The Ultimate Guide to Dental Billing: Streamline Your Practice and Maximize Revenue
Published by the American Dental Coders Association
Introduction
Dental billing is the backbone of a financially healthy dental practice. When done right, it ensures timely reimbursements, reduces claim denials, and improves patient satisfaction. This guide breaks down everything you need to know about dental billing—from foundational concepts to expert-level tips—to help your practice succeed.
Table of Contents
- What is Dental Billing?
- The Dental Billing Workflow
- Common Dental Billing Mistakes to Avoid
- Insurance Verification and Eligibility
- CDT Coding Basics
- Handling Denials and Appeals
- Tips to Increase Reimbursements
- Dental Billing Software Overview
- Getting Certified as a Dental Billing Specialist
- Learn More with ADCA Online Training
1. What is Dental Billing?
Dental billing is the process of submitting claims to insurance companies and ensuring timely payment for services rendered. It bridges the gap between clinical care and financial reimbursement.
- Submitting accurate claims using CDT codes
- Verifying insurance eligibility
- Posting payments and resolving unpaid claims
2. The Dental Billing Workflow
Understanding the billing workflow helps streamline the process and reduce administrative headaches.
- Patient registration: Collect accurate insurance info
- Insurance verification: Confirm coverage and limitations
- Treatment planning: Use proper CDT codes
- Claim submission: Submit to primary and secondary carriers
- Payment posting: Apply EOBs and resolve discrepancies
- Follow-up: Investigate unpaid or denied claims
3. Common Dental Billing Mistakes to Avoid
Billing errors lead to denials and delays. Avoid these common pitfalls:
- Incorrect CDT code usage
- Missing patient or provider information
- Failure to document procedures properly
- Submitting claims after the filing deadline
4. Insurance Verification and Eligibility
Insurance verification is critical before treatment is performed.
- Use real-time verification tools
- Confirm annual max, deductibles, and frequencies
- Obtain breakdowns for common procedures
5. CDT Coding Basics
Proper CDT coding is essential for reimbursement. Familiarize yourself with:
- Diagnostic codes (e.g., D0120 for periodic oral evaluation)
- Preventive services (e.g., D1110 for adult prophylaxis)
- Restorative codes (e.g., D2740 for crowns)
Stay current with CDT 2025 code updates to ensure accuracy.
6. Handling Denials and Appeals
A proactive approach to denials can recover lost revenue.
- Read the EOB carefully
- Correct errors and resubmit promptly
- Keep detailed documentation for appeals
7. Tips to Increase Reimbursements
- Bill for all completed procedures
- Educate your team on documentation standards
- Use billing software with integrated reporting
8. Dental Billing Software Overview
Top dental billing software can automate much of the process. Look for:
- Real-time eligibility checks
- Integrated CDT code libraries
- Denial tracking and analytics
- EHR and practice management system compatibility
9. Getting Certified as a Dental Billing Specialist
Formal certification increases job opportunities and billing accuracy. Enroll in the
Certified Dental Billing Specialist (CDBS) program to gain:
- Expert-level CDT knowledge
- Practical billing workflow training
- Nationally recognized certification
You can also expand your expertise through the
Certified Dental Coder (CDC) program.
10. Learn More with ADCA Online Training
The American Dental Coders Association offers comprehensive online training programs designed to prepare you for success in dental billing and coding. Whether you’re new to the field or advancing your career, ADCA provides the tools, training, and certification you need.
