How Does Medical Billing Work in General Dental Practice

Learning the ropes in finances, documentation, and coding associated with a dental practice can be overwhelming and entirely confusing. Sometimes, one of the most challenging and difficult parts of dentists’ job or any dental procedures is helping your patients figure out how they’re going to pay for the service they’ve availed. Medical billing gives both parties a chance for them to earn or save.

See also: Answers to: Medical Billing Commonly Asked Questions

Dental practices benefit greatly from an efficient medical billing process. Medical billing helps in collecting reimbursements from the payers. Not many dentists worldwide are aware that many surgical procedures performed in the mouth, like oral biopsies, excisions, and treating and handling traumatic injuries, are covered by medical benefit plans.

Insurance companies realize the smart benefits of having dental, medical plans. Similarly, many dentists understand the importance of analyzing what it takes to manage medical billing in dentistry and tying up with insurance companies. It’s essential to consider having an across the board system to manage their funds and operate their dental office without trouble.

Optimizing an effective and efficient medical billing process seems the only way out for dental practitioners to attain a lucrative practice and take full advantage of their revenue.

It’s easy to understand how medical billing works.

You also need to know that the qualification for a dental service to be considered for payment under a medical plan is that it should be a medically necessary procedure based upon the patient’s overall health condition and, therefore, the dental surgeon’s diagnosis.

Medical billing brings substantial benefits to dental offices. To assist dental practices in understanding this process better, here are a few advantages and reasons why dentists should start doing medical billing.

  • Dental plans have a yearly maximum limit, which other medical procedures usually don’t have.
  • The patient’s out-of-pocket expenses will lessen significantly when medical or trauma-related services are covered under both a dental and a medical plan.
  • The chances of accepting cases by the insurance carriers will also increase for those procedures that comprise medical plans’ filing guidelines.
  • You can attract new patients with the flexibility to bill procedures to Medical Insurance.

Medical billing for dentistry can make it less complicated for your patients to afford treatment. However, if dental surgery is medically necessary, medical insurance may reimburse nearly 70% of the cost. After you add medical billing capabilities to your practice, life gets easier for your patients.

How does medical billing work in a dental practice when it comes to documentation and reimbursements?

There has to be a strict and efficient documentation process in your practice. This process is the only means a dental office can function without facing any legal trouble or giving a chance to liabilities to emerge. If necessary official papers, billing statements, and actual receipts aren’t documented appropriately, the dental practice may come in under serious questioning regarding its finances. This is why most dental providers emphasize recording everything in detail and ensuring each step is considered. Remember that any law institutes its decisions based on the information that’s made available.


To succeed in your medical billing claims, you’ll need to document:

  • The primary presenting situation
  • Any secondary, supporting diagnosis
  • The diagnostic code for the treatment you plan
  • Surgical pre-authorization
  • Medical Necessity, in the form of a letter of medical Necessity
  • Support from the patient’s Primary Care Physician, in the form of a supporting letter of Medical Necessity
  • The procedures performed at each surgery location

You have to provide the medical insurance company a complete depiction of the service you’ve provided. Not just a simple one but explicit, legitimate, and accurate recordings, and that it should be qualified for reimbursement by the patient’s medical insurer.

See also: The 5 Critical Things to Look for in a Medical Billing Company

Your patients, as well as your practice, deserve to receive the treatment they need. Learning to work with insurance carriers can be an essential step if you’re determined to protect their overall health, improve their lives, and also to give your practice a great favor.

To make it all work for your dental practice, it boils down to just three simple ways: implement the right strategy, ensure proper documentation, and ensure your medical coding.


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