What Is Dental Billing? A Complete Guide for Patients and Practices

Did you know that according to the American Dental Association, dental billing errors contribute to nearly $7 billion in claim denials every year in the United States? For both dental offices and patients, understanding what is dental billing can make a huge difference in receiving timely payments and avoiding unnecessary stress.

In this comprehensive guide, we’ll break down what dental billing is, how it works, who handles it, and why it matters for your dental practice’s bottom line and your peace of mind.

What Is Dental Billing?

At its core, dental billing is the administrative process of submitting and following up on claims submissions with insurance companies to receive payment for dental procedures provided to patients. It ensures that dental practices get paid accurately and patients aren’t overcharged.

The dental billing process covers everything from coding systems like CDT codes, verifying patient medical insurance, processing explanation of benefits (EOB), to addressing denied claims and ensuring proper payment posting.

Understanding the Dental Billing Process Cycle

The dental billing process typically follows a cycle of carefully coordinated steps:

1. Patient registration & insurance verification:

Before treatment, dental staff confirm insurance coverage and collect necessary details.

2. Treatment planning & coding:

Providers document procedures and translate them into CDT codes for claims.

3. Claims submissions:

Claims are sent electronically or by mail to the patient’s insurance provider.

4. Claims processing:

The insurer reviews claims and sends back an EOB outlining what’s covered and what isn’t.

5. Payment posting:

The dental office applies payments to patient accounts and bills the patient for any remaining balance.

6. Follow-up & appeals:

If a claim is denied, billers follow up or file appeals to ensure payment is received.

This cycle repeats with each patient visit, requiring accuracy and up-to-date knowledge of billing rules and guidelines.

Who Handles Dental Billing?

Dental billing is a specialized task handled by trained administrative staff known as dental billers or billing coordinators. Larger dental practices may have an entire billing department, while smaller clinics often rely on a front desk team member who multitasks as a receptionist and biller.

Dental billers must be skilled in using coding systems, understanding insurance policies, communicating with patients about financial responsibilities, and staying up to date with industry guidelines. They play a critical role in the overall financial health of a practice.

Some responsibilities of a dental biller include:

• Checking patient eligibility before procedures.
  
  
• Gathering and entering accurate treatment details.
  
  
• Applying the correct CDT codes to services.
  
  
• Managing claims submissions and ensuring timely filing.
  
  
• Handling rejected or denied claims by appealing and resubmitting.
  
  
• Coordinating patient payment plans and following up on outstanding balances.
  
  

Strong dental billing skills help maintain steady cash flow, reduce errors, and build trust with patients who expect transparent billing.

The Basics of Dental Billing Everyone Should Know

The simplest way to explain the process of dental billing would be this:

Dentists perform procedures → Billers code the work → Claims go to insurance → Insurance pays the office → The patient covers the rest.

Sounds simple, but it requires trained staff and clear communication between the dental office, insurance companies, and patients.

Dental Billing Examples You Should Know

To make this clearer, here are a few examples of dental billings

• Routine cleaning: A patient comes for a cleaning. The front desk verifies coverage and submits the claim using the appropriate CDT codes. The insurer pays 100% if it’s preventive care, and any unpaid portion is billed to the patient.
  
  
• Root canal treatment: A more complex procedure requires pre-authorization. The biller ensures all paperwork is in place, submits the claim, and follows up on payment and denied claims if needed.
  
  

These examples highlight how dental billing helps both patients and dental practices stay on the same page financially.

Outsourcing vs. In-House Dental Billing

One major decision dental practices face is whether to handle billing in-house or partner with an external dental billing company.

In-house dental billing means hiring and training your own staff to manage the entire process. This gives you direct control but requires investment in training and technology. Practices with dedicated staff often prefer this model because it can offer more immediate communication with patients.

On the other hand, outsourced dental billing involves partnering with a professional billing service that handles claims processing, appeals, and payment tracking on your behalf. This is increasingly popular because:

• It frees up your in-house team to focus on patient care.
  
  
• You benefit from billing specialists who stay current with changing rules and insurance policies.
  
  
• It can reduce claim errors and speed up payment turnaround times.
  
  

However, outsourcing requires finding a trusted partner with a solid reputation and clear security protocols to protect patient data. Many practices use a hybrid approach, managing simple claims in-house and outsourcing complex or overflow work.

Common Dental Billing Mistakes to Avoid

Even experienced dental offices make billing mistakes that cost time and money. Here are a few common pitfalls and how to avoid them:

Incorrect patient information: Simple errors in names, dates of birth, or insurance IDs can result in claim denials. Double-check all patient data before submitting claims.

Missing or wrong CDT codes: Using outdated or incorrect codes confuses insurance companies. Always stay current with coding updates.

Failure to verify insurance: Assuming a patient has coverage can backfire if the plan changed or expired. Verify eligibility before every visit.

Late claims submissions: Many insurers have strict filing deadlines. Submitting claims late can mean forfeiting payment altogether.

Poor documentation: Vague treatment notes make it harder to justify claims during audits or appeals. Keep detailed, clear records for each procedure.

Neglecting follow-up: A denied claim shouldn’t end there, always appeal if you believe the claim is valid. Persistent follow-up can recover thousands in revenue.

By avoiding these mistakes, your practice stays financially healthy and patients remain satisfied with clear, accurate bills.

Dental Billing Jobs: A Growing Career Path

With more practices looking to streamline their revenue cycles, dental billing jobs are in high demand. These roles typically involve:

• Verifying insurance benefits
  
  
• Preparing and submitting claims
  
  
• Managing patient accounts and payments
  
  
• Following up on unpaid or denied claims
  
  
• Working closely with dentists and front office staff
  
  

For those interested in healthcare administration, it’s a stable career with good growth prospects.

Dental Billing Guidelines Every Practice Should Follow

Whether you handle billing in-house or use a billing service, these guidelines help keep operations smooth:

• Always verify insurance before treatment.
• Use the correct coding systems and double-check for accuracy.
• Submit claims promptly.
• Track claims processing closely.
• Educate patients about their coverage and financial responsibilities upfront.

Following these best practices prevents costly mistakes and improves cash flow for dental practices.

Is Dental Billing the Same as Medical Billing?

And the answer is no. While both involve insurance claims, medical billing typically uses CPT codes, while dental billing relies on CDT codes. Coverage policies and claim submission processes also differ.

Get Expert Help with Your Dental Billing and Grow your Practice

Knowing what is dental billing is just the first step. Managing it effectively requires time, skill, and constant updates on industry changes.

If you’re a dental practice owner or manager looking to simplify your billing and maximize revenue, Dr. Nate Schott and his experienced team can help. Explore our dental services to see how we can support your practice with professional, hassle-free billing solutions—so you can focus on what matters most: caring for your patients.