How does revenue cycle management work for dental practices?
Revenue cycle management for dental practices covers every step from when a patient schedules an appointment to when the final payment hits your bank account. It’s the process of making sure you get paid for the work you do, and get paid correctly and on time.
The cycle starts before the patient sits in the chair. Eligibility and benefits verification happens first. You need to know what insurance the patient has, what procedures are covered, what the copay or coinsurance amounts are, and whether there’s remaining deductible to meet. Skipping this step leads to surprise bills for patients and collection headaches for your practice.
For major procedures, predetermination or preauthorization comes next. You submit the treatment plan to the insurance company before starting work. They tell you what they’ll cover and at what rate. This isn’t required for routine cleanings, but for crowns, implants, and orthodontics it can save you from denials after the work is already done.
After treatment, claims get submitted. Dental claims use CDT codes instead of the CPT codes used in medical billing. Each procedure needs the right code, the right documentation, and the right supporting information. Incorrect coding is one of the top reasons dental claims get denied or underpaid.
Payment posting happens when the insurance payment arrives. This isn’t just depositing the check. It means recording what was paid, what was adjusted off based on your contracted rates, and what the patient now owes. Getting this wrong throws off your AR and leads to patient billing errors that damage relationships.
Denial management is where many practices struggle. When a claim gets denied, you need to understand why, fix the issue, and resubmit or appeal. Some denials are legitimate coverage issues. Many are administrative errors that can be corrected. Practices without a good denial workflow leave money on the table because they don’t follow up. This is often where professional medical billing and coding services make the biggest difference. Dedicated billing teams know how to work denied claims efficiently and have the time to pursue appeals that your front desk staff doesn’t.
AR follow-up closes the loop. Insurance claims unpaid after 30 days need attention. Patient balances past due need collection efforts. Without active follow-up, receivables age and become harder to collect.
The financial impact is real. A well-run revenue cycle means faster payments, fewer denials, and less money written off. A poorly managed one means cash flow problems even when your schedule is full. Many dental practices stay busy but struggle financially because money leaks out of their revenue cycle at multiple points. Working with a Metro Detroit bookkeeping service that understands dental practice finances can help you see where those leaks are happening and how they affect your overall financial picture.
The practices that thrive long-term treat revenue cycle management as a core business function, not an afterthought. Every step in the cycle affects your cash flow, and cash flow determines whether your practice can grow, invest in better equipment, and provide the patient care you went to dental school to deliver.
Metro Detroit's Small Business Bookkeeper
The Next Step:
A Short Conversation
Tell us about your business and your current bookkeeping situation. We'll listen, answer your questions, and give you a clear quote.
More Questions
What is HIPAA-compliant bookkeeping for healthcare providers?
HIPAA-compliant bookkeeping means protecting patient information that appears in financial records. It requires Business Associate Agreements, encrypted systems, secure data handling, and proper training for anyone accessing healthcare financial data.
Read answerWhy are my insurance claims getting denied?
Insurance claims get denied for reasons including missing prior authorization, eligibility verification failures, coding errors, and incomplete patient information. Most denials are preventable with proper front-end processes.
Read answerHow do I reduce claim denials at my medical practice?
Most claim denials are preventable with proper front-end processes. Focus on eligibility verification, prior authorization, accurate coding, and complete documentation to get claims paid the first time.
Read answerHow much does medical billing cost for a small practice in Michigan?
Medical billing for small practices typically costs 4% to 10% of collected revenue. The exact percentage depends on your specialty, claim volume, and what services are included. Full-service billing should cover eligibility verification, claims submission, denial management, and AR follow-up.
Read answerWhat bookkeeping software works best for medical practices?
QuickBooks Online is the practical choice for most medical practices. It's the industry standard, integrates with most practice management systems, and any bookkeeper or accountant you work with will know how to use it.
Read answerHow do dental practices manage insurance billing and patient copays?
Dental practices manage billing by verifying coverage before treatment, submitting claims with accurate CDT codes, posting insurance payments, and collecting patient portions at the time of service.
Read answer