Frequently Asked Questions

Dental billing is the process of submitting and following up on insurance claims to receive payment for dental services. Outsourcing to MedsDental frees your staff from complex billing tasks, reduces claim errors, accelerates reimbursements, and typically increases your collections rate — all while letting your team focus entirely on patient care.

MedsDental submits claims within 24 hours of receiving complete treatment documentation. Our streamlined workflow minimizes delays between the point of service and claim submission, helping your practice get paid faster.

Our denial management team reviews every rejected claim, identifies the root cause, corrects errors, and resubmits promptly. We also track denial trends to proactively prevent recurring issues and provide detailed reporting so you always know where your revenue stands.

We work with most major dental practice management systems including Dentrix, Eaglesoft, Open Dental, Curve Dental, and others. Our team adapts to your existing workflow — you don't need to change your software.

Absolutely. MedsDental is fully HIPAA-compliant. We use encrypted data transmission, strict access controls, and regular security audits to ensure your patient information and financial data are always protected.

Dental credentialing is the process of verifying a dental provider's qualifications — education, training, licenses, and experience — and enrolling them with insurance networks. Without proper credentialing, a dentist cannot bill insurers and will not receive reimbursement for services rendered.

Credentialing timelines vary by insurance carrier, but typically range from 60 to 120 days. MedsDental proactively follows up with payers and submits complete, accurate applications to avoid unnecessary delays. We keep you informed at every milestone.

Typical documents include state dental license, DEA certificate, NPI numbers (Type 1 and 2), malpractice insurance certificate, W-9, CAQH profile, and diplomas or specialty board certifications. MedsDental provides a complete checklist and assists with gathering every required document.

Yes. Most insurers require re-credentialing every two to three years. MedsDental tracks all expiration dates, sends timely reminders, and manages the entire renewal process so your in-network status never lapses and your revenue stream remains uninterrupted.

A lapse in credentialing can result in claim denials and loss of in-network status, meaning patients may have to pay out-of-pocket or choose another provider. MedsDental monitors all renewal windows and proactively initiates the process well before expiration to prevent any disruption.

Dental coding is the process of translating dental procedures and diagnoses into standardized CDT (Current Dental Terminology) codes used by insurance companies to process claims. Accurate coding ensures your practice is reimbursed correctly for every procedure performed.

Incorrect coding leads to claim denials, delayed payments, underpayments, or in serious cases, allegations of fraud. It can also trigger insurance audits. MedsDental's certified coding specialists review every claim to ensure codes are precise, complete, and compliant with current CDT guidelines.

Yes. Our team handles coding for all dental specialties including general dentistry, orthodontics, oral surgery, periodontics, endodontics, prosthodontics, and pediatric dentistry, ensuring specialty-specific nuances are accurately captured in every claim.

Signs include a high claim denial rate, frequent underpayments, or recurring adjustments on your EOBs. MedsDental offers a complimentary coding review that identifies missed procedures, unbundled codes, and documentation gaps, often recovering significant revenue for practices.

The ADA updates CDT codes annually, typically effective January 1st of each year. MedsDental stays current with every code cycle and trains our coding team accordingly, so your claims always reflect the latest compliant codes.

Dental insurance verification is the process of confirming a patient's active coverage, plan details, deductibles, co-pays, and covered benefits before the appointment. This ensures your practice bills accurately and patients understand their financial responsibility upfront.

Verification should occur at least 48 to 72 hours before each scheduled appointment, and again at the start of each benefit year. MedsDental completes verification for your appointment schedule in advance, so your front desk never starts the day without confirmed coverage information.

We collect active eligibility status, plan type, group and member ID, deductible (annual and remaining), co-pay and co-insurance amounts, covered procedures and exclusions, waiting periods, frequency limitations, and maximum benefit amounts, everything your billing team needs to submit a clean claim.

Yes. We verify benefits across all major dental insurance carriers including Delta Dental, Cigna, Aetna, MetLife, Guardian, United Concordia, Humana, and hundreds of regional plans. Our team contacts payers directly when electronic verification is unavailable.

The majority of claim denials stem from eligibility issues, invalid coverage, or missing plan details. By verifying benefits before every appointment, MedsDental ensures your claims are submitted with accurate information, dramatically reducing the risk of denial at the payer level.

A dental practice audit is a comprehensive review of your billing records, coding accuracy, claims history, and compliance procedures. The goal is to identify revenue leakage, coding errors, compliance risks, and opportunities to improve your overall financial performance.

Best practice recommends a thorough billing and coding audit at least once per year, with quarterly spot-checks if your practice processes high claim volumes. Regular audits protect you from payer audits, help recover underpaid claims, and ensure ongoing compliance.

Our audit covers a review of your fee schedules, a sample of clinical notes versus billed codes, payment posting accuracy, adjustment analysis, payer contract compliance, and documentation integrity. We deliver a detailed findings report with actionable recommendations and a prioritized remediation plan.

Yes. MedsDental's audit frequently uncovers underpaid or incorrectly adjusted claims that are still within the payer's appeal window. We identify these opportunities and pursue recovery on your behalf, often recovering thousands of dollars for practices within the first audit cycle.

No. MedsDental conducts audits remotely using secure data access or file transfers. We work around your schedule and require minimal time from your staff, typically just an initial setup call and access to the relevant records or reports.

After insurance processes a claim, MedsDental calculates the patient's remaining balance, generates accurate patient statements, and manages follow-up communication through friendly, professional reminders via mail, email, or text, maximizing collections without straining the patient relationship.

MedsDental supports online payments, credit/debit card processing, payment plans, and check/ACH payments. We can also assist in setting up patient payment portals through compatible practice management software, making it easier for patients to pay promptly.

We use a multi-channel approach: clear itemized paper statements, email notifications, and SMS reminders based on patient preferences. All communications are professional, HIPAA-compliant, and designed to encourage timely payment while preserving a positive patient experience.

Yes. By verifying benefits and presenting accurate cost estimates upfront, we set clear financial expectations before treatment begins. Combined with systematic follow-up and flexible payment options, this significantly reduces the number of accounts that become bad debt.

MedsDental focuses on proactive, patient-friendly early-stage collections. For accounts that require escalated collections, we can coordinate referrals to reputable third-party agencies while maintaining compliance and protecting your practice's reputation.