Pediatric Dental Billing Services

100+

Satisfied Clients

30%

Practice Revenue Rise

99%

Collection Rate

Outsourcing Pediatric Dentistry Billing

Is your medical team finding it challenging to manage dental billing? Inefficient billing often can lead to claims and payment denials, which can adversely affect your practice’s financial health and most importantly, patient care. We understand the unique challenges posed by pediatric dental billing.

Pediatric dentistry billing services requires a different approach because of the specialized treatments involved and patient demographics. Dealing with claim denials and reimbursements can be daunting. Our expert billing services will ensure streamlined pediatric revenue cycle management, thereby maximizing cash flow, minimizing errors and subsequently, reducing claim denials.

Optimize Your Pediatric Dental Billing Now!

Call (800) 670-2809

No Disruption to Your Existing Systems and Workflow

Our dental billing services require no disruption to your existing software and technology systems. We have experience with the following software:

Ortho & Oral

Services We Offer

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Claim Submission & Tracking

With a centralized tracking system, we ensure claims are submitted on time with real-time tracking features for enhanced transparency.
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AR Management

By adopting effective follow-up strategies, we mitigate aged accounts receivable, thereby speeding up the process of releasing reimbursements.
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Insurance Verification

We validate the patient’s insurance benefits before the treatment is rendered, ensuring the proposed medical procedures are covered under the plan.
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Payment Posting

We ensure the payment capture and post it promptly to the relevant account, thereby initiating a trial to confirm the patient balances and insurance payments.
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Denial Management

We proactively engage with the insurers in addressing claim denials by identifying the roadblocks and resubmitted revised claims to avoid further denials.
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Patient Billing

With our intuitive billing system, you now can send accurate and comprehensible billing to your patients, and offer support for any disputes or claims.
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Outsource Pediatric Billing for Better Accuracy and Efficiency

Dental physicians typically see a higher volume of patients on average compared to other providers, as pediatric dental services are included under Essential Health Benefits (EHBs). This ensures comprehensive coverage for preventive and developmental care, including immunizations, dental examinations, and cleanings. However, due to the complexities involved in the wide range of age-specific services, accurate billing and coding can be challenging.

We specialize in managing these complexities by ensuring that patients’ claims align with the age-specific requirements, coding accuracy, and payer-specific policies. We maximize revenue growth for your practice by optimizing the dental billing process and eliminating common errors to ensure timely payments. With our support, your practice can enjoy financial well-being and focus more on patient care than cumbersome paperwork.

Why Choose Us?

Pediatric Dentistry Billing Why Choose OSI

Outsource Strategies International started with a small team two decades ago, and with years passing, we have grown from a mere billing solutions provider to a comprehensive healthcare technology solutions provider—serving numerous healthcare practices across the globe.

HIPAA-compliant
2.5 Million Claims Processed and Counting
98% Rate of Accuracy
AR Process Reduced by 50 Days
State-of-the-art Technology
Dedicated Care Manager

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We serve all 50 states

Common Pediatric Billing and Coding Considerations

Pediatric dental billing requires adherence to specialized criteria for coding and billing, ensuring compliance with specific age groups, services, and payer requirements. Here are some important considerations for dental practices:

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Vaccine Coding

Vaccines require both product (e.g. 90658) and administration (e.g. 90460) codes. Proper documentation, including vaccine details and counseling provided, is essential for accurate billing.

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Well-Child Visits

Routine well-child visits should be coded using the correct age-specific CPT codes. For example, use 99381–99385 for new patients and 99391–99395 for established patients. Documentation should include growth measurements, developmental assessments, and immunization status.

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Age-based Coding Rules

Pediatric billing codes are age-dependent. Certain codes such as D9920 (behavior management) may need additional documents as reimbursements vary based on the payer’s guidelines.

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Medicaid and CHIP Billing

These programs have state-specific requirements. Always verify eligibility, obtain pre-authorizations when needed, and stay up-to-date with local Medicaid/CHIP rules to avoid denials.

Given the complexity of these factors, outsourcing your practice’s billing to an experienced pediatric medical billing company like OSI can help navigate these challenges. Our expertise ensures compliance with age-based and program-specific codes, which leads to faster payments and fewer denials.

Our Billing Process

Being in the industry for over twenty years, we understand the intricacies involved and the subsequent urgency with which dental billing has to be completed, while adhering to mandatory compliances. Therefore, we have a well-organized process set in place to ensure a seamless billing and revenue management for your practice:

1

Review

9

Claims Management

4

2

Submission

9

Payment Posting

5

3

Follow-up

9

Patient Billing

6

1

Review

"

2

Submission

"

3

Follow-up

"

4

Claims Management

"

5

Payment Posting

"

6

Patient Billing

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Review

We verify the patient’s insurance coverage and seek pre-authorization to avoid any last-minute hassles and ensure smooth claim submission.

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Submission

We submit accurate claims to insurers promptly, thereby mitigating errors and ensuring an increased likelihood of claim approval in the first attempt.

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Follow-up

We regularly track the submitted claims and promptly follow-up. In case of a denial, we would swiftly engage in minimizing any delays in reimbursement.

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Claims Management

We handle the flow of claims, making sure the resubmissions and/or appeals are handled promptly to avoid causing hassles in your revenue cycle.

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Payment Posting

Payments released from insurers and patients are posted promptly and accounts are regularly reconciled to ensure transparency.

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Patient Billing

Through our system, patients will receive accurate billing statements and we extend our services towards any other necessary payment collections as well.

Affordable & Flexible Pricing

Our straightforward pricing and flexible service packages help streamline your pediatric dentistry billing workflows in a cost-effective way.

Full-Time Equivalent

In this model, services are billed based on the equivalent cost of a full-time employee (FTE) for a specified duration, usually monthly or annually.

Per Verification Billing

Like an FTE model, a person is dedicated to your practice. Perfect for a practice that is busy. They work as an extension to your business.

FTE/Per Verification Billing

This option is ideal for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.

FAQs

What is pediatric dentistry billing?

This refers to the process of managing and submitting claims for dental services provided to children. It includes filing insurance claims, handling payment processing and ensuring all treatments – routine checkups and orthodontics – are promptly billed in adherence to the updated dental coding requirements.

What is the significance of specialized billing in pediatric dentistry?

Pediatric dental services often involve particularized procedures and care requirements. A separate billing system ensures that all services are appropriately coded and documented, which reduces the chances of a claim denial. It also helps practices comply with the state and federal regulations.

What are the benefits of billing services for my practice?

Dentistry billing services increase the accuracy of your claims, cut down errors and improve revenue by streamlining the entire process. This ensures timely reimbursements and reliability, allowing practices to dedicate more time towards delivering quality patient care.

What are the services generally covered under pediatric dentistry billing?

Under this billing, a wide range of treatments are covered including regular dental checkups, cleanings, fillings, extractions and orthodontic treatments. Other advanced procedures like sedation and/or specialized orthodontic treatments may require prior authorization and other relevant documentation.

How can I reduce claim denials?

Usage of accurate dental codes can help reduce claim denials by a significant margin. Also, make sure that the necessary documentation is submitted on time to avoid denials. Collaborating with an expert pediatric dentistry billing provider can help ensure accuracy and compliance as they stay updated with the latest changes.

What to look for in a dental billing service?

When going with a dental billing provider, ensure that the provider is well-versed and updated in pediatric coding, insurance policies, has a strong track record of reversing claim denials and an excellent support staff to assist you, especially during a crisis.

Healthcare and Dental Revenue Cycle Management Process

Ready to Take Your Pediatric Dental Billing to the Next Level?

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