Nebraska restructured Medicaid dental under Heritage Health on January 1, 2024, with three MCOs each carrying distinct credentialing and prior authorization protocols. The removed adult dental cap dramatically increased claim volume. TransDontics’s 1,100+ specialists manage your complete revenue cycle.
Nebraska’s 2024 Medicaid restructuring introduced three credentialing tracks across Nebraska Total Care, UHC Community Plan, and Molina Healthcare. Delta Dental dominates commercially with 82% network participation alongside BCBS Nebraska and Ameritas.
Heritage Health & the Three-MCO Dental Integration
The Adult Dental Cap Removal and What It Changed for Billing
Delta Dental of Nebraska’s Dominant Network Position
Ameritas and the Nebraska-Headquartered Payer Complexity
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for Nebraska’s dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
TransDontics combines RPA automation with specialist judgment. RPA handles Heritage Health eligibility checks across all three MCOs, claim scrubbing, portal submissions, and status tracking while specialists handle anything requiring clinical or contractual judgment.
Every payment is reconciled against your contracted rate, line by line. When Delta Dental of Nebraska or any commercial payer pays below the agreed fee, we flag it and appeal within 14 days. Most practices only catch outright denials. We go further.
Before every Heritage Health claim, we confirm MCO assignment, verify eligibility, format to that MCO's protocols, and attach required prior auth documentation including clinical documentation for pre-payment review triggers where most vendors stumble.
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.
Get in-network faster. We handle all payer paperwork, CAQH maintenance, renewals, and compliance tracking so you start seeing insured patients.
Robotic process automation eliminates manual repetitive tasks. Eligibility checks, reminders, and daily reports run without human intervention, 24/7.
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, Nebraska Total Care vs. Molina Healthcare PA differences, Delta Dental’s frequency limitation updates, or BCBS Nebraska’s COB processing. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t reconcile every EOB against your contracted rate, flag Heritage Health prior authorization documentation gaps, 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.
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 |
An Omaha practice had a 10% denial rate, 35% of A/R past 90 days, and Heritage Health claims denied across two MCOs due to PA documentation routed to the wrong dental benefit manager with front desk staff burning 2–3 hours daily on follow-up.
Our specialists know every Nebraska payer’s rules and appeal processes. National billing companies stumble on Heritage Health’s multi-MCO structure, miss Delta Dental PPO versus Premier differences, and lack dedicated Ameritas dual-coverage workflows. We don’t.
Heritage Health dental benefits administered through the SKYGEN Dental Hub portal. Former Healthy Blue members auto-enrolled in Molina, creating credentialing and billing challenges for practices that didn’t credential ahead of the transition.
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 Nebraska claims daily, knowing Delta Dental PPO vs. Premier reimbursement differences, Envolve versus Molina Dental authorization differences, and rural Nebraska’s Ameritas and Principal Financial Group workflows generalist billing companies don’t maintain.
Every Nebraska 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.
Nebraska practices carry HIPAA obligations alongside the Dentistry Practice Act and Heritage Health documentation standards. Neb. Rev. Stat. § 71-8401 requires seven-year record retention; three years past majority for minors. TransDontics is HIPAA certified and SOC 2 Type II compliant.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Nebraska’s medical records access requirements under Neb. Rev. Stat. § 71-8403. 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 Nebraska 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, providing proof of our security posture. Your Nebraska practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
Average Nebraska salary
Benefits + Payroll Taxes
Software + Training
Turnover Cost
Average Denial Rate
First-Pass Clean Claims Rate
Setup Fee
Contract
~$48,000/yr
~$14,400/yr
~$5,000/yr
~$70,000/replacement
8–12%
70–80%
—
—
Included
None
Included
None
Under 2.3%
98%
$0
Cancel Anytime
*Salary benchmarks based on Nebraska Glassdoor, ZipRecruiter, and BLS data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, Heritage Health MCO DBM routing errors, and underpayments.
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 factors: Heritage Health’s 2024 restructuring created three separate MCO dental workflows under one Medicaid program with distinct benefit managers and prior auth pathways. Delta Dental of Nebraska modifies frequency limitations on employer plans producing underpayment without thorough EOB reconciliation. Ameritas’s local dominance creates consistent dual-coverage underpayment without Ameritas-specific protocol knowledge.
RPA handles Heritage Health eligibility checks across all three MCO portals, claim scrubbing, status tracking, and payment posting. Billing specialists handle appeals, EOB reconciliation, prior authorization follow-up, and payer escalations. The combination sustains a 98% first-pass rate. Either layer alone doesn’t achieve that consistently.
No. Effective January 1, 2025, Nebraska Medicaid implemented centralized credentialing through Verisys CVO; one verification process covers all three MCOs. However, portal access, prior authorization protocols, and claims submission remain distinct per MCO and dental benefit manager. Billing complexity is unchanged.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
