Dental billing pricing should match the work being performed, the volume flowing through your practice, and the level of revenue-cycle accountability you want from your billing partner.
Flat monthly
A predictable monthly fee for a clearly defined scope, such as insurance verification, payment posting, patient statements, or AR follow-up. This model works best when your volume is steady and the responsibilities are easy to define.
Best for stable appointment and claim volume
Simple budgeting for office managers and owners
Scope should list included tasks, exclusions, and KPIs
Per claim / per verification
A unit-based fee tied to the number of claims, eligibility checks, or other transactions processed. This can fit growing practices, startups, seasonal offices, or groups that want outsourced help without a full monthly commitment.
Scales up or down with production volume
Useful when workload changes by provider or location
Confirm what counts as a billable unit
Percentage of collections
A fee based on collections is most common when a partner manages more of the revenue cycle, such as clean claim submission, AR follow-up, denials, posting, and patient balance workflows. The agreement should define which collections are included.
Often used for full-cycle billing support
Can align incentives when KPIs are transparent
Requires clear reporting on collections, adjustments, and aging
What affects the quote
Scoping factors
A reliable quote starts with operational facts, not a one-size-fits-all rate. Before comparing proposals, make sure each vendor is pricing the same scope.
Monthly claim, appointment, and verification volume
Payer mix, including PPO, DHMO, Medicaid, Medicare Advantage, commercial medical plans, and out-of-network workflows
Services selected, such as eligibility, pre-authorizations, claims, AR, denials, posting, credentialing, or patient statements
Specialties and billing complexity, including orthodontics, oral surgery, implants, sleep apnea oral appliances, teledentistry, or dental-to-medical billing
Starting AR position, because aged AR clean-up projects are usually scoped separately from ongoing billing
Number of locations, providers, tax IDs, fee schedules, and practice management systems
Documentation quality, coding support needed, and whether medical codes such as CPT, HCPCS, and ICD-10-CM are part of the workflow
Reporting expectations, including KPIs for clean claims, denial trends, days in AR, aging buckets, collections, and follow-up activity
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