Master dental billing optimization across all service categories—preventive (15-25% revenue), basic (40-60% revenue), and major services (20-40% revenue). Unlock $450,000-$1,800,000+ annual revenue potential through systematic optimization, AI-powered automation, and complete insurance compliance.
Preventive services generate 15-25% of practice revenue with 100% insurance coverage. Yet 70-80% of practices perform manual billing, losing $50,000-$200,000+ annually. Systematic optimization captures 100% of preventive benefits while improving patient compliance.
Adult and child cleaning services. Most common preventive service generating $75-$150 per cleaning with 2-4x annual frequency.
Routine examinations for established patients. Fee $50-$100 with 100% coverage, typical 2-4x annual frequency.
Full mouth series ($50-$150), bitewings ($30-$75), periapical imaging ($10-$25). Essential diagnostic tools with flexible frequency.
Therapeutic applications $20-$50 with coverage that varies significantly by plan and age. Pediatric focus delivers highest value.
Resin sealants $20-$40 per tooth for decay prevention. Age-limited pediatric service with high value when properly optimized.
Therapeutic cleaning for periodontal patients. $150-$250 per cleaning with 4x annual frequency vs. 2x for prophylaxis.
Basic services represent 40-60% of practice revenue with 70-80% insurance coverage. Most practices lose $100,000-$400,000+ annually from inadequate coding accuracy, improper coverage application, and documentation deficiencies.
Non-surgical erupted tooth removal. Fee $75-$150. Straightforward extraction without surgical intervention.
Impacted tooth removal. Soft tissue ($150-$250), partially bony ($200-$300), completely bony ($250-$400+). Requires pre-authorization.
D3310 (anterior/premolar) $400-$700, D3320 (molar) $600-$800+. Medical necessity documentation critical. Pre-authorization often required.
Tooth reinforcement after RCT. Fee $150-$300. Critical complexity: bundling rules vary by payer. Some bundle with RCT, others allow separate billing.
D4341 (4+ teeth) $100-$200, D4342 (1-3 teeth) $75-$150 per quadrant. Medical necessity documentation and frequency limits critical.
Major services represent 20-40% of practice revenue with highest-value procedures. Most practices lose $200,000-$800,000+ annually through inadequate coding, missing pre-authorizations, and alternate benefit denials.
Full crowns (D2740-D2790), three-quarter crowns, fixed bridges. Typically 50% major coverage, high-value procedures $800-$4,000+. Material selection affects reimbursement by $200-$500.
Surgical placement (D6010), restorations (D6064-D6066), abutments. Often NOT covered or 50% if covered. Highest-value procedures $2,000-$6,000 per implant. Alternate benefit issues common.
Complete dentures (D5110-D5140), partial dentures (D5210-D5221), relines and adjustments. Typically 50% major coverage with 5-10 year replacement cycles.
Resin veneers (D2920), porcelain veneers (D2930-D2940). Often NOT covered (cosmetic exclusion) or 50% if deemed functional. High patient cost typically.
Comprehensive treatment (D8010-D8040). Often NOT covered or age-limited (pediatric only). Lifetime maximum common ($1,500-$2,500). Treatment cost $3,000-$8,000+.
CDT (Current Dental Terminology) codes form the universal language of dental billing. 800+ active codes maintained by the American Dental Association with annual updates. Coding errors account for 25-30% of all claim denials—entirely preventable through systematic accuracy protocols.
Advanced AI engines handle preventive optimization, basic coding accuracy, major service management, and comprehensive CDT coding mastery. Proprietary systems unavailable elsewhere deliver 95%+ automation and 98%+ clean claim rates.
Reviews patient coverage, identifies frequency limits, calculates optimal visit schedule, triggers patient reminders. Improves compliance 40-60%, increases preventive revenue 200%-500%+. Cost $1,200-$1,800/month. ROI: 1,400%-6,900%.
Verifies patient age, selects adult vs. child codes (D1110 vs. D1120), applies payer-specific rules. Prevents age-based denials. Cost $900-$1,400/month. ROI: 640%-3,200%.
Reviews service history, identifies last service date, verifies insurance frequency rules, blocks non-compliant claims before submission. Cost $1,100-$1,600/month. ROI: 780%-4,450%.
Queries insurance databases in real-time, confirms 100% preventive coverage, identifies frequency limits, updates automatically with plan changes. Cost $1,300-$1,900/month. ROI: 950%-4,500%.
Reviews preventive claims for documentation completeness, identifies gaps, recommends enhancements. Prevents documentation-based denials. Cost $1,000-$1,500/month. ROI: 670%-2,900%.
Identifies procedure type, analyzes tooth surfaces, determines location (anterior vs. molar), selects correct code from 800+ CDT options. Prevents surface counting and material selection errors. Cost $1,200-$1,800/month. ROI: 1,400%-8,200%.
Reviews clinical documentation, assesses adequacy against insurance requirements, identifies gaps, recommends enhancements. Prevents medical necessity denials. Cost $1,400-$2,000/month. ROI: 1,250%-7,000%.
Identifies pre-authorization requirements, files before treatment, obtains authorization numbers, tracks expiration dates, references on claims. Prevents pre-auth denials. Cost $1,100-$1,600/month. ROI: 850%-4,200%.
Tracks deductible status, calculates coinsurance accurately, determines patient responsibility. Prevents billing disputes and improves collections. Cost $800-$1,200/month. ROI: 750%-3,500%.
Identifies crown material (ceramic vs. PFM vs. cast metal), selects correct code, applies payer rules. Each material error costs $200-$500. Cost $1,300-$1,900/month. ROI: 1,200%-6,500%.
Identifies alternate benefit situations (implant denials, downcoded services), manages downcode appeals, documents justification for original treatment. Prevents alternate benefit revenue loss. Cost $1,500-$2,100/month. ROI: 1,400%-7,200%.
Tracks annual maximum utilization by patient, identifies remaining benefits, optimizes treatment timing for maximum coverage. Coordinates major procedures for optimal benefit capture. Cost $1,000-$1,500/month. ROI: 900%-4,100%.
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