Dental billing and medical billing may sound similar, but they are different in many ways. For dental practices, knowing these differences is important to avoid claim denials, improve payment speed, and stay compliant.
What is Dental Billing?
Dental billing is the process of sending claims to dental insurance companies so a practice can get paid for patient treatments. It includes:
Using CDT codes (Current Dental Terminology)
Verifying insurance benefits
Sending complete claims with documents
Following up on unpaid claims
Managing patient balances
Key Steps in Dental Billing:
Insurance verification
Pre-authorization (for major treatments)
Claim submission using CDT codes
Posting insurance payments
Billing patients and collecting dues
How Is Dental Billing Different from Medical Billing?
Coding: Dental uses CDT codes; medical uses CPT and ICD codes
Coverage: Dental plans have yearly limits; medical plans usually don’t
Claims: Dental often requires extra documents (like X-rays); medical doesn’t
Coordination of Benefits: More common in dental billing
Insurance types: Dental is often employer-based; medical includes Medicare and Medicaid
Why This Difference Matters:
If dental offices treat billing like medical billing, they may:
Get claims denied
Lose revenue
Waste time on re-submissions
Upset patients and staff
Example:
A patient gets a surgical extraction. The dental biller must:
Verify insurance
Use the correct CDT code
Add an X-ray and a clinical note
Submit claims to both primary and secondary insurers
Collect any patient balance
If these steps are missed, the claim could be denied.
Conclusion:
Dental billing is a specialized process that needs attention to detail. It is not the same as medical billing. To get paid faster and avoid mistakes, dental practices should use trained dental billing professionals.