What to look for in a dental billing company. And what to run from.

They should work inside your software, not their own. If a billing company requires you to switch practice management systems or submit claims through their proprietary portal, that's a dependency you don't want. The best billing companies log into your Dentrix, Eaglesoft, Open Dental, Curve, or Denticon and work directly in your system. Your data stays in your control. If you ever leave, nothing is locked in their platform.

They should give you a dedicated team, not a rotating pool. Your billing gets better when the same people work your accounts every day. They learn your payer mix, your provider preferences, your common procedures. A rotating call-center model where a different person touches your claims each day means nobody knows your practice. Ask who will be working on your account and whether they'll be consistent.

They should report monthly with real numbers. Collection rate, days in AR, denial rate by payer, aging breakdown by bucket. If the billing company doesn't give you these numbers proactively every month, they're not tracking them. And if they're not tracking them, they're not managing your revenue cycle. They're just submitting claims.

They should have no long-term contracts. A billing company that locks you into a 12 or 24-month contract is protecting themselves, not you. If they're performing well, you'll stay. If they're not, you should be able to leave. Month-to-month arrangements force the billing company to earn your business every month. That's the incentive structure you want.

They should understand dental, not just billing. Medical billing companies that "also do dental" usually don't understand CDT codes, dental payer behavior, or the specific workflows of a dental practice. Look for a company that works exclusively or primarily with dental practices. Ask about their experience with your specific payer mix.

They guarantee a specific collection rate before seeing your numbers. Anyone promising "98% collection rate" without looking at your aging report, payer mix, and current processes is selling, not assessing. Collection rate improvement depends on where you start. A practice at 92% has different potential than one at 78%.

They want you to use their software. That locks you in. Your data lives in their system. If you leave, you lose access to your billing history or have to migrate everything. A billing company should work inside the system you already own.

They can't explain their pricing. Percentage of collections is standard, but the percentage should be clear and the scope of services it covers should be defined. If the pricing conversation is vague, the invoice will be confusing.

They don't ask about your practice during the sales process. A billing company that pitches you without asking about your current challenges, payer mix, volume, and what's not working is selling a generic service. Your billing is specific to your practice. The solution should be too.

They have no dental-specific experience. "We do medical and dental" is not the same as "we specialize in dental." CDT codes, dental payer behavior, frequency limitations, downgrade policies. These are dental-specific issues that general medical billing companies handle poorly.

Once you've hired a billing company, these are the metrics that tell you if they're doing their job.

Adjusted net collection rate should be 95%+ within 90 days. If your collection rate isn't improving within the first quarter, something isn't working. Either they're not following up on aging claims, not catching denials, or not posting payments accurately.

Days in AR should trend down every month. Not a dramatic drop overnight, but a steady decline. If days in AR is flat or increasing, claims aren't being worked with the right urgency.

90+ day AR should shrink as a percentage of total AR. This is the bucket where money goes to die. A good billing company attacks the 90+ day bucket first because those claims are closest to aging out entirely.

Denial rate should decrease over time. Denials happen. But the same denial happening repeatedly means nobody is fixing the root cause. A billing company tracking denial patterns will identify why claims are getting denied and address the issue upstream.

You should receive reports without asking. If you have to request your own billing reports, that's a problem. Monthly reporting should be automatic and include every metric listed above.