Every dental practice needs a strong billing process to keep patients happy and ensure bills are paid on time. That means handling insurance, avoiding coding errors, and making payments as simple as possible for patients.

The US dental services market was valued at $192.22 billion in 2023, and billing and payment procedures play a major role in the industry’s success. Below, we’ll explain how dental billing works, the most common mistakes that slow down payments, and the best ways to make your billing system more effective.

What’s in this article?

• What makes dental billing different from billing in other industries?
  
• How does insurance processing work in dental billing?
  
• What are common billing errors that cost dental practices money?
  
• How can dental practices improve their billing processes?
  
• How does Stripe help with dental billing and payments?
  

What makes dental billing different from billing in other industries?

Billing is a common challenge across industries, but dental billing has its own complexities that impact how practices get paid. Here’s how dental billing is different, especially compared to medical billing, and what to expect from the process.

Different codes

Healthcare providers in over 60 countries use Current Procedural Terminology (CPT) codes, but dental practices rely on different codes that denote details such as tooth numbers and surfaces. Dental practice billing codes have different names in different countries, including the Current Dental Terminology (CDT) codes in the US and Uniforme Particuliere Tarieven (UPT) codes in the Netherlands.

Different insurance policies

Dental insurance isn’t structured like medical insurance. Instead of covering most of the important treatments, it sometimes pays a percentage of each procedure up to an annual maximum. In many places, patients often pay out of pocket, which can make cost sensitivity a bigger factor in treatment decisions. Dental benefits can run out quickly, shifting more responsibility onto patients and practices to handle payments.

More pre-authorizations

Before they start work, practices often send pre-authorization requests to insurers for higher-cost treatments to ask how much the insurance will cover. This helps set patient expectations but doesn’t guarantee payment, because insurance policies can still change or claims can be denied later. Managing these pre-authorizations efficiently is important for getting paid.

Dental billing requires precise coding, careful insurance coordination, and strong patient communication. Any missteps can mean delays, denied claims, or lost revenue.

How does insurance processing work in dental billing?

Handling insurance is an important part of keeping a dental practice financially stable—and patients happy. It’s a multistep process that practices must manage accurately and efficiently to avoid payment delays, lost revenue, and patient frustration. Here’s how dental practices should interact with insurance at every step of the process.

Insurance verification

Before any work begins, the dental office needs to confirm:

• That the patient’s policy is active

• What procedures are covered and whether there are any exclusions

• Whether there are waiting periods, deductibles, or remaining benefits

Pre-authorization is often required for high-cost treatments. This means submitting a treatment plan to the insurer in advance to estimate what will be covered. It doesn’t guarantee payment because coverage can still change, but it helps set realistic patient expectations and minimize disputes later.

Claim submission

After treatment, the office submits a claim to the insurance provider. Each claim must include:

• Correct codes for every procedure

• Supporting documents such as X-rays, periodontal charts, and narratives for specific procedures

Most claims are submitted electronically for faster processing. Even a small error, such as a missing attachment or incorrect code, can lead to delays or outright denials.

Insurance review

Once the claim is received, the insurance company reviews it to determine how much it will pay. The insurance company issues an explanation of benefits (EOB), which details what services are covered and how much the insurer will pay the practice.

If the insurer doesn’t pay the entire cost and the patient has secondary insurance, the dental office submits a second claim along with the primary insurer’s EOB. This shows the secondary provider that the primary insurer didn’t cover everything.

Patient billing

After insurance has paid its portion, the patient is billed for the remainder. Ideally, the practice has already:

• Estimated the patient’s portion up front

• Collected a partial payment at the time of service

Once the insurance payment is finalized, the office issues a final statement or a refund if the patient overpaid. The most efficient practices post insurance payments immediately in their billing software, automatically calculate patient balances, and quickly notify patients of any outstanding amounts.

Some offices store patient payment details, with consent, to collect remaining balances, the rest of a scheduled payment plan, or any no-show fees. This can minimize unpaid accounts and the need for collection calls.

What are common billing errors that cost dental practices money?

Even the most organized dental offices can make billing mistakes. Errors in coding, documentation, or timing can mean lost revenue, wasted staff time, and frustrated patients. Here are some of the most common pitfalls and why they matter.

Incorrect or incomplete coding

Every claim relies on the right codes being used. A small mistake can lead to claim denials, reduced reimbursements, and lost revenue.

Missing documentation

Some procedures require supporting documents such as X-rays and periodontal charts to justify the treatment. If these aren’t included, the insurer might reject the claim outright. The office will then have to track down the missing documents and resubmit the claim, all while waiting on delayed payment. For procedures such as extractions, root canals, and deep cleanings, missing attachments can create unnecessary back-and-forth with insurers, further slowing cash flow and adding on administrative work.

Late claim submission

Insurance companies have strict filing deadlines, which can range from a few months to a year from the date of service. If a claim is submitted too late, the insurer automatically denies it, with no option for appeal, and the practice is forced to bill the patient instead. What should have been guaranteed insurance revenue turns into a loss if the patient doesn’t pay.

A well-organized billing system can submit claims promptly and prevent costly denials due to missed deadlines.

Incorrect billing

Errors in patient billing create financial and reputational risks. Miscalculating co-pays, deductibles, or insurance adjustments can cause:

• Overcharging, which leads to refunds, extra administrative work, and damaged trust

• Undercharging, which leads to lost revenue and awkward collection efforts in the future

Patients expect accurate bills. If you have too many errors, they might question your office’s reliability.

How can dental practices improve their billing processes?

Billing efficiency means creating a system that saves time, lowers stress, and keeps cash flow steady. Here’s how dental practices can improve their billing processes.

Use automation and software to minimize errors

Modern dental billing software can handle tasks that once required hours of manual work. The right system can:

• Check a patient’s insurance eligibility in real time before their appointment

• Submit claims electronically with required attachments

• Flag missing or incorrect information before claims are sent

Automating routine billing tasks can shorten processing times and help reduce denials.

Make patient payments simple and convenient

The easier it is for patients to pay, the faster you can collect. Consider offering:

• Multiple payment options, including credit cards, digital wallets, and financing for larger treatments

• Electronic invoices and payment links via email or text so patients can pay from their phones

• Automatic payment plans for high-cost treatments

Whenever possible, collect co-pays or estimated balances at the time of service to minimize unpaid accounts and avoid the need for follow-ups.

Set clear financial expectations

A well-informed patient is less likely to dispute a bill. Practices can reduce confusion by:

• Providing up-front cost estimates and explaining insurance coverage before treatment

• Having a written financial policy that outlines payment responsibilities and is signed by patients in advance

• Clarifying policies on noncovered services, payment plans, and late payments

How does Stripe help with dental billing and payments?

Stripe doesn’t process insurance claims, but it simplifies patient payments, which can lead to better billing practices and less administrative work. Here’s how Stripe can help.

Payment methods

With Stripe, dental offices can accept payments in the ways that work best for their patients, including the following:

• Online through secure payment links sent via email or text

• In person, with a Stripe Terminal card reader at the front desk

• With stored payment details for quick future charges

All transactions sync to a central system for easier payment tracking and reconciliation.

Recurring payments

Stripe’s subscription billing automates payment plans for high-cost procedures or memberships. Once set up, Stripe:

• Charges the patient’s card on a predetermined schedule

• Sends automated receipts and payment confirmations

• Helps reduce staff time spent following up on missed payments

This keeps cash flow predictable without requiring staff to process each installment manually.

Digital invoices and payment reminders

With Stripe Invoicing, you can:

• Email Stripe-hosted or PDF invoices

• Track who has and hasn’t paid

• Send automatic reminders for outstanding balances

• Generate electronic receipts

This speeds up collections and eliminates the need for paper statements.

Practice management software integration

Many dental practice management and patient communication platforms integrate with Stripe. That means all billing information is stored in one place and payments can be recorded in the office’s system automatically. Practices with unique software needs can also implement custom integrations using Stripe’s application programming interfaces (APIs).