Dental billing can make or break your practice - one slip, like a missing x-ray or messy note, and insurance slams the door on your claim.
At Wisdom, we get it: the details matter because they drive your revenue. Master the process, or watch profits bleed out fast.
It’s not just a task - it’s a must-know for dental pros, especially front office teams handling it daily.
So, what is the process? This article breaks down dental billing and insurance — so you can avoid delays, reduce denials, and protect your bottom line.
What is Dental Billing?
It’s the process that determines whether your practice gets paid — or doesn’t.
From submitting claims to insurance companies to following up on payments, dental billing keeps your revenue on track.
Every step matters — from ensuring the right CDT codes are used to tracking claims — because one mistake could mean no payment.
This isn’t just a box to check. It’s a skill that requires precision and a solid grasp of insurance plans, continuously updated regulations, and more.
Miss the mark, and you’re leaving money on the table — and nobody wants that.
Every detail counts: accurate codes, precise patient and insurance info. Get it wrong, and you risk denials or delays, straining your cash flow and causing unnecessary stress.
At Wisdom, we understand that dental billing is the difference between smooth, reliable payments and financial headaches. Get it right, and you’ll minimize delays, reduce denials, and keep revenue on track.
What You Need to Know About Dental Billing
- Dental billing means getting paid by both insurance companies and patients.
- Mistakes in paperwork, processes, or even the mail can cause delays.
- There are 7 key steps in the billing process, from scheduling to getting paid.
- You can make billing easier by improving your systems, training your team, using automation, or hiring experts.
How Long Does Dental Billing and Insurance Take?
Dental billing involves several steps, and the whole process can take anywhere from a few days to several months to complete.
The key to keeping things on track is accurate billing and quick follow-ups.
Generally, insurance companies must pay claims within 21 to 30 days, depending on the state.
Who Handles Dental Billing and Insurance?
While various dental professionals can take on billing tasks, it’s usually the job of Dental Billers or Front Office Teams.
What’s the Difference Between Dental Billing and Medical Billing?
*Note: Wisdom does not offer medical billing services.
Dental billing and medical billing are two different things, and knowing the difference is key to keeping your practice running smoothly.
Dental billing is all about getting paid for dental treatments. From cleanings to fillings to x-rays — it’s all sent to dental insurance companies. Getting it right means using the right codes and filling out the paperwork correctly. One small mistake can mean a delay or denied payment.
Medical billing covers everything outside of dental care, like doctor visits, lab tests, and medical equipment. It follows its own rules, uses different codes, and can take more time to process.
A dental billing service handles administrative burden, insurance follow up, and tedious tasks for you, so you can focus on your patients, not the insurance companies.
If you’re looking for more insights on mastering dental billing, our Exclusive Guide to Dental Billing Secrets is the perfect resource.
Why’s Dental Billing So Important?
Over 65% of dental offices handle insurance, and half of US adults are covered. Mess it up, and about 10% of your revenue slips away every year. Ouch.
Here’s why dental billing matters:
- Cash Flow: Dental insurance billing gets you paid. Get it wrong, and your practice suffers financially.
- Stay Compliant: Incorrect billing leads to denials, audits, or even legal issues. Do it right, and you avoid the headaches.
- Track It: Proper records show where your money's going. No gaps, no confusion.
- Patient Trust: Clear, accurate billing builds trust. Happy patients, help keep your practice going.
Bottom line: Dental insurance billing fuels your revenue, cuts risks, and keeps patients smiling.
Is Dental Billing Difficult?
Dental billing can definitely be challenging. There’s a lot to manage, with a range of rules, codes, and regulations that must be followed to get paid for services.
Practices need to have a strong understanding of insurance plans, government programs, and billing laws to ensure accurate and timely payment.
These rules, codes, and regulations change at least annually, making it essential to stay up to date—one reason why outsourcing can be so valuable, as experts stay on top of these updates for you.
Additionally, dental billing requires great attention to detail. Even a small mistake in coding or documentation can lead to denied claims or lower payments.
This can take up a lot of time - especially for practices that want to focus on patient care and customer service.
Outsourcing your claims processing to experts who specialize in dental billing services lets your team focus on patient care while they handle the claims.
What’s the Dental Billing Process?
The Dental billing process involves several tasks to ensure the practice gets paid properly.
Here’s a breakdown of the main steps:
- Pre-authorization: Before certain procedures, you need to get approval from the insurance company or government programs.
- Documentation: Write down all the details about the services provided, including the patient’s information, diagnosis, and the treatments done.
- Coding: Use the right codes (called CDT codes) to categorize the services given. This is crucial for proper billing.
- Preparing Claims: After the treatment, you prepare and send claims to the insurance company, government programs, or the patient. This can be done electronically or by mail.
- Following Up: Make sure the insurance company or government program has processed the claim and will pay. You may need to call or check the status.
- Posting Payments: When you receive a payment—from insurance or a patient—enter it in the system and update the ledger accurately. Make sure all adjustments and payments are posted to the correct provider.
- Managing Unpaid Bills: Keep track of any unpaid bills and make sure to follow up with the insurance company or patient until payment is made.
In short, dental billing includes documenting, coding, submitting claims, following up on payments, and making sure you get paid for the services you provide.
It’s essential for a dental practice’s financial health!
What are the Types of Dental Insurance?
Dental insurance helps people pay for dental care, but not all plans are the same. Here’s a breakdown of the main types:
- PPO (Preferred Provider Organization) Plans
PPOs are flexible and cover a wide range of treatments, including big work like crowns or implants. You can choose any dentist, but staying within the plan’s network can get you better benefits. - DHMO (Dental Health Maintenance Organization) Plans
DHMOs focus on preventive care like cleanings and fillings. You must pick a primary dentist from their network, and coverage is limited if you go outside the network. - Discount Dental Plans
These aren’t technically insurance, but they offer discounts on dental services. You pay a fee to join the plan and get lower prices at participating dentists.
Each plan has its benefits, depending on your needs and how much flexibility you want.
What is Dental Coding?
Dental coding is the process of using special codes to describe the services you provide to patients.
These codes, called Current Dental Terminology (CDT) codes, are created by the American Dental Association (ADA).
ICD-10 is the primary coding standard applied.
The goal of dental coding is simple: it helps insurance companies and other health programs know what treatments were given, so they can pay the dental practice correctly.
To get paid properly, dental practices must use the right codes for each service. This means knowing the CDT codes well and understanding the treatment the patient received.
If the coding is wrong, the practice may not get paid, or the payment could be lower than expected.
So, getting the codes right is important to avoid problems with insurance payments.
In short, dental coding is key to getting paid for the services you provide, and helps keep everything in line with insurance rules.
What are the Common Reasons for Dental Claim Denials?
- Incorrect Coding
One of the most common reasons for a claim denial is using the wrong codes for the services provided. These codes must match what the insurance company uses to process claims. To avoid this, dental practices must stay updated on the latest coding rules and make sure to apply the right codes for each treatment. - Missing Information
Another reason claims get denied is missing information. This could be anything from missing patient details, signatures, or necessary authorization forms. To prevent this, ensure all required information is complete before submitting claims. - Incorrect Patient Details
Claims can also be denied if the patient’s details are wrong, such as their name, birthdate, or insurance information. To avoid this, check that patient information is accurate and updated during every visit. - Lack of Prior Authorization
While most government plans may require prior approval for certain procedures, typical dental insurance often does not.
However, it’s still important to check with the insurance company before providing treatment.
If prior authorization is needed and not obtained, the claim could be denied
By staying on top of these common issues, dental practices can avoid claim denials and get paid more efficiently.
Want to take a closer look at common billing mistakes and how to fix them? Download our free resource: 5 Dental Revenue Cycle Mistakes to Stop Now.
How Can You Improve Your Dental Billing Process?
- Stay Updated on Codes Insurance Rules: Dental insurance rules can change often. Make sure you're always in the loop. You can do this by attending courses, reading industry updates, or talking to billing experts.
- Hire Billing Experts:Outsourcing your dental billing is an efficient and cost-effective way to access expert support - without the challenges of hiring, training, or keeping in-house staff. It helps reduce errors and takes the stress out of dental billing.
- Keep Accurate Records: Maintaining up-to-date and detailed records is essential. This means keeping patient details current, logging all treatments, and following up on claims. A good record system helps prevent issues like denied claims and delays.
These simple steps can make dental billing much more efficient and ensure you get paid properly.
How We Can Help
Your dental billing? We’ve got it. You focus on patients!
At Wisdom, we take dental billing off your plate. Insurance claims? Patient payments? Consider it done.
Оur team of experts fights for every dollar, chases the insurance companies, and ensures you get paid fast and accurately.
Why choose us? You get rid of the workload. Errors disappear. Cash flows in - fast and accurate.
With Wisdom, dental billing becomes effortless.
Revenue climbs. Paperwork fades - your practice prospers.
.png)