South Carolina routes all Healthy Connections dental through DentaQuest as a separate ASO. MCO medical claim knowledge tells you nothing about dental processing. Four military installations and surging coastal employer volume make South Carolina harder to bill correctly than most vendors acknowledge.
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
TransDontics’s 1,100+ in-house dental billing specialists are supported by RCM automation engineered for South Carolina’s dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
TransDontics combines RCM automation with specialist judgment. Automation handles eligibility, claim scrubbing, and payment posting while specialists handle EPSDT prior authorization documentation, adult annual cap tracking, five-MCO crossover claim routing, and sedation permit verification.
Every payment is reconciled against your contracted rate, line by line. When BCBS South Carolina, Delta Dental, or any commercial carrier pays below the agreed fee, we flag it and appeal within 14 days; catching underpayments that never generate a denial code but steadily drain monthly collections.
Before every Healthy Connections claim, we confirm DentaQuest eligibility, verify MCO enrollment for medical-dental coordination, and format to DentaQuest's submission requirements. Mid-treatment coverage changes; common in South Carolina's Medicaid population are caught.
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.
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 schedule; not the July-to-June Medicaid cap, DentaQuest’s MCO separation, crossover sedation claim splitting, or January 2026 EPSDT orthodontic prior auth requirements.
Most billing companies submit claims. They won’t route dental Medicaid correctly, track adult benefit balances, verify sedation permits, or catch commercial carrier underpayments on specific plan tiers.
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 Columbia practice came to us with a 10% Medicaid denial rate, adult benefit caps hit mid-treatment without warning, and dental claims routed to MCO portals instead of DentaQuest and front desk spending three hours daily on billing follow-up with no systematic resolution.
Our specialists know every South Carolina payer’s rules and appeal processes. National billing companies stumble on DentaQuest’s separate ASO role and miss Absolute Total Care versus Molina Healthcare crossover claim authorization differences. We don’t.
No dollar cap, comprehensive EPSDT coverage including January 2026 orthodontic CDT additions; prior auth tracking, frequency limit monitoring, and audit defense documentation built into every claim workflow.
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 South Carolina claims daily; knowing BCBS SC’s employer group benefit designs, Delta Dental PPO versus Premier fee schedule differences, and TRICARE’s separate submission workflow in Beaufort, Columbia, and Charleston.
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.
South Carolina practices carry HIPAA obligations alongside S.C. Code § 40-15-83 and Board of Dentistry Chapter 39 standards that DentaQuest’s review processes depend on. TransDontics is independently certified under both frameworks statewide.
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)
Benefits + Payroll Taxes
Software + Training
Turnover Cost
Average Denial Rate
First-Pass Clean Claims Rate
Setup Fee
Contract
~$40,057/yr
~$12,017/yr
~$5,000/yr
~$56,000/replacement
8–12%
70–80%
—
—
Included
None
Included
None
Under 2.3%
98%
$0
Cancel Anytime
*Salary benchmarks based on South Carolina BLS/ZipRecruiter data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, DentaQuest routing errors, adult cap exhaustion write-offs, 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: DentaQuest administers all Healthy Connections dental as a separate ASO from the five MCOs; wrong routing creates permanent denials. The adult $1,000 annual cap runs July-to-June on a first-submitted basis. January 2026 EPSDT orthodontic CDT additions created new prior authorization obligations generating systematic denials.
RCM automation handles eligibility checks, adult benefit balance tracking, claim scrubbing, DentaQuest portal monitoring, and payment posting. Specialists handle EPSDT prior authorization, five-MCO crossover routing, sedation permit verification, DentaQuest reconsideration, and commercial EOB reconciliation. The combination consistently sustains a 98% first-pass rate. Either layer alone doesn’t get there.
Yes. Our protocols satisfy S.C. Code § 40-15-83 and Board of Dentistry Chapter 39 recordkeeping requirements alongside full HIPAA certification and AICPA SOC 2 Type II compliance. Every claim meets both DentaQuest’s Medicaid audit standards and Board of Dentistry clinical requirements simultaneously.
Yes. S.C. Code §§ 40-15-10 through 40-15-380 and Chapter 39 mandate clinical recordkeeping standards directly affecting claim documentation and audit defensibility. Section 40-15-83 specifically addresses recordkeeping requirements and penalties. Every claim satisfies both DentaQuest and commercial payer documentation requirements alongside Board standards simultaneously.
TransDontics charges a percentage of successfully collected insurance revenue only; no upfront fees, no retainers, no hidden charges. If your practice doesn’t collect, we don’t earn. Our financial incentive is always directly aligned with your revenue performance from the first claim submitted.
All active South Carolina payers, including BlueCross BlueShield, Delta Dental, Cigna, Aetna, MetLife, Guardian, TRICARE through United Concordia, GEHA, FEDVIP, Healthy Connections Medicaid through DentaQuest, and all five Medicaid MCOs: Absolute Total Care, Healthy Blue by BlueChoice of SC, First Choice, Molina, and Humana Healthy Horizons.
Adult Healthy Connections members receive a $1,000 annual dental benefit running July 1 through June 30; not the calendar year. Caps are tracked on a first-submitted basis. Delayed claims risk consuming remaining benefit before earlier date-of-service claims process. Real-time benefit balance verification before treatment prevents unrecoverable write-offs.
South Carolina’s four installations generate significant TRICARE Dental Program volume for practices in those corridors. TDP runs through United Concordia with its own CDT coverage rules and cost-sharing structure. Active-duty members use on-base facilities; civilian TRICARE billing covers primarily family members and retirees. We manage TDP as standard workflow near all four installations.
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
