Maine’s dental billing environment shifted significantly when adult MaineCare enrolled 217,000+ adults as of July 1, 2022. Practices from Portland to Presque Isle now manage surging MaineCare volume, a prior auth process that catches most billers off guard, and clinical documentation standards that directly affect claim review outcomes.
MaineCare Adult Dental Expansion & Prior Authorization
Low MaineCare Reimbursement Rates
Workforce Shortages and the Billing Pressure That Follows
Maine's Dual Compliance with HIPAA and 22 MRSA § 1711-C
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for Maine’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 automated. TransDontics uses a combination of both. Our RPA handles high-volume, repetitive tasks like claim scrubbing, eligibility checks, and status tracking, while our billing specialists handle anything requiring clinical judgment.
Every payment is reconciled against your contracted rate, line by line. When Anthem BCBS Maine or any commercial payer pays below the agreed fee, we flag it and appeal within 14 days. Most practices only catch outright denials because that is where the process stops.
Before every MaineCare claim goes out, we confirm prior authorizations are in place, documented correctly, and submitted through Health PAS Online with the clinical detail reviewers require. When authorization is denied or returned, we manage re-submission from start to finish.
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 MaineCare’s prior auth protocols, Delta Dental of Maine’s downcoding patterns, or Anthem BCBS Maine EOB reconciliation. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They will not reconcile every EOB against your contracted rate, flag MaineCare PA errors, or chase the revenue that a clean submission still leaves uncollected.
Most billing companies are a service. TransDontics is a system; RPA catching what humans miss at volume, experienced billers catching what automation cannot judge. The result is a first-pass acceptance rate of 98%.
Three steps. No disruption. No risk.
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 central Maine general practice came to us with a 10%+ denial rate, a third of A/R past 90 days, and MaineCare claims regularly returned for missing prior authorization documentation front desk spending two to three hours daily on billing follow-up.
Our specialists know every Maine payer’s rules and appeal processes. National billing companies stumble on MaineCare’s Section 25 documentation and Anthem BCBS state employee plan nuances. We don’t.
Maine’s major commercial dental insurer with distinct benefit designs across all plan types. We manage every Anthem plan with full protocol compliance.
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 Maine claims daily, knowing Delta Dental’s employer plan reimbursement differences, MaineCare’s Health PAS Online Portal prior auth requirements, and Anthem BCBS Maine’s plan-specific pre-authorization rules.
Every Maine practice qualifies. If your city isn’t listed, it’s coming. Reach out now and we’ll onboard your practice without delay.
Every state has its own payer rules, Medicaid structure, and billing landmines. TransDontics expertly navigates all of them.
Maine practices carry federal HIPAA obligations alongside 22 MRSA § 1711-C which imposes patient health information confidentiality requirements that in several respects exceed HIPAA’s baseline federal protections. TransDontics is certified under both frameworks.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Maine's 22 MRSA § 1711-C 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 Maine practice owners do not 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 and third-party verified proof of our security posture. Your Maine 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’s fee is a percentage of what you actually collect. That is the whole model.
Average Maine salary
Benefits + Payroll Taxes
Software + Training
Turnover Cost
Average Denial Rate
First-Pass Clean Claims Rate
Setup Fee
Contract
~$40,000/yr
~$12,000/yr
~$5,000/yr
~$60,500/replacement
8–12%
70–80%
—
—
Included
None
Included
None
Under 2.3%
98%
$0
Cancel Anytime
*Salary benchmarks based on Maine BLS/ZipRecruiter data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, Fee for Service discrepancies, 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
MaineCare requires prior authorization through Health PAS Online with clinical documentation reviewers reject if incomplete. Delta Dental reimburses certain procedures at lower fee tiers on specific employer plans. Maine’s 22 MRSA § 1711-C privacy statute exceeds HIPAA baseline — your billing partner’s compliance posture matters here more than most states.
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.
Yes. 32 MRSA, Chapter 143 mandates clinical record-keeping standards that directly affect claim documentation and audit defensibility. Every claim we submit satisfies both payer requirements and Maine Board of Dental Practice clinical record standards simultaneously.
TransDontics charges a small percentage of what your practice successfully collects from insurance payers. No upfront fees, no monthly retainers, no hidden charges. If you don’t collect, we don’t earn. Our financial incentive is always aligned directly with your practice’s revenue performance.
Yes. The July 2022 adult dental expansion caught many practices unprepared for prior authorization volume, Section 25 fee schedule reconciliation, and Health PAS Online submissions. TransDontics handles all of it; from PA verification through remittance reconciliation, so your team stays focused on patients.
Denied claims. Aging A/R. Unbilled hours. That is 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 will know exactly what is recoverable before you decide anything.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
HIPAA and 22 MRSA § 1711-C-compliant from day one.
Pay only a percentage of what we collect for you
