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Pediatric Dental Billing Services To Maximize Your Practice Revenue

Your front desk can’t manage patients and navigate Medicaid fee schedules, CHIP coordination, and age-specific CDT codes simultaneously. Something always gets missed. TransDontics runs the complete pediatric billing cycle the way a specialist requires.

Live in 24 Hours

1,100+ Certified Billers

Serving Nationwide

Pay Only When We Collect

ISO 27001
HIPAA COMPLIANT
AICPA SOC 2
Periodontal Billing Services
The TransDontics Difference

Six Generic Billing Errors That Quietly Drain Pediatric Dental Practice Revenue

Error No.1

Primary and Permanent Dentition Codes Used Interchangeably

Failure

Billing permanent tooth codes on primary dentition, or vice versa triggers automatic rejection and accounts for an estimated 18% of all first-pass denials in pediatric practices.
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Error No.2

Medicaid Prior Authorization Not Obtained Before Restorative or Sedation Cases

Failure

Submitting restorative, crown, pulp therapy, or sedation claims without Medicaid authorization produces full-case denials that retrospective requests almost never reverse.
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Error No.3

Behavior Management Codes Omitted or Bundled Incorrectly

Failure

Protective stabilization, nitrous oxide, and oral sedation are separately billable, omitting them leaves $50–$350 per appointment uncollected and bundling triggers recoupment demands.
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Error No.4

Space Maintainer Claims Submitted Without Supporting Radiographs

Failure

Submitting space maintainer claims without radiographic documentation produces standard denials, adding 60–90 days to collection when imaging is attached only on appeal.
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Error No.5

Stainless Steel Crown Claims Not Matched to Medicaid Fee Schedules by State

Failure

State-specific Medicaid reimbursement rates for stainless steel crowns vary by up to $120; using a single submitted fee leaves money uncollected or triggers recoupment audits.
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Error No.6

Early Intervention Services Billed Under the Wrong Specialty Tier

Failure

Interceptive orthodontic services billed under general restorative codes or without required diagnostic records, result in denial on procedures reimbursing $400–$900 per case.
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Pediatric Dentistry Billing Excellence

Ten Pediatric Dentistry Billing Services. One Specialist Team.

Every service is delivered by specialists trained specifically in pediatric dental billing; dentition-specific codes, state Medicaid authorization, behavior management documentation, and CHIP coordination protocols.
Eligibility Verification

Eligibility Verification

Real-time insurance verification before every appointment, eliminating surprise denials and protecting your cash flow from day one.
Dental billing & Coding

Dental Billing and CDT Coding

Expert CDT coding, clean claim submission, and aggressive denial management by specialty-certified billers. 98% first-pass rate, compared to the industry average of 82%.
Ar-management

A/R Management

No claim goes 48 hours without follow-up. We pursue every outstanding balance across all payers until it is paid, appealed to exhaustion, or written off with documented reason.

Provider-Credentialing

Credentialing Services

Get in-network faster. We handle all payer paperwork, CAQH maintenance, renewals, and compliance tracking so you start seeing insured patients sooner.
Dental RPA Automation

Dental RPA Automation

Robotic process automation eliminates manual repetitive tasks. Eligibility checks, reminders, and daily reports run without human intervention, 24/7.
Dental RCM

Complete Dental RCM

Full revenue cycle coverage from patient registration to final payment. We manage every financial touchpoint, close every gap, and maximize what your practice collects on every claim submitted.
Practice Management

Practice Management

Complete front office billing support covering patient billing inquiries, insurance communications, prior authorizations, and appointment-linked verification so your staff focuses on patients, not paperwork.
Front Office Management

Front Office Management

Complete front office billing support covering patient billing inquiries, insurance communications, prior authorizations, and appointment-linked verification so your staff focuses on patients, not paperwork.
Transcription Services

Transcription Services

HIPAA-compliant dental transcription delivered fast and accurately. Clinical notes, procedure documentation, and patient records are transcribed by trained professionals, keeping your records clean and claim-ready.

Dental Billing Audit

Dental Billing Audit

We review your last 12 months, find your top 3 revenue leaks, and show you exactly what we would fix. Most practices discover $30K to $80K in recoverable revenue, no strings attached.
Complete CDT Coverage.

Every Pediatric Dentistry Code Range. Billed Correctly. Every Time.

Pediatric dental billing spans 14 CDT code categories that must be applied with strict attention to patient age, dentition type, and state Medicaid program rules. TransDontics staff is trained across every range, not just the preventive codes that any dental biller can handle.

D0100–D0199

Clinical Oral Evaluations

D0200–D0299

Radiographs / Diagnostic Imaging

D0300–D0399

Tests & Lab Examinations

D1000–D1099

Dental Prophylaxis

D1100–D1199

Topical Fluoride Treatments

D1200–D1299

Other Preventive Services

D1300–D1399

Sealants

D1400–D1599

Space Maintenance

Total Payor Mastery Across Every Network

Whatever dental insurance your practice accepts, we ensure you get paid. TransDontics’ billing experts navigate the complexities of every major dental insurance network to maximize your revenue.
Specialist vs. Generalist

Why General Dental Billers Cost Pediatric Practices Revenue They Never Get Back

Pediatric dental billing operates under a different code set, a Medicaid and CHIP-dominated payer mix, and documentation standards most general billers were never trained to meet. The financial consequences of that gap are measurable and consistent.

Capability

Primary vs. Permanent Dentition Coding

Medicaid / CHIP Prior Authorization

Behavior Management Billing

Space Maintainer Documentation

State Medicaid Fee Schedule Compliance

Stainless Steel Crown Authorization

Interceptive Orthodontic Code Accuracy

Medicaid Recoupment Audit Support

In-House / Generic Biller

Errors on 18%+ of claims

Inconsistent; high denial rate

Omitted or bundled into restorative

X-ray attachments missed

Single fee used across all states

Submitted without auth; denied

Billed under restorative codes

Not offered

Audited per claim before submission

Full package; under 4% denial rate

Stand-alone line items, fully documented

Radiographic necessity attached

State-specific annual benchmarking

Auth confirmed before procedure date

D8010–D8040 with diagnostic record

Documentation review and audit response

*Industry averages sourced from publicly available compensation and claims performance benchmarks. Individual results may vary.

Nationwide Coverage. Local Expertise.

Trusted by Pediatric Dental Practices Across All 50 States

TransDontics delivers the same 98% clean claim rate and 48-hour guarantee in every state; with current knowledge of Medicaid fees, CHIP authorization rules, and state-specific documentation standards. Multiple state programs are never a limitation.
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Dentistry Billing Gap

The 16 Point Claim Rate Gap

In a pediatric practice where Medicaid dominates, a payer with no appeals flexibility and strict timely filing windows, every claim that doesn’t go out clean may never come back. The 82% to 98% gap compounds harder in pediatric dentistry than almost any other specialty.
Mini Chart – TransDontics
82%

Industry Average

98%

TransDontics

Orthodontic Collection Performance Analysis
Monthly Revenue Impact By Practice Voulume
Monthly Billing
At 82%
At 98%
Monthly Billing
$50,000/mo
$41,000
$49,000
+$8,000/mo
$100,000/mo
$82,000
$98,000
+$16,000/mo
$200,000/mo
$164,000
$196,000
+$32,000/mo
$300,000/mo
$246,000
$294,000
+$48,000/mo

You Pay Nothing Until We Collect For You!

No setup fees, no retainers, no contracts. TransDontics earns only on successfully recovered claims; Medicaid, CHIP, and private carriers. The average pediatric practice saves $31,000–$58,000 annually after transitioning to a dedicated pediatric billing team.
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Full-Spectrum Payor Coverage

TransDontics Provides Coverage Across All Dental Payors

Whatever dental insurance you accept, we’ve got you covered. Transdontics billing experts navigate every major dental insurance network with 15+ years of payor expertise.

Frequently Ask Questions

What pediatric dentistry billing services does TransDontics provide?

End-to-end pediatric dental billing; Medicaid, CHIP, and PPO verification, prior authorization management, primary and permanent dentition CDT compliance, behavior management billing, space maintainer claims, stainless steel crown and pulp therapy billing, denial management, A/R recovery, and state Medicaid fee schedule benchmarking by pediatric-trained specialists exclusively.
Medicaid and CHIP billing runs on a completely separate workflow from private carrier billing. We verify eligibility per visit, identify prior auth requirements before the procedure date, apply state-specific CDT codes and maximum allowable fees, and track adjudication through state portals. Medicaid has zero tolerance for timely filing errors.
D9230, D9243, and D9930 are separately billable only with complete documentation; clinical justification, sedation time records, patient age and behavior classification, and clinician signature. We audit every behavior management claim for documentation completeness before submission and work with your clinical team to establish a billing-supportive documentation workflow.
Every authorization trigger is identified at scheduling; restorative surface thresholds, crown counts, sedation modalities. Complete pre-auth packages with radiographs, clinical narratives, ICD-10 codes, and procedure lists are submitted and confirmed before the appointment date. Our prior authorization denial rate is under 4% against a national average exceeding 28%.
TransDontics achieves a 98% clean claim rate across Medicaid, CHIP, and PPO submissions versus the 82% industry average without a dedicated pediatric billing team. In Medicaid-heavy practices the stakes are highest: strict timely filing windows and limited appeal options mean the claim must be correct the first time.
SSC reimbursement rates differ by up to $120 per crown across state Medicaid programs and update annually. We maintain a current state-specific fee schedule database, apply correct submitted fees on every D2930–D2933 claim, and perform annual benchmarking reviews. Multi-state practices typically recover $15,000–$40,000 annually from previously undercharged Medicaid maximums.
Yes. We provide pre-audit documentation reviews to identify record gaps before audits are initiated, and support practices through audit responses with organized clinical record packages, written response narratives, and appeal submissions for contested recoupment demands. Clean documentation at submission is the most effective defense against recoupment risk.
Onboarding completes in five business days; PMS access, Medicaid portal credentialing, A/R audit by payer type, workflow mapping, and prior auth protocol setup. Live submission begins day six. A 48-hour audit report with dollar-quantified recovery projections is delivered before engagement begins.
Complimentary. No Obligation. Results in 48 Hours.

Ready to Stop Leaving Money on the Table?

Join 500+ dental practices; from solo general dentists to multi-location DSOs, that trust TransDontics, the dental billing company built for growth. Start with our complimentary audit. Our billing specialists will review your claims and show you exactly what’s recoverable.

Dedicated specialist assigned to your practice + weekly performance reports 

 The team took time to understand our vision and delivered a sleek, professional site that not only looks great but also improved our conversion rates. Their design process was smooth, communication was clear, and they met all deadlines. We’ve received numerous compliments on the new site, and it’s easier for customers to navigate.

Maxin Will

Product Manager

 The team took time to understand our vision and delivered a sleek, professional site that not only looks great but also improved our conversion rates. Their design process was smooth, communication was clear, and they met all deadlines. We’ve received numerous compliments on the new site, and it’s easier for customers to navigate.

Maxin Will

Product Manager

 The team took time to understand our vision and delivered a sleek, professional site that not only looks great but also improved our conversion rates. Their design process was smooth, communication was clear, and they met all deadlines. We’ve received numerous compliments on the new site, and it’s easier for customers to navigate.

Maxin Will

Product Manager

 The team took time to understand our vision and delivered a sleek, professional site that not only looks great but also improved our conversion rates. Their design process was smooth, communication was clear, and they met all deadlines. We’ve received numerous compliments on the new site, and it’s easier for customers to navigate.

Maxin Will

Product Manager

Claim Your Free Pediatric Dental Practice Audit

We analyze your clean claim rate, denial patterns by code and payer, prior authorization history, behavior management billing, and A/R aging by payer type. Structured report with dollar-quantified recovery opportunities delivered within 48 hours.

No obligation, no sales call before delivery

Dollar figures tied to your actual billing volume

Reviewed by a general dentistry billing specialist

Live in 24 hours with no contracts, no upfront fees

Most practices find $8,000–$48,000 monthly in recoverable revenue

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Dental Billing Partner

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