All About Dental Billing and Process of Billing

What is dental billing?

Dental billing is the process of billing for dental services and recording payments from dental benefit plans and patients. Insurance billing includes submitting and following up on claims; patient billing addresses the amount the patient owes. The American Dental Association’s guide to explanation of benefits statements distinguishes the amount paid by the plan from patient responsibility.

What is the difference between dental billing and medical billing?

Dental billing involves different claims submission processes, using different coding (CDT) vs. medical coding (CPT/ICD).  Medical billing also tends to have higher deductibles, need verification of benefits more often, and takes longer to get paid.

What is the process of billing?

The dental billing process starts with entering the patient data into the EHR (Electronic Health Records) system—this includes the treatment, coding, and insurance.  Then the claim can be submitted, and typically involves consistent follow-up, and on the rare cases appealing denials.  Patients are then billed and payments are posted in the EHR, with the billing company keeping the provider up to speed with monthly collections reports.

Why is dental billing important?

Without dental billing, providers cannot be compensated by insurance companies for their work.

What is the best way to bill a client?

The best way to bill a client is to send patient statements periodically through the EHR system, for the client to pay electronically.

What information is needed for billing?

The information needed for billing is patient demographics, treatment, coding, and insurance information.

Also Read: 10 Reasons Why Your Dental Insurance Claims Will Get Denied

What details to include in billing?

Dental billing details should include the correct CDT coding, clinical notes, treatment performed, and diagnostic information.

Using the ADA Dental Claim Form instructions

The ADA Dental Claim Form provides a common format for reporting dental services to a patient’s dental benefit plan. The ADA publishes completion instructions for the form and supplementary guidance for reporting procedure-specific details.

For example, its oral-cavity and tooth-anatomy supplement identifies, by CDT code, when to report the area of the oral cavity, tooth numbers or tooth surfaces in claim-form items 25, 27 and 28. Consult the ADA Dental Claim Form and completion instructions for the applicable fields rather than assuming every procedure needs the same anatomical details.

Explore our dental insurance billing services for claims follow-up, payment posting and accounts receivable support. Contact eDental Billing to discuss your practice’s billing needs.

Comparing billing providers? Use our questions to ask a dental billing company to organize your discussion.