New York dental billing is among the country’s most complex. A 90-day Medicaid timely filing window, dual FFS/MMC routing, expanded prior authorization requirements, and a commercial landscape dominated by MetLife, Guardian, Healthplex, and EmblemHealth creates layered denial risk. TransDontics’s 1,100+ specialists manage your complete revenue cycle.
New York practices navigate a strict 90-day Medicaid timely filing window, a dual eMedNY FFS and Managed Care billing structure, January 2024 coverage with new prior auth requirements, and New York-specific commercial payers like Healthplex and EmblemHealth that out-of-state vendors routinely mishandle.
New York's 90-Day eMedNY Timely Filing Deadline
eMedNY FFS & Medicaid Managed Care: New York's Split System
New York’s DSO Surge and the Multi-Location Billing Challenge
HIPAA and New York’s Health Privacy Requirements
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for New York’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 eligibility verification, eMedNY FFS versus MMC routing, CDT scrubbing, and payment posting while specialists handle prior authorization documentation, appeals, EOB reconciliation, and payer escalations.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of New York or any commercial carrier pays below the agreed fee on a specific plan type, we flag it and file the appeal within 14 days. Most practices only catch outright denials. We go further.
New York's 90-day eMedNY timely filing window is strictly enforced. We flag every Medicaid FFS claim at day 30 for status review and day 60 for escalation. Claims approaching day 90 without payment confirmation are escalated immediately. We prevent timely filing denials before they happen.
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 eMedNY’s 90-day filing rules, Healthfirst versus eMedNY FFS submission differences, or January 2024 prior auth documentation changes. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t track the 90-day eMedNY window, reconcile EOBs against contracted rates, or capture January 2025 eConsult billing opportunities. TransDontics does all of it.
Most billing companies are a service. TransDontics is a system. RPA catches what humans miss at volume. Experienced billers catch what automation can’t 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 Brooklyn practice came to us with a 10%+ denial rate, 35% of A/R past 90 days, Medicaid Managed Care claims routed through eMedNY instead of the correct MCO dental administrator, and crown prior auth requests denied for missing clinical documentation.
Our specialists know every New York payer’s rules and appeal processes. National billing companies stumble on eMedNY’s 90-day enforcement, miss FFS versus MMC pathway distinctions, and fail to recognize Healthplex and EmblemHealth/GHI. We don’t.
TransDontics handles New York claims daily, knowing eMedNY’s strict 90-day window, MMC patients never route through eMedNY, January 2024 crown prior auth documentation requirements, and Healthplex and EmblemHealth/GHI credentialing workflows.
Every New York 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.
New York practices carry HIPAA obligations alongside NY Public Health Law §18, 8 NYCRR §29.2(a)(3) requiring six-year minimum record retention, and OPD oversight with no complaint statute of limitations. TransDontics is HIPAA certified and AICPA SOC 2 Type II compliant.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and New York Public Health Law §18 patient records 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 New York practice owners don’t 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. Your New York 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 eMedNY write-offs and MMC routing errors, most New York practices are spending far more and collecting far less. TransDontics’s fee is a percentage of what you actually collect. That is the whole model.
Average New York salary
*Salary benchmarks based on New york 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.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
