North Carolina’s dental market is growing faster than most practices’ billing infrastructure. From the Research Triangle’s dense commercial payer environment to Medicaid managed care volumes and TRICARE footprint surrounding Fort Liberty and Camp Lejeune, the state presents more billing complexity than most out-of-state vendors can handle.
NC Medicaid Managed Care: Four Plans, Four Sets of Rules
NC Health Choice (CHIP) and Adult Benefit Complexity
TRICARE Billing: Fort Liberty and Camp Lejeune Markets
HIPAA & NC’s Identity Theft Protection Act, N.C.G.S. § 75-60 et seq.
TransDontics’s 1,100+ in-house dental billing specialists are supported by RCM automation engineered for North Carolina’s dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
Most billing companies are either fully manual or fully automated. TransDontics is a combination of both. RPA handles eligibility verification, claim scrubbing, status tracking, and payment posting while specialists handle NC Medicaid appeals, pre-auth follow-ups, and lEOB reconciliation.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of North Carolina or any commercial carrier pays below the agreed fee on specific plan types, we flag it and file the appeal within 14 days. Most practices only catch outright denials. We go further.
Before every NC Medicaid claim, we confirm managed care plan enrollment, format to that plan's portal, and include required documentation. Mid-treatment switches between Healthy Blue, UnitedHealthcare, Molina, and WellCare are caught before they become rejections.
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 which NC Medicaid plan your patient switched to, Delta Dental NC’s PPO versus Premier fee differences, or WellCare’s pre-authorization appeal documentation.
Most billing companies submit claims. They won’t reconcile every EOB against your contracted rate, flag MCO routing errors, or chase the revenue that a clean submission still leaves uncollected. TransDontics does it all.
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 |
A Research Triangle practice came to us with a 10% denial rate, 35% of A/R past 90 days, and NC Medicaid claims submitted to the wrong managed care plan with front desk spending 2–3 hours daily on inconsistent billing follow-up.
Our specialists know every North Carolina payer’s rules and appeal processes. National billing companies stumble on NC’s four-plan Medicaid structure and miss coverage differences between WellCare, Molina, and Healthy Blue. We don’t.
TransDontics handles North Carolina claims daily, knowing Delta Dental NC’s PPO versus Premier fee schedule differences, WellCare versus Molina documentation divergences, and TRICARE’s separate submission workflow in Fayetteville and Jacksonville.
Every North Carolina 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.
North Carolina practices carry HIPAA obligations alongside N.C.G.S. § 75-60 through 75-66, which applies to billing vendors accessing patient data. TransDontics is independently certified under both frameworks statewide.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and the data protection obligations applicable to North Carolina health care providers. Every transmission meets the highest applicable standard; not just the minimum required.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability most North Carolina practice owners don’t realize they’re 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 North Carolina practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
Average NC salary
*Salary benchmarks based on North Carolina BLS/ZipRecruiter 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.
HIPAA-compliant from day one.
Pay only a percentage of what we collect for you
