Dental billing guides on denials, verification, AR, credentialing, coding, and revenue cycle management. Written by the team at PracticeAlpha.
A free dental insurance verification form and template: every field to capture before the visit, eligibility, maximums, frequencies, waiting period...
How Arkansas Medicaid dental billing works now: the state moved from managed care back to fee-for-service in 2024, billed directly to Medicaid.
How Iowa Medicaid dental billing works: the Dental Wellness Plan, now carried by Delta Dental of Iowa and DentaQuest (MCNA ended July 2026).
How Nevada Medicaid dental billing works: LIBERTY Dental Plan for managed care, fee-for-service elsewhere, and a $1,000 adult benefit.
How Missouri MO HealthNet dental billing works: managed-care dental via DentaQuest, Envolve, or UnitedHealthcare, and limited adult coverage.
How Georgia Medicaid dental billing works: CMOs plus DentaQuest for dental, and the 2025 adult benefit expansion. Enrollment, claims, denials.
How Maryland Medicaid dental billing works: the Healthy Smiles program, run by SKYGEN, now covers adults with no annual max. Enrollment, claims, de...
Michigan Medicaid dental for children runs through Healthy Kids Dental. Delta Dental of Michigan becomes the only HKD plan on October 1, 2026. Bill...
Outsourced dental billing for Detroit, MI practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim...
Outsourced dental billing for Michigan practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim so...
Ohio Medicaid dental runs through Next Generation managed care plans, with DentaQuest as the dental benefit manager. How billing and claims work in...
Outsourced dental billing for Columbus, OH practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim...
Outsourced dental billing for Ohio practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim so you...
Outsourced dental billing for Phoenix, AZ practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim...
Outsourced dental billing for Arizona practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim so y...
Outsourced dental billing for Charlotte, NC practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every clai...
Outsourced dental billing for North Carolina practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every cla...
Outsourced dental billing for Philadelphia, PA practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every c...
Outsourced dental billing for Pennsylvania practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every claim...
NY Medicaid dental runs through managed care plans like Healthfirst, Fidelis, and MetroPlusHealth, with DentaQuest behind several. The 2026 billing...
Outsourced dental billing for NYC (New York City) practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work ever...
Denti-Cal billing guide for 2026. How Medi-Cal dental claims flow, the managed care to fee-for-service shift, provider enrollment, TARs, and common...
Outsourced dental billing for Los Angeles, CA practices, from a team that actually knows your Medicaid MCOs and commercial payers. We work every cl...
Two plan managers, DentaQuest and MCNA: how to route claims, the adult limits, and Act 629.
The 2026 move to fee-for-service and the UUSOD adult requirement, explained for billers.
The NCTracks carve-out: why NC dental is billed fee-for-service, not through managed care plans.
Dual-track: DentaQuest fee-for-service vs HealthChoice managed care subcontractors (Molina uses Avesis).
Smiles For Children, administered by DentaQuest: enrollment, claims, adult coverage, and clean billing.
Health First Colorado and DentaQuest: the $3,000 adult benefit, enrollment, claims, and denials.
Claims addresses, payer IDs, and credentialing guides for every major dental payer in one place.
Why there is no single BCBS address, and how to route claims by the member's alpha prefix.
United Concordia claims address, the separate FFS and DHMO boxes, payer ID, and how to submit.
Principal dental claims: payer ID 61271, mailing address, email submission, and how to submit.
Ameritas dental claims address, clearinghouses, the no-X-ray fax line, and how to submit.
DentaQuest claims: payer ID CX014, mailing address, and why it varies by state Medicaid plan.
How the three big Medicaid dental MCOs compare on networks, portals, credentialing, and claims.
MetLife dental claims address, payer ID, fax, portal, and how to submit.
Guardian dental claims address, payer ID (GI813), and how to submit PPO and DHMO.
Cigna dental claims address, payer ID (62308), DPPO vs Dental Care, and how to submit.
Humana dental claims address, payer ID (73288), Availity, and how to submit.
Aetna dental claims address, payer ID (60054), and how to submit.
UHC dental claims address, payer ID (52133), DBP network, and how to submit.
Why there's no single Delta address, how to file to the patient's state Delta.
Anthem/Elevance dental claims, address by state, payer ID, and how to submit.
Sun Life dental claims address, payer ID (70408), and how to submit.
Honest comparison of dental revenue cycle management providers.
The verification companies compared, with who each fits.
Credentialing providers compared, honestly.
Multi-location billing providers compared for groups.
What CARC and RARC codes mean and what to do about each.
The buckets, the benchmarks, and how to work it weekly.
What each procedure needs so claims do not bounce.
The top denial reasons and how to prevent each one.
Why aged claims lose value and how to recover them.
What to confirm before the visit so claims do not get denied.
A field-by-field guide to the Explanation of Benefits.
The real timeline, the steps, and how to speed it up.
The metrics that show whether your revenue cycle is healthy.
When you have leverage and how to raise your fee schedule.
Which billing model fits a growing dental group.
The errors that quietly cost practices money, and the fixes.
Gross vs net, what is healthy, and how to improve it.
Revenue cycle management explained with an interactive health calculator. Check your practice metrics.
Coordination of benefits and the birthday rule, plus a tool to find which of your plans is primary.
Outsourced billing for Miami-Dade practices, from Brickell to Doral, with bilingual support and Florida Medicaid expertise.
The 2026 guide to the Florida Prepaid Dental Health Program: DentaQuest, Liberty Dental, and the post-MCNA two-plan setup.
Outsourced billing for Illinois practices: DentaQuest, All Kids, Molina, BCBS IL, and the Chicago DSO market.
Outsourced billing across Chicago, the suburbs, and collar counties, with Illinois Medicaid and DSO support.
Outsourced billing for Georgia practices: Georgia Families CMOs, DentaQuest, PeachCare for Kids, and the Atlanta market.
Outsourced billing across metro Atlanta, from Marietta to Gwinnett, with Georgia Medicaid and DSO expertise.
Outsourced dental billing for Texas practices: DentaQuest, MCNA, UHC Dental, Delta Dental of Texas, BCBSTX, and the DSO market.
Outsourced billing for Houston-area dental practices including Sugar Land, The Woodlands, Pearland, Katy, Cypress.
The 2026 guide to DentaQuest, MCNA, and UnitedHealthCare Dental for Texas Medicaid and CHIP billing.
Vendor-neutral comparison of Dentrix, Eaglesoft, Open Dental, Curve, Denticon and more.
How dental clearinghouses work, the major vendors compared, and what the Change Healthcare outage taught practices.
Keeping billing in-house on software versus outsourcing it: the true cost, control, and how to decide.
What fee-for-service means, how it compares to PPO, and what it means for billing.
What waiting periods are, typical lengths by procedure, and how to avoid or waive them.
How to appeal a denied claim: appeal vs resubmit, the letter, deadlines, and the levels of appeal.
How preventive care is usually covered at 100 percent, the two-per-year frequency limit, the fine print, and why cleanings still get denied.
How bitewings, panoramic, and full-mouth X-rays are covered, the frequency limits by type, and why an X-ray gets denied.
When nitrous, oral, and IV sedation are covered, why most plans call it elective, and when medical necessity changes it.
The restoration billed separately from the implant: the osseointegration timing rule, abutment bundling, and why these claims get denied.
The 50-80 percent coverage, basic vs major classification, cost with and without insurance, and the crown that follows.
The 50 percent coverage, waiting period, the 5-to-10-year replacement rule, and the missing tooth clause.
When dental covers a soft tissue graft for medically necessary recession, the threshold, and why medical won't pay.
Why buildups get denied and how to get them paid: the tooth-structure criteria, bundling, and the documentation that works.
How orthodontic coverage works: the lifetime maximum, the 50 percent share, age limits, waiting periods, and what you pay.
The major-service share, the waiting period, how core buildups and material limits work, and what you actually pay.
The 80 percent basic-service share, and why composite fillings get downgraded to the amalgam rate on back teeth.
The roughly 50 percent coverage, typical costs, and how the annual maximum and missing tooth clause limit it.
When dental pays for bruxism, when medical covers it for sleep apnea, why lab-direct guards aren't reimbursed.
Why coverage is limited, when medical may pay, how the missing tooth clause and annual maximum apply, and typical costs.
What each one is, when to use them, how long they take, and why a predetermination is an estimate, not a guarantee.
The 90-to-180-day deadlines, why timely filing denials turn into write-offs, and how to appeal them with proof of submission.
How deductibles, coinsurance, and copays work, what 100/80/50 means, and a clear example of what a patient actually pays.
Why SRP claims get denied and how to get them paid: the pocket-depth, radiograph, and charting documentation insurers require.
How to write a narrative that gets paid: the who-what-why formula, the vague phrases that trigger denials, and which claims need one.
How the annual maximum works, what counts against it, the 2026 minimum changes, rollover, and planning treatment around it.
How insurers set the allowed amount, the difference between UCR, MAC, and in-network fees, and where write-offs and balances come from.
How often plans cover cleanings, exams, and X-rays, why a cleaning gets denied for frequency, and how to time visits so nothing is uncovered.
Dual coverage explained: which plan is primary, the birthday rule for kids, billing secondary, and the COB errors that cause denials.
Why the plan pays less than you billed: the alternate benefit clause, composite-to-amalgam downgrades, and how to handle them.
Which plan pays for wisdom teeth removal, when it's medical vs dental, and how practices bill the surgical cases right.
Billing dental procedures to medical insurance: what qualifies, what documentation you need, and the revenue most practices miss.
D4910 vs D1110: when to bill each, whether you can alternate them, and how to stop maintenance denials and downgrades.
Why a plan won't cover that bridge or implant, which procedures it hits, and the exceptions.
The real differences in cost, networks, and flexibility, and which is better for your situation.
The true cost of each, the honest pros and cons, and a framework to decide.
When it makes sense, how the switch works, what it costs, and when to keep billing in-house.
How to evaluate a billing partner, with an honest checklist instead of a fake ranking.
Questions to ask, red flags, and the metrics that tell you if your biller is performing.
Florida Medicaid managed care, the local payer mix, and what FL practices should look for.
Dental support organizations explained: types, DSO vs DPO vs independent, pros and cons.