Dental RCM Solutions

Dental Shield's Revenue Cycle Management (RCM) service is a managed, done-for-you billing service that handles a dental practice's entire billing workflow end-to-end - eligibility verification, claim submission, denial management, payment posting, and A/R follow-up - all inside the practice's existing Dentrix Ascend environment.

Dental Shield's RCM service costs 2.8% of monthly collected insurance claims, with no flat monthly fee and no setup fee - the practice only pays when claims are actually collected, and patient co-pays and self-pay balances are excluded from the fee calculation.

No, Dental Shield's RCM service has no setup fee, and onboarding and transition are included as part of the 2.8% collections-based fee.

Dental Shield's RCM engagement includes insurance eligibility verification, claim preparation and submission, denial management and appeals, payment posting and reconciliation, accounts receivable follow-up, prior authorization management, patient statements and collections, monthly reporting, a dedicated billing specialist, and payer liaison and issue escalation - all for one percentage-based fee.

No, unlike traditional billing companies that charge per claim or for add-on services, Dental Shield's RCM service covers unlimited claim submissions, eligibility checks, denial management, payment posting, and prior authorizations under a single percentage-based fee.

Yes, Dental Shield verifies every patient's active coverage - including benefits breakdown, deductibles, co-pays, frequency limits, and coordination of benefits - before the patient's appointment, so coverage issues can be addressed at check-in.

Dental Shield's billing team reviews completed treatment records in the practice's PMS, codes each procedure to ADA/CDT standards, and submits clean claims electronically to all major dental payers, typically going out via a clearinghouse within 24 hours of chart finalization.

Yes, Dental Shield submits prior authorization requests for high-value procedures such as implants, crowns, and orthodontics, including the supporting clinical documentation needed to secure approval before treatment begins.

Denied claims are analyzed for root cause - such as coding errors, missing attachments, or frequency conflicts - and are re-submitted or formally appealed with the correct documentation within payer deadlines.

Outstanding balances aged over 30 days receive proactive payer outreach, and Dental Shield tracks every open claim, escalating to supervisor review or state-mandated appeal timelines when needed.

No, Dental Shield's RCM team works directly inside a practice's existing Dentrix Ascend environment through secure shared access, so there's no new software to install and no data migration required.

After insurance adjudication, Dental Shield posts patient-responsibility balances, generates patient statements, and supports online payment collection through a secure patient billing portal.

Dental Shield reconciles ERA/EOB remittances against submitted claims, posts payments to the correct patient ledgers, and applies payer adjustments accurately to keep accounts receivable clean.

Dental Shield provides a monthly report covering claims submitted, payments received, denial rate, collections rate, and outstanding A/R aging, along with a dedicated billing specialist who knows the practice's payer mix, providers, and coding preferences.

No, Dental Shield's RCM service requires only a 30-day written termination notice rather than a long-term contract, and it includes a HIPAA Business Associate Agreement (BAA). Practices can book a free consultation to review their current collections rate, denial rate, and A/R aging before signing up.