Dental Billing Challenges: Boosting Efficiency and Profit

Published by the American Dental Coders Association

Dental billing is the financial heartbeat of a thriving practice — but it also comes with a wide range of daily challenges that can slow down cash flow and shrink profit margins. From insurance verification issues to claim denials and coding errors, inefficiencies in the billing process can cost your practice thousands in lost revenue.

In this blog post, we’ll break down the most common dental billing challenges and provide actionable strategies to improve efficiency, reduce stress, and increase profitability.

Want to take your billing expertise to the next level? Enroll in the Certified Dental Billing Specialist (CDBS) program or explore our Dual Certification Program at the American Dental Coders Association.

1. Insurance Verification Breakdowns

• Not confirming coverage before treatment
• Missing plan limitations (e.g. frequency, waiting periods)
• Failing to verify COB (Coordination of Benefits)

Solutions: Assign a team member to verify insurance 48 hours before appointments. Use a checklist and train staff through the CDBS program.

2. High Volume of Claim Denials

• Incorrect CDT or ICD-10 codes
• Missing documentation (x-rays, narratives)
• Untimely submissions or payer-specific errors

Solutions: Audit claims weekly. Stay updated via the Certified Dental Coder (CDC) course. Use software to track claim status.

3. Lack of Internal Billing Policies

What’s Missing:

• Standardized workflows
• Escalation paths for overdue claims
• Timelines for submission, resubmission, and appeals

Solutions: Create a billing SOP, assign roles, and update it annually.

4. Poor Communication Between Front Desk and Clinical Staff

• Clinical notes don’t match billing
• Incomplete documentation
• Incorrect treatment scheduling

Solutions: Cross-train your front desk and hygiene teams. Use documentation checklists and weekly huddles.

5. Underutilizing Software and Technology

• Manual eligibility checks
• Missing batch claim tools or alerts
• No integration between EHR and billing tools

Solutions: Customize dashboards. Automate where possible. Train staff during onboarding and continuing education.

6. Reactive Instead of Proactive Billing

Flip the Script:

• Monitor KPIs: clean claim rate, days in A/R, collection percentage
• Schedule regular reviews — not just denial follow-ups
• Set goals based on ADA benchmarks

7. Lack of Certified Billing and Coding Professionals

Benefits of Certification:

• Reduced errors and faster payments
• Improved audit readiness
• Higher confidence from patients and payers

Explore certification with the American Dental Coders Association:

• Certified Dental Billing Specialist (CDBS)
• Certified Dental Coder (CDC)
• Dual Certification Program
• CDBS Exam
• CDC Exam

Final Thoughts

Dental billing doesn’t have to be a daily struggle. With the right processes, training, and mindset, your practice can transform billing challenges into opportunities for growth.

Efficiency isn’t just about speed — it’s about accuracy, accountability, and teamwork. Invest in the right training and systems now, and your future self — and your bottom line — will thank you.

Need a proven next step? Get certified and take control of your billing process with expert guidance from the American Dental Coders Association.