If your practice is losing revenue to denials, downcoding, or Maryland Medicaid managed care errors, it is because Maryland dental billing carries a level of real-world complexity that most out-of-state billing vendors never bother to understand. TransDontics’s 1,100+ certified dental billing specialists manage your complete revenue cycle effectively.
Maryland runs a fully managed Medicaid dental program through HealthChoice, mandates all-payer rate-setting compliance, and anchors a dense federal employee benefits market. Practices from Baltimore to Montgomery County navigate all of it simultaneously.
Maryland Medicaid HealthChoice and the MCO Structure
Maryland All-Payer Model and Its Billing Implications
Federal Employee Benefits Market & GEHA, FEDVIP, TRICARE.
HIPAA and Maryland’s Health Care Access and Availability Act
TransDontics’s 1,100+ in-house dental billing specialists are supported by RCM automation engineered for Maryland’s dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
TransDontics combines RCM automation with specialist judgment. Automation handles claim scrubbing and eligibility verification checks while specialists handle MCO routing verification, federal plan identification, and TRICARE prior authorization tracking.
Every payment is reconciled against your contracted rate, line by line. When CareFirst BCBS or any commercial plan underpays, we flag it and appeal within 14 days. Maryland's large federal contractor workforce creates high self-insured plan volume with underpayment issues.
Before every Maryland Medicaid claim, we confirm HealthChoice MCO enrollment, identify the correct dental benefit manager, format to that entity's portal requirements, and include all required documentation. Mid-treatment MCO changes are caught before they become two-layer denials.
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 Maryland’s two-layer HealthChoice dental benefit manager structure, CareFirst’s downcoding, or how to route a FEDVIP claim after an annual change. Turnover resets that knowledge.
Most billing companies submit claims. They will not reconcile every EOB against your contracted rate, identify HealthChoice dental benefit manager routing errors, or chase uncollected revenue. 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 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.
Claims out in 48 hours, every denial worked, every payment reconciled. Full real-time visibility into your revenue cycle.
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 Baltimore County practice came to us with a 10% denial rate, 35% of A/R past 90 days, and HealthChoice claims submitted to the MCO instead of the correct dental benefit manager with 2–3 hours daily of inconsistent billing follow-up.
Our specialists know every Maryland payer’s rules and appeal processes. National billing companies stumble on Maryland’s two-layer HealthChoice structure and miss CareFirst FEP versus commercial employer plan authorization differences. We don’t.
We confirm MCO enrollment and dental benefit manager assignment before every submission; the two-layer routing step most billing teams skip, and the reason most HealthChoice claims are denied.
TRICARE Dental Program and commercial employer group plans run on entirely different submission rules. We maintain separate, current workflows for each United Concordia product line across both plan categories.
TransDontics handles Maryland claims daily, knowing CareFirst FEP versus commercial reimbursement differences, United Concordia’s TRICARE versus commercial prior auth timelines, and HealthChoice dental benefit manager assignments that shift at open enrollment without notice.
Every Maryland 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.
Maryland practices carry HIPAA obligations alongside the Maryland Medical Records Act under Health-General Article §4-301, which exceeds federal minimums in specific areas. TransDontics is independently certified under both frameworks statewide.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Maryland Health-General Article §4-301 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 Maryland 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, third-party verified proof of our security posture. Your Maryland 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 and collecting far less. Maryland’s above-average cost of living makes every one of those line items more expensive than in most states.
Average Maryland salary
*Salary benchmarks based on Maryland BLS and ZipRecruiter market data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, MCO routing errors, and underpayments, no obligation, no pitch.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
