Why Do Growing Practices Need Professional Dental Billing Partners?

Managing a practice’s dental billing is tough, especially when your practice is growing. Dental claims start piling up and managing heavy workload becomes challenging.

Your staff is overburdened with billing tasks. And if they aren’t able to focus, chances are that claim submissions can go wrong.

Result? A revenue loss of thousands of dollars which is unaffordable!

Plus, when you’re hiring new staff, you’re investing time and resources, which could’ve been utilized in offering quality care to your deserving patients.

The best solution in this case is to partner with industry experts. These experts offer professional dental billing services to get claims approved fast. 

Want to know how they work? Let’s explore.

Challenges in In-House Billing

In-house dental billing may sound great! You’ve your own staff, protocols, software, and control. Your billers manage your claims under your supervision, so you directly observe how your patient data is being handled and where your money is moving.

But it comes with its fair share of challenges.

Billing Expenditures

When your practice grows, you need to:

• Acquire billing software licenses
• Keep up with regular payer policy updates
• Train new hires
• Monitor compliance

Experts are hired to handle each of these tasks and charge you a great deal of money. The following team members manage these tasks:

• An IT expert to deploy and manage your dental billing software
• Three billers (one biller to train new hires and two billers to manage your claims)
• A compliance specialist to ensure billing complies with dental billing policies
• A credentialing expert to negotiate your contracts with insurance companies
• A billing analyst to review your billing and revenue performance

The table below explains average salaries per annum for each of these positions.

If you total it, the average annual salary expenses account for $3,28,509. Now, if your growing practice generates $1 million annually, 33% of it is dedicated to billing overhead.

And you’ve to manage the other costs of your practice in the remaining 67%, which includes:

• salaries for dental providers, hygienists, and front desk staff
• utility and rental charges for the facility
• dental practice supply costs for treatments

Even if you still manage to cover these costs in your annual revenue, it affects your practice profitability and slows down revenue growth.

Staff Shortage and Turnover

There is one major challenge which practices often encounter with in-house billing. And that’s unavailability of billing staff.

No matter how efficient and fast they are, human beings have a capacity to work and can get tired after submitting claims and managing claim denials throughout the day. 

Plus, your billing staff avails sick leaves or casual vacations to take time off. And if you don’t have backup to cover up for their absence, it disrupts your billing process.

Another staff-related issue is that when they resign from the job, you need trained billers who can manage these aspects easily. If you don’t have trained staff, it’s difficult to manage billing and insurance coordination.

Billing Compliance Issues

Dental billing policies are always subject to change, which means your staff must stay updated with the latest policies to maintain regulatory compliance, and ensure your claims are ready to submit.

Each dental insurance company like Delta Dental, Aetna, Cigna, and Humana, has its own policies for claim submissions, and insurers frequently change them with evolving technology and varying health conditions.

Furthermore, the American Dental Association (ADA) updates its CDT codes every year. It adds some codes, deletes codes no longer required, and modifies some existing codes. For example, in the latest 2026 update, ADA deleted all the COVID-19 related procedure codes, as they aren’t in use.

Another issue is with Medicaid and Medicare, which are state-run insurance plans with complex billing standards. Their reimbursement is low but they have a higher patient volume, which appeals to practices, so they don’t want to lose out on this revenue source.

With that, it becomes challenging for billers and a compliance specialist to keep up with multiple insurance policies and regulations, and implement them in billing processes.

High Claim Denial Ratio

Humans are prone to mistakes, but sometimes, mistakes can be very costly! 

When your billers manage multiple claims throughout the day, they get exhausted, which affects their productivity, and it can result in multiple manual errors such as:

• Missing details
• Using wrong CDT codes
• Attaching incomplete documents

As a result, insurance rejects your claims, which delays your payments and wastes your time and efforts spent in preparing and submitting a claim. 

It adds to the headache, as staff need to appeal for a denied claim, where they’ve to start the process all over again to correct the claim.

And these aren’t the results you expect and want when you’re spending a significant portion of your revenue on billing!

How Can Professional Billing Partners Help?

If you partner with professional dental billing partners, this helps with smooth claim submissions and faster reimbursements. And that’s how it works!

Lower Costs

Billing partners usually charge you very less than what you spend on billing in your practice. Their costs are easily affordable for a growing practice, which has just started scaling and isn’t profitable enough to manage billing overhead.

You save a lot with these partnerships! 

First, you reduce your overhead as you don’t have to pay any salaries or membership fees. don’t have to pay salaries or membership fees to these partners. Companies like TransDental set up their maximum fee at 4-5% of your total collections or even less if the claim recovery is huge.

Second, you don’t need to invest in any costly billing software. These companies have their internal systems, which easily integrate with your practice management software or electronic health records (EHR) system. 

All they need is your approval and access to these systems to get patient and insurance data, which they use to bill your claims.

The amount they charge is much lesser than the value of services these companies provide. It makes outsourcing your billing more profitable than billing in-house.

Smooth Insurance Credentialing

Insurance companies can change their criteria of in-network membership anytime through the year. And their membership expires after every 4-5 years.

These partners stay in touch with insurance companies, knowing their policies, and starting the re-credentialing process as soon as your ongoing membership is set to expire.

They also negotiate with insurance companies when you sign agreements with them, helping you secure considerable reimbursement rates, so you receive fair payments on each dental procedure.

Overall, professional billing partners may offer you credentialing as a complimentary service or charge you some additional fees. But, still, it’s a cost-effective option if you compare it to paying full-time salary to a credentialing specialist.

Uninterrupted Process

These billing partnerships smoothly fill the void left by staff turnovers or vacations. Billing companies employ many billers as it’s their daily job to work with multiple practices and manage numerous billing claims at a time.

Plus, smart companies leverage automation to assist their staff and speed up billing processes. By automating processes, billers perform time-taking tasks in seconds, which otherwise require days or even months to complete.

As a result, your insurance claim management continues. You don’t have to worry if your expert staff resigns and new staff isn’t expert enough to run things smoothly for your growing practice.

Easy Compliance

Your professional partners provide complete support and use their expertise when you need to comply with policies like:

• HIPAA to securely access and use Patient Health Information (PHI)
• ADA’s CDT code updates to learn coding changes and use accurate procedure codes
• Changing insurance rules for claim submissions, coding, and documentation requirements

These companies have dedicated teams, which keep an eye on changes in the laws, and update their billing patterns once changes come into effect.

The result is that you don’t have to worry about meeting regulatory standards when you choose a trusted partner to handle your billing aspects.

Accurate Processes

While your billing staff may make errors, billing partners follow all the protocols in dental billing and review the complete process very carefully.

Their ratio of billing errors is very less as compared to in-house billing.

Billing companies hire certified billing experts, who have spent years working in the industry, and dealing with multiple insurers and practices. 

They know the ins and outs of insurance billing requirements and ensure your claims are complete according to payer expectations. These billers:

• Verify patient data and insurance coverage details upfront
• Fill all the required and mandatory fields in claim forms
• Attach all the required documents and use appropriate CDT codes
• Scrub claims before submission to check and rectify errors
• Submit claims accurately

This accuracy in claim submissions reduces denials and improves net collection rate on dental claims.

Accountability in Errors

Your in-house billers may not accept responsibility for errors, but well-reputed companies live up to their claims and expectations. These companies are responsible if they ever commit a billing error, which causes claim denials and eventual payment delays or revenue losses.

Professional Claim Management

Professional billing partners manage all the aspects of your insurance claim with expertise. From submitting claims to tracking their progress, and requesting instant appeals on denials and underpayments, expert billers do that all. And they perform each task on time, so your practice doesn’t experience payment delays.

Conclusion

Choosing a dental billing partner is the best choice for a growing dental practice, as it’s difficult for a rising practice to invest in high-quality software, hire experienced billers, and manage a complete infrastructure. Outsourcing is the right solution as billing companies have expertise to support billing-related tasks and secure revenue recovery. They charge very less, allowing a practice to scale and improve the quality of care.