Dental Billing That Captures Every Dollar You Earn
From CDT coding and predeterminations to medical-dental cross-coding for oral surgery and sleep appliances — our dental RCM team turns clinical work into clean, fully-paid claims.
97.5%
Clean Claim Rate for Dental
2.4%
Write-off Rate
+19%
Avg Collections Lift
<35 Days
Average A/R Days
WHY DENTAL BILLING IS COMPLEX
The Dental Reimbursement Issues We Solve Daily
Dental practices leave significant revenue uncollected in cross-coding, predeterminations, and aging insurance A/R. These are the issues we resolve.
Medical-Dental Cross-Coding
Oral surgery, trauma, sleep apnea appliances, biopsies, and TMJ care are often billable to medical insurance at far higher reimbursement. We cross-code with CPT/ICD-10 and medical necessity narratives to capture it.
Predeterminations & Frequency Limits
Missed predeterminations and exceeded frequency limitations (cleanings, x-rays, perio) are top write-off causes. We verify benefits and submit predeterminations before treatment so patients and the practice aren't surprised.
PPO Fee Schedule Management
Every PPO contract has its own allowed fees, downgrades, and bundling rules. We load and maintain your fee schedules so claims post against the correct contracted amount and underpayments are caught.
Downgrades & Alternate Benefits
Composite-to-amalgam downgrades, LEAT clauses, and alternate-benefit provisions quietly reduce payments. We identify them, bill correctly, and balance-bill patients where contractually allowed.
Orthodontic & Phased Treatment Billing
Ortho banding, continuation claims, and lifetime maximums require precise installment billing across months. We manage the full ortho claim lifecycle so payments arrive on schedule.
Attachments & Narrative Documentation
Perio charting, x-rays, intraoral images, and narratives are required for crowns, SRP, and surgical codes. Missing attachments are a leading denial trigger we eliminate.
How Aethera Handles Dental Billing
Dental billing sits at the intersection of two coding systems — CDT and medical CPT/ICD-10 — and most practices only bill one of them. The result is uncollected cross-codable revenue, write-offs from missed predeterminations, and insurance A/R that ages past collectability.
Aethera assigns a dental-dedicated team that codes from your clinical notes, cross-codes to medical where it pays more, submits predeterminations and attachments proactively, and works your insurance aging every week — driving a 97.5% clean claim rate and a measurably lower write-off rate.
Specifically, we handle:
CDT (D-code) coding from clinical documentation
Medical-dental cross-coding (CPT/ICD-10) for oral surgery, trauma, sleep, TMJ
Insurance verification and benefit breakdowns before treatment
Predetermination submission and tracking
PPO fee schedule loading, downgrades, and alternate-benefit handling
Claim attachments (x-rays, perio charts, narratives, images)
Orthodontic banding and continuation/installment billing
Oral surgery and implant medical-necessity claims
Secondary and coordination-of-benefits claims
Insurance A/R follow-up and appeals
Patient billing, statements, and balance collection
Annual maximum and frequency-limit tracking
PROCEDURE CODES
Common Dental Codes We Bill
A sample of the CDT codes \u2014 and their common medical cross-codes \u2014 our team handles daily, each with payer-specific rules.
| CDT Code | Description |
|---|---|
| D0150 | Comprehensive oral evaluation, new or established patient |
| D1110 | Prophylaxis – adult cleaning |
| D2740 | Crown – porcelain/ceramic |
| D4341 | Periodontal scaling and root planing, 4+ teeth per quadrant |
| D7140 | Extraction, erupted tooth or exposed root |
| D6010 | Surgical placement of implant body, endosteal |
| D8080 | Comprehensive orthodontic treatment, adolescent |
| D9944 | Occlusal guard – hard appliance, full arch |
Group Dental Practice
This group was billing CDT only — never cross-coding oral surgery, implants, or sleep appliances to medical — and carried $190,000 in insurance A/R over 90 days from missing attachments and predeterminations.
Clean Claim Rate
88%
97.5%
A/R > 90 Days
$190K
$41K
Collections
Baseline
+19%
Write-offs
6.1%
2.4%
FAQ
Dental Billing Questions
Common questions from dentists and practice managers considering outsourcing their revenue cycle.
Do you do medical-dental cross-coding?
Yes — it's one of the biggest revenue opportunities we capture. Oral surgery, trauma, biopsies, implants, sleep apnea appliances, and TMJ care are frequently billable to medical insurance at higher reimbursement. We code them with CPT/ICD-10 and the required medical-necessity narratives.
Will you load and maintain our PPO fee schedules?
Yes. We load every contracted fee schedule, apply downgrades and alternate-benefit provisions correctly, and flag underpayments where a payer pays below your contracted amount.
Can you handle orthodontic installment billing?
Absolutely. We manage banding claims, monthly continuation claims, and lifetime-maximum tracking so ortho payments arrive on schedule across the full treatment plan.
Do you work our aging insurance A/R?
Every week. We work insurance aging, resubmit with missing attachments, file appeals, and escalate timely-filing risks before claims become uncollectable.
How quickly can you start?
Most dental practices are fully transitioned within 3–4 weeks, including PMS access, clearinghouse setup, fee-schedule loading, and parallel claim processing.
Ready to Collect Everything You Produce?
Start with a free dental billing assessment. We'll audit your cross-coding opportunities and aging A/R and show you exactly where revenue is being left behind.
Get Free Dental Assessment