Texas dental billing, with its STAR/CHIP plan routing, Medicaid complexities, and payer-specific rules is a landscape most out-of-state vendors get wrong, and your revenue pays the price. TransDontics’s 1,100+ certified dental billing specialists manage your complete revenue cycle, from eligibility to payment posting.
Texas dental billing matches the state’s complexity at every level. Practices from DFW to the Rio Grande Valley navigate a fragmented multi-DMO Medicaid and CHIP structure, Texas Health Steps dental certification, carrier-specific timely filing windows, and TSBDE record-keeping standards affecting claim defensibility.
Texas’ Multi-DMO STAR & CHIP Dental Structure
Texas Health Steps Dental Certification & Billing Complexity
DSO Expansion and the Texas Multi-Location Billing Challenge
HIPAA and Texas’ Health Privacy Requirements
TransDontics’s 1,100+ in-house dental billing specialists are supported by RCM automation engineered for Texas’ dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
Billing companies are typically either fully manual (slow and error-prone at volume) or heavily automated (missing judgment calls). TransDontics uses both. Our RCM automation handles high-volume, repetitive tasks, while our billing specialists handle anything requiring clinical judgment.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of Texas or any commercial payer 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 than that.
Before every STAR or CHIP dental claim, we confirm DMO enrollment, format to that plan's portal, and include required documentation. Mid-treatment DMO assignment changes; common in Texas' STAR population 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 necessarily Texas’ STAR/CHIP DMO routing rules, Delta Dental’s downcoding patterns on specific plan types, or which DMO your pediatric patient was reassigned to last quarter.
Most billing companies submit claims. They won’t reconcile every EOB against your contracted rate, flag DMO routing errors on STAR claims, or chase the revenue that a clean submission still leaves uncollected.
Most billing companies are a service. TransDontics is a system; RPA catching what humans miss at volume, experienced billers catching 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 |
Our specialists know every Texas payer’s rules and appeal processes. National billing companies stumble on Texas’s multi-DMO STAR/CHIP structure and miss coverage differences between MCNA, DentaQuest, and UnitedHealthcare Dental. We don’t.
A state-contracted DMO managing Texas Medicaid and CHIP dental benefits; credentialing is separate from HHSC TMHP enrollment. Covers comprehensive dental for members under 21, emergency-only dental for STAR adults, and limited supplemental benefits for STAR+PLUS members.
State-contracted DMO with its own covered-service criteria, periodicity limits, and prior authorization requirements distinct from MCNA’s. Claims without DMO-specific documentation are automatically denied.
Employer group PPO and DMO products billed compliantly statewide. Aetna participating providers have a 90-day timely filing window, which is why we verify terms before the first claim, not after the first denial. We submit within 48 hours, so deadlines are never a variable.
Cigna’s standard in-network timely filing window is 90 days; among the shortest of any major Texas commercial payer.. A late submission on any Texas corporate employer plan is a permanent write-off. We file before payers close the window.
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.
Our team handles Texas claims daily, knowing Delta Dental of Texas PPO reimbursement differences, MCNA versus DentaQuest portal distinctions, and UnitedHealthcare’s 90-day STAR timely filing deadline shorter than their national standard.
Every Texas practice qualifies. If your city isn’t listed, it’s coming. Reach out now and we’ll onboard your practice without delay.
Whether you practice in Bexar County or Lubbock County, TransDontics knows your payers, your plans, and exactly how to get your claims paid.
Every state has its own payer rules, Medicaid structure, and billing landmines. TransDontics expertly navigates all of them.
Texas practices carry HIPAA obligations alongside Texas Health & Safety Code Chapter 181, and 22 TAC § 108.8(b). TransDontics is independently HIPAA certified and AICPA SOC 2 Type II compliant statewide.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Texas’ Chapter 181 electronic health information 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 Texas 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 Texas practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
In-house billing appears cost-effective until the numbers tell a different story. Staffing overhead, turnover, training, and unworked denials mean most Texas practices spend more than they budget while collecting less than their claims are worth. TransDontics charges a percentage of what you collect.
Average Texas salary
Our Complimentary audit covers denied claims, DMO routing errors, and underpayments, no obligation, no pitch.
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
Yes. Under 22 Tex. Admin. Code § 108.8, TSBDE mandates clinical record-keeping standards, including billing records, treatment plans, progress notes, and informed consent that directly impact audit defensibility. Under 22 TAC § 108.8(b), dental records must be retained for a minimum of five years from the last date of treatment. TransDontics ensures every claim satisfies both TSBDE standards and payer-specific documentation requirements simultaneously.
Texas Health Steps expanded dental benefits on March 1, 2025, adding two codes with strict pairing rules that are generating denials at practices still on old workflows.
D9994 — Oral Health Education: Reimbursable only for patients aged 6–35 months, billed same-day alongside D0145 by the same provider. Not a general-use code.
D9995 — Teledentistry Indicator: A required claim indicator, not a standalone billable service. Must be paired with D0120 (ages 3–20) or D0140 (birth–20) to flag synchronous audiovisual delivery. Billing it alone or with the wrong age group triggers immediate denial.
Both codes restrict eligible provider types; FQHCs, Texas Health Steps dental providers, and local health departments for D9994; oral maxillofacial surgeons are also eligible for D9995. Our team has updated all Texas Health Steps workflows to reflect the March 1, 2025 TMHP guidelines in full.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
HIPAA and Texas Health & Safety Code Chapter 181-compliant.
Pay only a percentage of what we collect for you
