Dental Billing Explained: How to Master Claims, Coding, and Collections in 2025

Published by the American Dental Coders Association

As the dental industry evolves in 2025, the role of dental billing is more important than ever. Proper billing ensures timely reimbursement, legal compliance, and a thriving practice. Whether you’re new to the field or looking to sharpen your skills, this guide breaks down everything you need to know about how dental billing works — from insurance claims to coding and collections.

What Is Dental Billing?

Dental billing is the process of submitting and following up on claims with dental insurance companies to receive payment for services provided. It includes verifying patient insurance, selecting accurate CDT codes, submitting claims, handling denials, posting payments, and managing patient balances.

Key Components of Dental Billing:

• Insurance eligibility verification
• CDT code selection
• Claim submission (electronically or by mail)
• Denial management and appeals
• Payment posting and adjustments
• Patient billing and collections

Inaccurate or delayed billing can lead to revenue loss, compliance risks, and frustrated patients.

How Dental Insurance Works in Billing

Dental insurance differs from medical insurance in several key ways. It often includes:

• Annual maximums (e.g., $1,500/year)
• Coverage percentages based on service category (e.g., preventive vs. restorative)
• Frequency limitations
• Waiting periods and exclusions

A dental biller must understand these limitations to avoid claim denials and to properly inform patients of their financial responsibilities.

Understanding CDT Codes in Dental Billing

CDT codes (Current Dental Terminology) are used to report dental procedures to insurance companies. These codes are updated annually by the American Dental Association and are critical to accurate claim submission.

Examples include:

• D0120: Periodic oral evaluation
• D1110: Adult prophylaxis
• D2740: Crown – porcelain/ceramic

Each code must be backed by proper clinical documentation. Using incorrect or outdated codes can lead to denials or audits.

Tip: Stay current with CDT changes by taking a certification course like the Certified Dental Coder (CDC) program.

Submitting Dental Insurance Claims

Dental claims can be submitted using the ADA Dental Claim Form (2024 version) or electronically through dental software and clearinghouses.

Claim must-haves include:

• Accurate patient and provider information
• Correct CDT codes
• Tooth numbers/surfaces when applicable
• Supporting documentation (x-rays, narratives)

Pro Tip: Submitting clean claims on the first try significantly reduces delays and denials.

Common Dental Billing Mistakes (and How to Avoid Them)

• Submitting outdated CDT codes
• Not verifying insurance eligibility before treatment
• Missing documentation or attachments
• Failing to follow up on unpaid claims
• Posting payments inaccurately

Avoiding these errors helps ensure faster payments, cleaner audit trails, and better patient satisfaction.

Collections and Patient Billing

Once insurance payments are posted, the remaining balance often falls to the patient. Clear communication, accurate estimates, and timely statements are essential to collect these balances effectively.

Best Practices for Collections:

• Discuss financial responsibility before treatment
• Offer payment plans or financing when appropriate
• Send timely statements and reminders
• Follow up consistently on outstanding balances

Reminder: All billing processes must comply with HIPAA and state regulations regarding patient data and collections practices.

Why Certification Matters in Dental Billing

Dental billing and coding are not just clerical tasks — they’re specialized skills. Earning credentials like the Certified Dental Billing Specialist (CDBS) or Certified Dental Coder (CDC) shows you’re trained in best practices, compliance, and up-to-date coding systems.

Certification benefits:

• Boosts your credibility and job prospects
• Prepares you for audits and payer requirements
• Increases your earning potential

Already experienced? Validate your knowledge with the CDBS Exam or CDC Exam.

Conclusion: Master Dental Billing for Practice Success

Understanding dental billing — from insurance basics to coding accuracy and patient collections — is key to any successful dental practice in 2025.

Whether you’re managing a front office, working as a dental biller, or seeking career advancement, staying educated and certified will keep you ahead in this fast-evolving field.

Get trained, get certified, and join the nation’s top dental billing and coding professionals at the American Dental Coders Association.