Utah extended full Medicaid dental benefits to all adults through two managed care plans; MCNA Dental and Premier Access; each with its own portal, prior authorizations, and fee schedule. Delta Dental, SelectHealth, and Regence BCBS anchor the commercial market. TransDontics’s 1,100+ specialists manage your complete revenue cycle.
Utah’s April 2025 adult Medicaid dental expansion added 120,000 newly covered adults into a managed care system requiring credentialing, prior authorization, and plan-specific documentation most generalist billing companies have never handled.
Utah Medicaid’s Dual Dental Plan with MCNA & Premier Access
EPSDT & CHIP Dental: Where Pediatric Billing Gets Complicated
Delta Dental Insurance Company’s Network Footprint in Utah
SelectHealth and the Intermountain Health Payer Dynamic
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for Utah’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 with specialist judgment. RPA handles MCNA and Premier Access eligibility checks, claim scrubbing, portal formatting, and status tracking while specialists handle authorization follow-up, EOB reconciliation, and appeals driving our first-pass rate to a consistent 98%.
Every payment is reconciled against your contracted rate, line by line. When Delta Dental or any commercial payer pays below the agreed fee, we flag it and appeal within 14 days; catching underpayments, partial payments, and COB errors that never generate a formal denial notice.
Before every MCNA or Premier Access claim, we confirm enrollment, format to each plan's portal, and attach required prior auth documentation. MCNA and Premier Access operate under different utilization management guidelines; we handle each as a distinct workflow.
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 MCNA’s prior auth windows, Premier Access’s documentation requirements, or SelectHealth’s dual-coverage COB processing. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t reconcile EOBs against contracted rates, catch MCNA pre-authorization gaps, or identify revenue a clean claim leaves uncollected. TransDontics does all of it.
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 Salt Lake City practice came to us with an 11% denial rate, 38% of A/R past 90 days, and Utah Medicaid claims rejected by MCNA for missing prior authorization documentation with front desk spending 3+ hours daily on inconsistent billing follow-up.
Our specialists handle Utah claims daily; knowing Delta Dental PPO versus DeltaCare HMO differences, MCNA’s prior auth documentation requirements, and SelectHealth’s tiered network fee schedule exposure.
TransDontics handles Utah claims daily; knowing Delta Dental PPO versus DeltaCare HMO differences, MCNA’s prior auth requirements, and Utah’s January 2026 IOTN switch generating denials for practices billing pre-2026 orthodontic criteria.
Every Utah 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.
Utah practices carry HIPAA obligations alongside Utah Code Title 58 Chapter 69, Administrative Rule R156-69, and MCNA and Premier Access managed care documentation standards. TransDontics is independently HIPAA certified and SOC 2 Type II compliant statewide.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Utah’s patient records obligations under Title 26B, Chapter 3. Every data transmission meets the highest applicable standard, not just the minimum required for HIPAA baseline compliance.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability most Utah practice owners don’t realize they’re carrying until it’s too late.
Our AICPA SOC 2 Type II certification is independently audited and renewed annually. Everything is documented and third-party verified, providing proof of our security posture. Your Utah practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
Average Utah salary
*Salary benchmarks based on Utah 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.
Three factors: Utah’s full adult Medicaid dental benefit routes through two separate managed care plans; MCNA and Premier Access, each with distinct prior auth systems and portals. Delta Dental and DeltaCare HMO fee schedule differences hide underpayment without thorough EOB reconciliation. Utah’s January 2026 IOTN orthodontic standard is generating unrecognized pediatric claim denials.
RPA handles MCNA and Premier Access eligibility checks, claim scrubbing, portal-specific submission formatting, and payment posting. Billing specialists handle prior auth follow-up, EOB reconciliation, appeal preparation, and payer escalations. The combination sustains a 98% first-pass rate. Either layer alone doesn’t achieve that.
Yes, it is managed as distinct workflows within the same practice account. MCNA and Premier Access operate separate portals, prior auth systems, and clinical review criteria. Members are state-assigned to one plan; treating them interchangeably produces front-end denials and PA rejections every time.
Yes. Utah Code Title 58 Chapter 69 and Rule R156-69 require comprehensive treatment documentation, radiographic records, and provider notation. MCNA and Premier Access managed care contracts require clinical records available for audit on request. Claims lacking required documentation cannot survive managed care audits or post-payment reviews.
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.
All active Utah payers, Delta Dental, Alpha Dental DeltaCare USA, SelectHealth, Regence BCBS Utah, Cigna, Aetna, UnitedHealthcare, Humana, MetLife, Guardian, United Concordia, GEHA, FEDVIP, TRICARE, Utah Medicaid through MCNA, Utah Medicaid through Premier Access, and CHIP through both plans.
MCNA and Premier Access timely filing windows are governed by each plan’s state contract. TransDontics tracks every claim against its specific deadline. Cigna’s 90-day commercial window is among Utah’s shortest; deadline tracking maintained for every active payer in your claim portfolio.
Denied claims. Aging A/R. MCNA authorization rejections. That is your uncollected money. TransDontics recovers it. Most practices find 5–10% in hidden leakage. Start with the audit. We review your current claims, A/R aging, and denial patterns at no cost and no commitment. You will know exactly what is recoverable before you decide anything.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
