Every stage of dental RCM, one accountable team
Choose the full cycle or start with the stage that hurts most. Each service below is shown with a situation we see regularly.
Insurance verification
We confirm each patient's coverage before the appointment, so your team knows what insurance will pay before treatment starts and there are no surprises at checkout.
What's included
- Eligibility and active-coverage checks before scheduled visits
- Benefit breakdowns: deductibles, annual maximums, coinsurance and remaining benefits
- Frequency limits, waiting periods, missing-tooth clauses and downgrades
- Coordination of benefits for patients covered by more than one plan
- Pre-treatment estimates and pre-authorizations where the payer requires them
- Alerts when a patient's plan has changed or terminated
A patient's plan changed in January. We caught it the day before the visit, and the front desk updated the policy.
Claims & coding
We prepare and submit clean claims with accurate CDT coding and the documentation each payer expects, so more claims are paid on the first submission.
What's included
- CDT code review against clinical notes and payer rules
- Attachments: x-rays, perio charting, intraoral photos and narratives
- Claim checks before submission to catch errors and missing information
- Electronic submission through your clearinghouse
- Timely filing tracking, so no claim misses its deadline
- Secondary claims once the primary payer has processed
A claim was going out without a required narrative. We added it before submission.
Denial management
When a claim is denied, we find out why, correct what can be corrected and appeal when the denial is wrong. Then we track the cause so it does not happen again.
What's included
- Review of every denial and EOB remark code
- Corrected claims and resubmissions
- Written appeals with supporting documentation
- Denial log by payer, procedure and reason
- Process changes to prevent repeat denials
A repeated denial turned out to be a payer rule. We changed the submission step to prevent it.
AR follow-up
We work your outstanding insurance claims on a set schedule until each one is paid or properly resolved, so nothing sits unattended in aging.
What's included
- Regular review of 30/60/90+ day insurance aging
- Claim status checks through payer portals and phone calls
- Follow-up on unacknowledged, pending and underpaid claims
- Notes on every claim follow-up in your practice management system
- Escalation of stuck claims with a clear next step
We reviewed claims at 60+ days and found several never acknowledged by the payer.
Payment posting
We post insurance payments accurately and check each one against your fee schedule, so your ledger reflects what was actually paid.
What's included
- ERA and EOB posting to the correct procedure
- Contractual adjustments checked against your fee schedules
- Flags for underpayments and incorrect write-offs
- Reconciliation of insurance deposits
- Secondary claims triggered after the primary payment is posted
A payment came in below contract. It was flagged and disputed instead of written off.
Reporting & insights
Clear, plain-language reports on how your revenue cycle is performing, with practical next steps for your office.
What's included
- Monthly insurance collections summary
- Insurance AR aging by payer
- Denial trends by payer, procedure and reason
- Claim turnaround and first-pass acceptance
- Recommended actions for your team
Collections dipped one month. The report showed a payer processing delay, not lost claims, so nothing was written off.