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 Envolve, UHC Dental, and Molina Dental. 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.
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, Envolve versus Molina Dental 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 came to us with a 10% denial rate, 35% of A/R past 90 days, and Heritage Health claims denied for prior auth documentation submitted to the wrong dental benefit manager with 2–3 hours daily of inconsistent 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.
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
*Salary benchmarks based on Nebraska Glassdoor, ZipRecruiter, and BLS data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, MCO routing errors, and underpayments, no obligation, no pitch.
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.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
