SMMC Prepaid Dental Health Plan routing, Medicaid managed care rules, and Florida’s payer maze don’t forgive out-of-state guesswork; your denied claims do. TransDontics 1,100+ certified dental billing specialists own your entire revenue cycle, from eligibility to payment posting, so you focus on patients and we focus on getting you paid.
Florida practices navigate a two-plan Medicaid PDHP with major February 2025 contract changes, a retiree-heavy commercial population with Medicare Advantage dental riders, multilingual eligibility demands, and FL Board of Dentistry record-keeping rules.
Florida’s SMMC 3.0 Dental Plan Transition
Florida’s Retiree and Medicare Advantage Dental Complexity
DSO Expansion and the Florida Multi-Location Billing Challenge
HIPAA and Florida’s Health Information Protections
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for Florida’s dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
Billing companies are typically either fully manual or heavily automated. TransDontics uses both. Our RPA handles high-volume, repetitive tasks, while our billing specialists handle what requires clinical or contractual judgment. The combination is what keeps our first-pass rate at 98%.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of Florida or any commercial carrier pays below the agreed fee on a specific plan type, we flag it and file the appeal within 14 days. Most practices only catch outright denials. We go further.
Before every Florida Medicaid dental claim goes out, we confirm the patient’s current SMMC dental plan enrollment (DentaQuest or Liberty Dental), format the claim for that specific plan’s portal, and include the documentation that plan requires. When a plan assignment changes, we catch it.
Claims processed within 48 hours of receipt. No setup fee, no monthly minimum, no long-term contract, and no hidden costs buried in the fine print. Our fee is a nominal percentage of what we successfully collect from payers on your behalf. We only earn when you get paid.
Expert CDT coding, clean claim submission, and aggressive denial management by specialty-certified billers. 98% first-pass clean claim rate.
No claim goes 48 hours without follow-up. We pursue every outstanding balance across all payers until it is paid, appealed or written off.
Get in-network faster. We handle all payer paperwork, CAQH maintenance, renewals, and compliance tracking so you start seeing insured patients.
Full revenue cycle coverage from patient registration to final payment. We manage all claims, close every gap, and maximize your collections.
Strategic oversight of your practice’s operational and financial performance. We track collections, payer mix, and productivity metrics
Complete front office billing support covering patient billing inquiries, insurance comms, prior auth, and appointment-linked verification.
HIPAA-compliant dental transcription delivered fast and accurately. Clinical notes, procedure documentation, and patient records are transcribed.
We review your last 12 months, find your top 3 revenue leaks, and show you exactly what we fix. Practices often discover recoverable revenue.
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An in-house biller knows your practice; not Florida’s SMMC dental enrollment nuances, Liberty Dental’s prior auth requirements, or how to route a Medicare Advantage dental rider. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t reconcile every EOB against your contracted rate, flag SMMC dental plan routing errors, or chase the revenue that a clean submission still leaves uncollected.
Most billing companies are a service. TransDontics is a system. RPA catches what humans miss at volume. Experienced billers catch what automation can’t judge. The result is a first-pass acceptance rate of 98%.
We connect directly to Dentrix, Eaglesoft, or your existing PMS. No migration, no new systems, no disruption.
Three steps. No disruption. No risk.
We review your claims, A/R, and denial patterns at zero cost. Most practices find 5–10% in hidden revenue leakage.
We connect directly to Dentrix, Eaglesoft, or your existing PMS. No migration, no new systems, no disruption.
We don’t publish named case studies because most clients prefer to keep billing performance private. What we can share is what the numbers look like across practices with comparable payer profiles.
Based on aggregated results across dental practices in comparable payer environments.
| Metric | Before TransDontics | After TransDontics |
|---|---|---|
| Average Denial Rate | 8–12% | Under 2.3% |
| First-Pass Clean Claim Rate | 70–80% | 98% |
| A/R Over 90 Days | 30–40% of Total AR | Reduced by 30%+ |
| Average A/R Resolution | 45+ Days | 18–25 Days |
| Claim Turnaround | 3–5 Days | 48 Hours |
| Revenue Growth (120 days) | Baseline | 5–12% Increase |
A general dentistry practice came to us with a 10% denial rate, 35% of A/R past 90 days, and Medicaid dental claims routing to the wrong SMMC dental plan after MCNA’s February 2025 exit. Their front desk was burning 2–3 hours a day on billing follow-up.
Our specialists know every Florida payer’s rules and appeal processes. National billing companies stumble on SMMC structure, miss Liberty versus DentaQuest differences, and overlook Medicare Advantage dental riders. We don’t.
Florida’s DPIP offers 140% of the Medicaid FFS rate for qualifying preventive and diagnostic services for children under 21, administered through both DentaQuest and Liberty Dental
Cigna’s 90-day in-network filing window isn’t new, it’s been the standard for years, and it’s exactly why it deserves close monitoring. A missed submission is a permanent write-off. We file in 48 hours.
Commercial and Medicare Advantage dental riders each require separate workflows. We maintain current protocols across all three Aetna product lines.
Humana Dental’s standard filing window is 180 days from the date of service; one of the more forgiving timelines in Florida. Commercial medical claims have a 90-day filing window.
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.
We bill Florida claims daily, knowing Liberty Dental and DentaQuest apply different authorization thresholds for the same procedures, Florida Blue filing windows vary by plan type, with some employer plans offering up to one year; always verify per specific plan.
Every Florida practice qualifies. If your city isn’t listed, it’s coming. Reach out now and we’ll onboard your practice without delay.
Florida practices carry HIPAA obligations alongside F.S. § 456.057, § 466.018, and FAC Rule 64B5-17.002 governing patient records and dental record content. TransDontics is independently HIPAA certified and AICPA SOC 2 Type II compliant.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Florida’s patient records privacy requirements under § 456.057. Every data transmission meets the highest applicable standard.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability most Florida practice owners don’t realize.
Our AICPA SOC 2 Type II certification is independently audited and renewed annually. Everything is documented and third-party verified. Your Florida practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
In-house billing looks cheaper on paper. It rarely is. Staffing overhead, turnover, training costs, and unworked denials mean most Florida practices spend more than they realize and collect less than they should. TransDontics charges a percentage of what you actually collect. That is the whole model.
Average Florida salary
*Salary benchmarks based on Florida BLS/ZipRecruiter data. Results vary by practice size and payer mix.
Our complimentary audit covers denied claims, MCO routing errors, and underpayments, no obligation, no pitch.
Specific, verified outcomes, not generic praise. Every metric sourced from client data.
In the first 60 days, TransDontics recovered $18,400 in claims our team had written off as uncollectable. They caught 47 denied claims we had given up on. The Dentrix integration was seamless as they were billing the same day.
General Dentist · Austin, TX
I was spending 3 hours a day chasing orthodontic claims. TransDontics took over and our denial rate dropped from 22% to under 4% in three months. The multi-visit treatment plan billing alone recovered $31K we had been losing annually.
Orthodontist · Los Angeles, CA
We run 3 oral surgery locations on Eaglesoft. The OMS anesthesia cross-coding was a mess; TransDontics cleaned it up in week one. Collections are up 11% across all three locations.
Oral Surgeon · Dallas, TX
RPA handles eligibility checks, claim scrubbing, status tracking, and payment posting automatically. Billing specialists handle appeals, EOB reconciliation, pre-auth follow-up, and payer escalations. Neither layer alone achieves what both together deliver: a consistent 98% first-pass acceptance rate.
MCNA exited Florida’s SMMC program February 1, 2025. Practices credentialed only with MCNA needed enrollment with DentaQuest and Liberty Dental before that date. Outstanding MCNA claims fell under AHCA continuity-of-care provisions. If your practice was affected, TransDontics can audit your post-transition A/R and identify any recoverable claims prior to the 90-day window.
All active Florida payers: Delta Dental, Florida Blue, Cigna, Aetna, UnitedHealthcare, Humana, TRICARE, MetLife, Guardian, and both current SMMC Prepaid Dental Health Plans — DentaQuest and Liberty Dental Plan.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours
HIPAA-compliant from day one.
Pay only a percentage of what we collect for you
