MaineCare Adult Dental Expansion & Prior Authorization
Low MaineCare Reimbursement Rates and the Collection Gap
Workforce Shortages and the Billing Pressure That Follows
Maine's Dual Compliance Burden: HIPAA and 22 MRSA § 1711-C
Billing companies are typically either fully manual or heavily 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 or contractual judgment.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Anthem BCBS Maine 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 because that is where the process stops. We go further.
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. PA errors shouldn't be a surprise. For our clients, they never are.
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, which means our incentives are aligned with yours from day one.
TransDontics is not a clearinghouse or a claim-submission portal. We are your complete outsourced dental revenue cycle management department handling every step from eligibility verification to final payment posted to your ledger.
Coverage and benefits are confirmed before every appointment so claims go clean and no one gets caught by a lapsed policy or a MaineCare eligibility issue at claim time.
Clean CDT coding combined with Maine payer-specific scrubbing and a 48-hour turnaround. Claims go out right the first time.
Outstanding balances pursued systematically for every claim over $50 with every Maine payer. Average resolution time of 18–25 days
Delta Dental of Maine, Anthem BCBS Maine, MaineCare, and all applicable commercial payers. We handle applications, follow-ups, and re-credentialing so your providers stay in-network.
Full revenue cycle coverage from patient registration to final payment. We manage every financial touchpoint, close every gap, and maximize what your practice.
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.
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.
01
An in-house biller knows your practice; not necessarily MaineCare’s prior authorization protocols, Delta Dental of Maine’s downcoding patterns, or how to reconcile an Anthem BCBS Maine EOB against a custom employer plan design. Turnover resets that knowledge every 12–18 months. Ours does not.
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. TransDontics does all of it.
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 that consistently holds between 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 general dentistry practice in central Maine came to us with a denial rate above 10%, more than a third of their A/R aging past 90 days, and MaineCare claims regularly returned for missing prior authorization documentation. Their front desk was spending two to three hours daily on billing follow-up with inconsistent results.
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.
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
Average Maine salary
*Salary benchmarks based on Maine BLS/ZipRecruiter data. Results vary by practice size and payer mix.
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. Title 32, Chapter 16 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
