Medical billing in dentistry isn’t just about codes and claims — it’s about building confidence, getting paid, and protecting your practice from denials. Yet, even the most experienced dental teams fall into common traps that cost time, money, and patient trust. Let’s break down the five biggest mistakes I see in practices every week — and how your team can sidestep them.

1. Skipping the Verification of Benefits

• The Mistake: Relying on assumptions or patient-reported coverage instead of verifying benefits with the payer.

• The Fix: Always verify eligibility and benefits before treatment planning. A strong verification process ensures accurate estimates and reduces nasty surprises.

2. Weak or Missing Medical Necessity Documentation

• The Mistake: Sending claims without supporting narratives, diagnostics, or physician notes.

• The Fix: Use detailed SOAP notes and medical necessity narratives (yes, the story matters!) to connect dental procedures to systemic health needs.

3. Using Dental Codes Instead of Medical Codes

• The Mistake: Submitting CDT codes to medical carriers.

• The Fix: Cross-code correctly using CPT, ICD-10, and HCPCS where appropriate. Medical payers require their own language — learn to “speak insurance.”

4. Forgetting Pre-Authorizations and Pre-Determinations

• The Mistake: Skipping pre-approval steps for surgeries, appliances, or sedation.

• The Fix: Build pre-auth workflows into your practice management system. Think of it as insurance diplomacy: you’re asking for permission, not forgiveness.

5. Not Following Up on Denials

• The Mistake: Treating the first denial as the final word.

• The Fix: Appeal! Many claims are overturned with the right documentation and persistence. Have a system for tracking, resubmitting, and escalating.

Medical billing success isn’t about avoiding mistakes — it’s about building systems that catch them before they cost you. Training your team to spot these pitfalls turns billing from a headache into a revenue driver.

If your team needs hands-on help mastering these systems, check out Dental Classroom’s 12-module Medical Billing in the Dental Practice course — complete with live group coaching and CE credits.