Specialized Healthcare Billing for Dentists, Orthodontists & Oral Surgeons - Scriptem
Dental and orthodontic practices face unique Healthcare Billing challenges that general medical billers simply don’t understand—from complex CDT codes and PPO fee schedules to orthodontic treatment plans spanning years. Scriptem provides expert Healthcare Billing tailored for general dentists, pediatric dentistry, orthodontists, oral surgeons, and periodontists, ensuring maximum reimbursements for crowns, braces, extractions, implants, and sedation services.
Whether you’re filing Delta Dental PPO claims in Texas, negotiating orthodontic contracts in California, or handling oral surgery prior authorizations in New York, Scriptem’s dental Healthcare Billing delivers 96% clean claims, 25-day payment cycles, and 30% average revenue recovery from denials. We bridge medical and dental insurance seamlessly for TMD treatment, implants, and hospital-based oral surgery.
Common Healthcare Billing Challenges for Dental & Orthodontic Practices
Dental offices lose 20-25% of potential revenue to Healthcare Billing errors every year. Here are the top challenges Scriptem solves daily:
1. CDT Coding Errors & PPO Claim Denials
The Challenge: 22-28% denial rates on crowns (D2740), root canals (D3330), and bridges because Delta Dental, Aetna Dental, and Cigna reject incorrect material descriptions, quadrant errors, or missing radiographs. Orthodontic codes like D8080 (comprehensive ortho) denied for incomplete treatment plans or missing diagnostic records. General dentists struggle with periodontal scaling/root planing (D4341/D4342) documentation.
Our Healthcare Billing Solution: Dental billing specialists trained in 2026 CDT updates review every claim pre-submission, verifying quadrant designators, X-ray attachments, narrative documentation, and PPO fee schedules. We code implants (D6010), surgical extractions (D7210), and bone grafts with precision. A Texas general dentistry practice reduced denials from 25% to 3%, recovering $75K through Scriptem’s Healthcare Billing expertise.
2. Orthodontic Contract & Lifetime Maximum Issues
The Challenge: Orthodontists face payment delays when insurers apply incorrect lifetime maximums ($3,000-$5,000 typical) to multi-year braces treatment (D8080/D8090). Bands, wires, and retainers (D8090) denied as “non-covered” despite contracts. Pre-treatment orthopantomogram (D0330) and cephalometric (D0340) requirements trip claims.
Our Healthcare Billing Solution: Scriptem verifies orthodontic benefits pre-treatment, negotiates payment plans with lifetime maximums, and appeals non-covered determinations with diagnostic imaging and treatment forecasts. We maximize banding (D2330-D2394) and expansion appliance reimbursement. California orthodontic practice collected 98% of contracted rates ($120K additional revenue) after Scriptem fixed their contract management.
3. Medical vs. Dental Insurance Coordination for Implants & Oral Surgery
The Challenge: Dental implants (D6010-D6199), sinus lifts (D7950), and hospital-based oral surgery billed incorrectly to medical insurance. Medical payers reject without D0364 cone beam CT documentation or prior authorization. TMD appliances (D7880) and sleep apnea devices denied for missing sleep study referrals.
Our Healthcare Billing Solution: Cross-trained medical/dental coders determine primary payer correctly, filing medical claims first with CBCT imaging and ENT referrals. We secure prior auth for hospital extractions (D9215) and sedation (D9223). New York oral surgeon recovered $95K from medical payers for implant surgeries Scriptem properly routed.
4. Accounts Receivable Aging from PPO Negotiations & Adjustments
The Challenge: PPO reimbursement rates 40-60% below dentist’s full fee schedule create patient balance headaches. Delta Premier and MetLife claims age 60+ days waiting for Explanation of Benefits (EOB) matching. Periodontal maintenance (D4910) denied as “non-covered” despite active perio contracts.
Our Healthcare Billing Solution: Automated EOB reconciliation matches payments to contracts instantly. We negotiate PPO fee schedule uplifts and appeal underpayments. Scriptem’s AR team collects 92% of aged dental claims within 45 days. Texas perio practice cleared $150K backlog through systematic PPO appeals.
5. Prior Authorization Delays for High-Cost Procedures
The Challenge: Crowns (D2740), implants, orthognathic surgery, and sedation dentistry require prior auth that delays treatment 4-6 weeks. Missing clinical documentation (periapicals, bitewings) causes automatic rejections.
Our Healthcare Billing Solution: Electronic prior auth submission with clinical charts, radiographs, and treatment rationale achieves 95% approval rates. We expedite urgent sedation and surgical cases. Nationwide dental practices save months on complex treatment starts.
Why Scriptem Leads Dental & Orthodontic Healthcare Billing
CDT Mastery: 2026 code updates, quadrant precision, PPO fee schedule expertise
Dual Medical/Dental Billing: Implants, TMD, oral surgery medical coverage maximization
Orthodontic Specialization: Lifetime maximum navigation, multi-year treatment plans
Nationwide PPO Networks: Delta Dental, Aetna, Cigna, MetLife contract optimization
Real-Time Dashboards: Track claims, AR, production by procedure and doctor
“Scriptem unlocked 30% more revenue from our PPO contracts—orthodontic billing finally works.” – Dr. Sarah L.
Transform Your Dental Practice Revenue Today
Contact Scriptem for your free dental Healthcare Billing audit and discover lost revenue hiding in PPO denials, implant medical claims, and orthodontic underpayments. North America’s dental and orthodontic billing specialists serving practices coast-to-coast.
Frequently Asked Questions About Dental & Orthodontic Healthcare Billing
1. How does Scriptem handle complex PPO fee schedule negotiations?
We audit every PPO contract quarterly, identifying underpayments and negotiating rate uplifts. Most dental practices recover 12-18% additional revenue from existing contracts.
2. Can you bill medical insurance for dental implants and oral surgery?
Absolutely. Cross-trained coders determine medical necessity and primary payer status, filing medical claims first with CBCT documentation and prior authorization for 85% higher reimbursements.
3. What makes your orthodontic billing different?
Lifetime maximum optimization, diagnostic imaging bundling (D0330/D0340), and multi-year payment plan appeals ensure orthodontists collect 98% of contracted rates vs. industry 78%.
4. How quickly do you resolve aged dental accounts receivable?
Free AR audit identifies recoverable claims. We collect 92% of 90+ day dental AR within 45 days through PPO appeals, EOB reconciliation, and patient balance management.
5. Do you support popular dental practice management software?
Full integration with Dentrix, Eaglesoft, Open Dental, and Curve for automated charge posting, insurance tracking, and production reporting.