by proper documentation, and comply with payer contracts.
Regular staff training and audits help maintain compliance and reduce legal risk.
Final Thoughts
Dental billing errors cost time, money, and patient trust — but they’re 100% preventable.
By fixing these common mistakes, your practice can reduce denials, stay compliant, and get paid faster.
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