What is Dental Billing & Is It the Same as Medical Billing?

What is Dental Billing & Is It the Same as Medical Billing?
Dr Josh September 27, 2022 medical billing

Medical billing involves sending invoices to insurance companies and patients for services rendered. Medical billing is broken down into three main stages: insurance verification, coding and auditing, and payment posting. 

The medical billing service uses diagnostic codes and other data to determine the amount patients are expected to pay and any insurance premiums they may have incurred.

Related: CPT Codes & Billing For Remote Patient Monitoring

Medical bills are sent to the patient or the responsible third party, such as an employer or health plan provider. This information is submitted to health plan members, providers, and payers. Health plans include HMOs and PPOs, as well as Medicare and Medicaid. 

Medical billers translate the doctor or patient’s statement into professional, legible statements and codes to process a claim. Medical billing services vary based on the medical offices they serve. 

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What is Dental Billing?

The world of dental billings can be a little overwhelming, but it doesn’t have to be. Understanding the basics allows billing to be more manageable and payments to be faster. Dental billing is used to obtain money from insurance providers and patients for the medical services covered under dental billing codes. 

It includes coordinating with patients to provide them with insurance cards and collecting payments from them after consultation. Patients are also encouraged to contact their insurance company to receive information about their coverage.

Dental billing focuses on the business side of dentistry and the reimbursement process. You must gather patient data, confirm insurance coverage, check that the right codes are used, etc. Your billing department has to be updated on the latest updates to the codes used for dental billing.

Related: What Are The Top 10 Denials In Medical Billing?

The practice manager reviews fee schedules before adding a procedure to the schedule, writes patient charts, and works with staff members to determine schedules and patient information. Some specific skills are required for success in this position.

Medical Billing for Dentists

An effective billing system is one of the numerous difficulties of running your dental practice. Even if your firm has effective internal procedures, dealing with insurance carriers to get prompt reimbursement can be challenging. Your staff’s time may be significantly consumed by the ensuing back and forth with insurance firms.

Some steps to take before introducing medical billing in your organization, regardless of whether you decide to learn how to submit medical claims internally or outsource medical billing.

  • Audit your dental practice’s documentation

  • Review dental/medical claims for errors before submission to an insurance company

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Codes for Medical and Dental Billing

Unlike medical billing and coding, dental coding sends claims using various data. The three main languages used are:

  • ICD-9


  • CPT

Instead, dental coding uses current dental terminology (CDT), updated and published by the American Dental Association. The primary distinction between dental coding is CDT and medical.

CDT only permits dental codes specified by hygienists or other dental professionals in conjunction with different CDT code categories. 

Dental code d1999: Unspecified preventive procedure

It is used to document and report the use and cost of additional personal protective equipment (PPE).

Dentists should establish the following standards for documentation and billing:

  • All patients must be subject to a common office procedure for recording the additional PPE.

  • A process for documenting why all patients should pay the same amount.

  • Documenting the specific PPE used for the visit by adding a note to the patient’s file and charging various costs depending on the type of additional PPE utilized.

  • All CDT codes that have “by report” in the terminology should have a narrative.

The American Dental Association (ADA), which has always placed the greatest importance on the patient, dentist, and dental team safety, has worked to develop this code.

Dental code d1330: Oral hygiene instructions

The American Dental Association (ADA) publishes the D1330 Dental Code and all other CDT codes (Current Dental Terminology) each year as a reference guide for the Code on Dental Procedures and Nomenclature (CDT Code), which is widely accepted by dentists, dental facilities, and dental insurance providers.

Is Dental Billing the Same as Medical Billing?

Yes, dental billing and medical billing are similar. They both come under the umbrella of practice management, but the process is different. For example, in the dental biller’s job description, there will be times when they need to consult with their dentist. Likewise, a medical biller may be required to read up on treatment plans to ensure accurate coding and billing.

The two share the following characteristics.

  • You must know the fundamental principles and how insurance companies accept and process claims in both procedures.

  • In both billing processes, you must properly communicate with insurance companies.

  • In-depth information on patient demographics is needed.

  • In both types of billings, you need information regarding submitting claims, including the proper codes and corresponding with insurance companies.

Difference between Dental Billing and Medical Billing

Dental billing and medical billing are two different things that are important for patient care. Dental billing includes submitting all your practice claims to dental insurance companies and third-party payers.

Dental insurance claims usually involve several processes, including supervision and coding. While medical billing might take extra time, dental insurance claims often require a little more effort because dental office staff members don’t deal with them regularly. 

The difference is that medical billing includes claims for other medical professions, such as medical devices, lab tests, equipment, vaccines, and employee compensation.

Receiving money for medical bills for a dental practice is not simple. Medical insurance claims often involve a few different processes and particular coding.

A dental billing service, in contrast, is used by doctors to handle the paperwork and ensure prompt payment. This means you can focus on your patients instead of dealing with insurance companies, who often contact the office directly to ensure they are billed correctly.

Reliable Dental and Medical Billing Services

If you’re trying to get hold of expert medical billing services, SmartClinix can help in the prospect while lowering your dental rate, skipping AR delays, and increasing your revenue, all for as low as 3.9%. Experienced medical billing teams at SmartClinix offer smart medical billing services for enhanced cash flow. Our teams can manage your revenue cycle completely, from claim submissions to dental management. 

SmartClinix understands your specialty requirements and thus offers specialized services, ensuring elevated cash flow for your practice; follow now to know more and avail of these outstanding services at the minimum cost!

Dr Josh

Dr. Josh is a physician who's helping spread the knowledge about Telehealth and its advantages. At SmartClinix, he's providing his expertise and knowledge in the form of engaging articles on various health & tech related topics.

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