Dental Billing
Benefit verification, claim submission with the right attachments, insurance follow-up and appeals for general and specialty dental practices.
Dental Billing
Mid Cycle of the revenue cycle
Where it sits
- Front End
- Mid CycleThis service
- Back End
- Intelligence
Capture & Coding. Turning care delivered into a claim that will survive review.
What is included
- Benefit verification
- Pre-treatment estimates
- Claim submission
- Insurance follow-up
- Denials and appeals
- Works inside your existing systems
- Scope and reporting agreed up front
- Engage it alone or with the full cycle
The service
What Dental Billing involves.
Dental insurance behaves nothing like medical insurance. A plan can cover a procedure and still pay nothing: the annual maximum is used up, the frequency limit has not reset, the waiting period has not passed, or the plan pays for a cheaper alternative instead. Most of those answers are available before the patient sits in the chair, and most practices find out after.
Kitronixe works the dental revenue cycle from the front: benefits checked before treatment is planned, claims sent with the radiographs and narratives the payer needs to decide them, and unpaid claims followed up until they are resolved rather than left to age.
Without it
Benefits checked too late
Remaining maximums, frequencies and waiting periods discovered at the denial, after the treatment has been delivered.
Claims sent without what the payer needs
Missing radiographs, periodontal charting or narratives turn a payable claim into a request for information and a delay.
Downgrades accepted as paid
Alternate-benefit payments post as if the claim paid in full, and the patient balance is never billed correctly.
Medical coverage missed
Procedures that a medical plan may cover are billed only to dental, or not billed at all.
The revenue cycle
One part of an end-to-end cycle.
Every stage hands work to the next, which is why Kitronixe looks at the whole cycle even when you engage one part of it.
Where Dental Billing sits
Mid Cycle: Capture & Coding
- 04Charge Capture
- 05Medical Coding
- 06Claim Scrubbing & Submission
Patient Scheduling & Pre-Registration
Demographic and insurance capture before the visit.
Reporting, Analytics & Revenue Integrity
KPI dashboards and revenue integrity review.
Patient Billing & Collections
Clear patient statements with online payment.
A/R Follow-Up & Recovery
Ageing buckets prioritised to cut days in A/R.
Denial Management & Appeals
Root-cause analysis stops preventable denials.
Payment Posting & Reconciliation
ERA/835 and EOB posting with accurate balances.
Eligibility & Benefits Verification
Real-time coverage, copay and deductible checks.
Prior Authorization
Pre-certification and payer approval secured.
Charge Capture
Every charge captured before the claim goes out.
Medical Coding
Coded to documentation, then checked before the claim goes out.
Claim Scrubbing & Submission
Clean EDI 837 claims sent to the clearinghouse.
RCM
Process
Patient Scheduling & Pre-Registration
Demographic and insurance capture before the visit.
Eligibility & Benefits Verification
Real-time coverage, copay and deductible checks.
Prior Authorization
Pre-certification and payer approval secured.
Charge Capture
Every charge captured before the claim goes out.
Medical Coding
Coded to documentation, then checked before the claim goes out.
Claim Scrubbing & Submission
Clean EDI 837 claims sent to the clearinghouse.
Payment Posting & Reconciliation
ERA/835 and EOB posting with accurate balances.
Denial Management & Appeals
Root-cause analysis stops preventable denials.
A/R Follow-Up & Recovery
Ageing buckets prioritised to cut days in A/R.
Patient Billing & Collections
Clear patient statements with online payment.
Reporting, Analytics & Revenue Integrity
KPI dashboards and revenue integrity review.
What is included
Everything in Dental Billing, handled by specialists.
Benefit verification
Maximums, deductibles, frequencies and waiting periods confirmed before treatment is planned.
Pre-treatment estimates
Predeterminations submitted where a plan offers them, so the patient knows their share up front.
Claim submission
Claims sent with the radiographs, charting and narratives each payer asks for.
Insurance follow-up
Unpaid and pending claims worked by age, not left until they cannot be recovered.
Denials and appeals
Downgrades and denials reviewed, corrected and appealed where the documentation supports it.
Medical cross-billing
Procedures a medical plan may cover identified and billed to the right payer.
How it runs
The workflow, step by step.
- 01
Verify
Benefits and history checked before the appointment.
- 02
Submit
Claims sent clean, with attachments, soon after the visit.
- 03
Follow up
Outstanding claims worked on a schedule until resolved.
- 04
Report
Collections, ageing and denial causes reported against agreed measures.
Reporting
Measured the same way, every month.
Whatever part of the cycle Kitronixe runs for you, reporting is set against the same core measures, so performance is something you check rather than something you are told.
Days in A/R
How long, on average, a billed charge waits before it is paid.
Commonly cited target
Under 35 days
First-pass denial rate
The share of submitted claims a payer refuses on first adjudication.
Commonly cited target
Under 5%
Clean claim rate
The share of claims accepted on first submission, with no rejection or rework.
Commonly cited target
Above 96%
A/R over 90 days
The share of outstanding receivables that is more than 90 days old.
Commonly cited target
Under 12%
Targets are commonly cited reference points, not licensed benchmark data and not Kitronixe results. Treat them as directional: what is realistic depends on specialty, payer mix and where a practice is starting from.
Revenue cycle performance
Illustrative view of the measures Kitronixe reports against
$1.24M
Net collections, TTM
32.4
Days in A/R
6.1%
Denial rate, first pass
96.8%
Clean claim rate
Collections
Last 12 monthsClaim quality
This month- Clean96.8%
- Pending2.1%
- Denied1.1%
A/R by age
$1.34M outstanding- 0-30 days$841K
- 31-60 days$310K
- 61-90 days$128K
- 90+ days$64K
Denials by cause
Share of denials- Eligibility31%
- Authorization24%
- Coding19%
- Timely filing14%
- Other12%
Recovery opportunities
Open- UnderpaymentsAgainst contracted rates$48,500
- Appealable denialsWithin appeal window$26,400
- Unbilled encountersApproaching timely filing$9,750
Payer performance
Average days to pay- Commercial A28 days
- Commercial B41 days
- Medicare19 days
- Medicaid52 days
Collections density
By weekdayYour systems
Works alongside the systems you already use.
Kitronixe works inside the systems your practice already runs. There is no migration, nothing to replace, and no new system for your team to learn.
Kitronixe team
Working in your systems, with the access you grant.
- No migration
- Nothing replaced
- Your data stays put
- EHRWhere documentation and encounters live.
- Practice managementScheduling, charges, claims and patient accounts.
- ClearinghouseClaim submission, edits and rejections.
- Payer portalsEligibility, claim status, appeals, enrollment.
- RemittanceERA and EOB files, and the deposits behind them.
- ReportingThe reports and exports your team already reads.
Revenue Leakage Calculator
See where your own numbers say revenue is leaking.
Enter the figures from your own reports and the calculator shows an estimated range for each category of loss, with the arithmetic behind it. It does not assume a denial rate for you, and it never counts the same dollar twice.
What you will enter
- Monthly collections and appointment volume
- Your denial rate and clean claim rate
- Days in A/R and how your A/R is aged
- Payer mix, no-show rate and patient balances
It runs in your browser. Nothing you type is sent to Kitronixe, and there is no email gate. Results are estimates, shown as ranges.
Keep exploring
More across the cycle.
- Mid Cycle
Medical Billing
Professional and institutional billing, electronic claim submission, clearinghouse management and claim status monitoring.
Learn more about Medical Billing - Mid Cycle
Physician Billing
Professional-fee billing for physicians and advanced practice providers, from documentation and charge capture through coding, claims, posting and follow-up.
Learn more about Physician Billing - Mid Cycle
Medical Coding
CPT, HCPCS and ICD-10-CM coding, modifier review, E/M support, coding audits and documentation review.
Learn more about Medical Coding
Start with your actual numbers.
We will look at what your revenue cycle is really doing before suggesting what to change. No obligation, and you keep the findings either way.