Georgia dental billing carries complexity most out-of-state vendors never fully grasp; Medicaid MCO errors, denials, and downcoding quietly drain revenue while generalist billing teams look the other way. TransDontics’s 1,100+ certified specialists manage your complete revenue cycle so you stay focused on your patients.
Georgia’s fast-growing dental market brings escalating billing complexity. Practices from Atlanta to Savannah navigate a multi-CMO Medicaid structure, narrower adult benefits than most providers anticipate, and recordkeeping obligations that directly affect claim defensibility.
Georgia Families® and the Multi-CMO Medicaid Maze
PeachCare for Kids® and Adult Benefit Complexity
DSO Expansion and the Atlanta Market Pressure
HIPAA and Georgia's Health Information Privacy Requirements
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for Georgia’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 a combination of both.Our RCM automation handles high-volume, repetitive tasks like claim scrubbing, eligibility checks, etc. while our billing specialists handle anything requiring clinical or contractual judgment.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of Georgia or any commercial payer pays below the agreed fee on certain plan types, we flag it and file the appeal within 14 days. Most practices only catch outright denials. We go further.
Before every Georgia Medicaid claim goes out, we confirm the patient's current MCO enrollment, format the claim for that specific plan's portal, and include what that MCO requires. When a patient switches plans mid-treatment, we catch it before it becomes a rejection.
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.
All billing companies are not built the same. Before you decide, see exactly what you’re getting by partnering with TransDontics.
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An in-house biller knows your practice; not necessarily Georgia’s CMO routing rules, Delta Dental’s downcoding patterns, or which payer your patient switched to last month. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t reconcile every EOB against your contracted rate, flag MCO routing errors, or chase the revenue that a clean submission still leaves uncollected. TransDontics does it all.
Most billing companies are a service. TransDontics is a system; RPA catching what humans miss at volume, experienced billers catching 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 Georgia general dentistry practice came to us with a 10% denial rate, 35% of A/R past 90 days, and Medicaid claims submitted to the wrong MCO. Front desk staff were spending 2–3 hours daily on billing follow-up with no consistent outcome.
Our specialists know every Georgia payer’s rules and appeal processes. National billing companies stumble on Georgia’s multi-CMO Medicaid structure and miss coverage differences between Humana, CareSource, and UnitedHealthcare. We don’t.
The sole incumbent CMO to retain its Georgia Families® contract through the 2024 DCH procurement. CareSource delivers dental benefits across Georgia Medicaid, PeachCare for Kids®, and Georgia Pathways with age-stratified prior authorization requirements.
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.
TransDontics handles Georgia claims daily, knowing Delta Dental’s plan-specific reimbursement differences, Humana versus Molina Healthcare claim format distinctions, and Anthem BCBS pre-auth requirements that vary by employer plan type.
Whether you practice in Fulton County or Wilkes County, TransDontics knows your payers, your plans, and exactly how to get your claims paid.
Every state has its own payer rules, Medicaid structure, and billing landmines. TransDontics expertly navigates all of them.
Georgia practices carry HIPAA obligations alongside O.C.G.A. § 31-33, which governs patient health record access and disclosure obligations. TransDontics is independently certified under both frameworks statewide.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Georgia’s O.C.G.A. § 31-33 electronic health information protections. Every data transmission meets the highest applicable standard; not just the minimum.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability most Georgia practice owners don’t realize they are carrying until it is too late.
Our AICPA SOC 2 Type II certification is independently audited and renewed annually. Everything is documented, third-party verified proof of our security posture. Your Georgia 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. Between staffing overhead, turnover, training costs, and the revenue lost to unworked denials, most practices are spending far more than they realize and collecting far less than they should. TransDontics fee is a percentage of what you actually collect. That’s the whole model.
Average Georgia Salary
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
Three things most billing companies underestimate: Medicaid routes through 4 separate MCOs with conflicting portals and documentation requirements, Delta Dental of Georgia reimburses certain procedures at lower fee tiers on specific plan types, and the state’s 30-day clean claim window is shorter than most billers actively track.
RPA handles volume tasks automatically and continuously such as eligibility checks, claim scrubbing, status tracking, payment posting. Billing specialists handle what requires judgment like appeals, EOB reconciliation, pre-auth follow-up, payer escalations. The combination is what keeps the first-pass rate at 98%. Either layer alone doesn’t achieve that.
Yes. Our data handling protocols satisfy Georgia’s health records statute, O.C.G.A. § 31-33, which governs patient health record access and disclosure obligations in Georgia; in addition to our full HIPAA certification and AICPA SOC 2 Type II audit compliance.
Yes. The Georgia Board of Dentistry (GBD), operating under the Georgia Secretary of State and governed by O.C.G.A. § 43-11, mandates specific clinical record-keeping standards that directly affect claim documentation and audit defensibility. Our team ensures every claim submitted for your Georgia practice satisfies both CMO and commercial payer requirements alongside GBD clinical standards simultaneously.
TransDontics charges a small percentage commission based solely on what your practice successfully collects from insurance payers. There are no upfront fees, no monthly retainers, and no hidden charges. If you don’t collect, we don’t earn! Our financial incentive is always directly aligned with your practice’s revenue performance.
All active Georgia payers including Delta Dental of Georgia, Anthem BCBS Georgia, Cigna, Aetna, UnitedHealthcare, Humana, TRICARE, MetLife, Guardian, and all 4 Medicaid MCOs: UnitedHealthcare, CareSource, Humana, and Molina Healthcare.
The July 1, 2026 transition, which adds Humana, Molina, and UnitedHealthcare as new CMOs under Georgia Families®, will require provider credentialing with all three new plans and updated billing workflows for each CMO’s portal and documentation requirements. Practices that have not completed credentialing by transition date risk payment interruptions. TransDontics is actively managing credentialing for Georgia practices with all three new CMOs and building out the specific billing workflows ahead of the transition date.
Denied claims. Aging A/R. Unbilled hours. That’s your uncollected money! TransDontics recovers it. Most practices find 5–10% in hidden leakage. Start with the audit. We review your current claims, A/R aging, and denial patterns at no cost and no commitment. You’ll know exactly what’s recoverable before you decide anything.
Complimentary 12 months claims audit
Uncover your top 3 revenue leaks
Custom strategy for your specialty and PMS software
Live in 24 hours with no contracts & no upfront fees
Pay only a percentage of what we collect for you
