DentaQuest as the Dental ASO: Separate from the Five MCOs
The Adult Annual Benefit Cap: $1,000 per Year, July 1–June 30
EPSDT and Pediatric Prior Authorization Complexity
HIPAA and South Carolina’s S.C. Code § 40-15-83
Most billing companies are either fully manual; error-prone at volume or fully automated, missing judgment calls only an experienced biller can make. TransDontics combines both. RPA handles eligibility, claim scrubbing, and payment posting while specialists handle EPSDT prior authorization documentation, adult annual cap tracking, five-MCO prior auth routing for medical-dental crossover claims, and sedation permit verification before every claim.
Every payment is reconciled against your contracted rate, line by line, across every payer. When BlueCross BlueShield of South Carolina, Delta Dental, 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, that’s where their process stops. We go further, identifying the underpayments that never generate a denial code but steadily drain monthly net collections without ever triggering an alert in a standard PMS report.
Before every Healthy Connections dental claim goes out, we confirm patient eligibility through DentaQuest’s portal, verify which MCO the patient is enrolled in for cross-reference on any medical-dental coordination, and format every claim for DentaQuest’s specific submission requirements. When a patient’s Medicaid coverage changes mid-treatment, which happens with real frequency in South Carolina’s Medicaid population, we catch it before it becomes a denial.
Claims processed within 48 hours of receipt. No setup fee, no monthly minimum, no long-term contract, and no costs buried in the fine print. Our fee is a nominal percentage of what we successfully collect from payers on your behalf; nothing more. We only earn when you get paid, which means our incentives are fully aligned with yours from day one. The more we recover for your practice, the better we both do.
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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 |
Our dental billing specialists are fully versed in the submission rules, fee schedules, timely filing deadlines, and appeal processes for every significant payer active in South Carolina. National billing companies frequently stumble on DentaQuest’s role as the dental ASO operating separately from all five MCOs, and miss the nuances between what Absolute Total Care authorizes for a medical crossover claim versus what Molina Healthcare requires for the same procedure. We don’t.
Every South 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.
All patient data is encrypted end-to-end, satisfying the HIPAA Security Rule and the state patient privacy obligations applicable to South Carolina dental providers and their billing business associates. Every transmission meets the highest applicable standard, not just the minimum required by federal law.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability most South 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. Third-party verified documentation of our complete security posture. Your South Carolina practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
Average SC salary (medical biller)
*Salary benchmarks based on South 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.
Yes. Our documentation protocols satisfy the obligations under S.C. Code § 40-15-83 and the South Carolina State Board of Dentistry’s regulations under S.C. Code of Regulations Chapter 39, which govern patient dental recordkeeping requirements and associated penalties for violations, in addition to our full HIPAA certification and AICPA SOC 2 Type II audit compliance. Every claim we submit for your South Carolina practice is supported by documentation that meets both DentaQuest’s Medicaid audit standards and the Board of Dentistry’s recordkeeping requirements simultaneously.
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
