Washington’s Apple Health delivers dental through ProviderOne fee-for-service under HCA’s billing guide and WAC 182-501-0160 prior authorization requirements. Delta Dental, Premera, and Regence dominate commercially. TransDontics’s 1,100+ specialists manage your complete revenue cycle.
Apple Health dental runs through ProviderOne with procedure-specific prior authorizations managed within the state portal. Premera and Regence divide Washington’s geography with distinct portals. Delta Dental of Washington adds a third EOB reconciliation track.
Apple Health’s ProviderOne Fee-for-Service Dental Portal
Prior Authorization, Limitation Extensions, and Exceptions
Premera Blue Cross and Regence BlueShield’s Geographic Split
Federal Employee and Military Dental Volume in Washington
TransDontics’s 1,100+ in-house dental billing specialists are supported by RPA automation engineered for Washington’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. RCM automation handles Apple Health eligibility checks, claim scrubbing, status tracking, and payment posting while specialists handle anything requiring clinical or contractual judgement.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of Washington 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.
Before every Apple Health claim, we confirm ProviderOne eligibility, identify whether the procedure requires standard prior auth, a Limitation Extension, or Exception to Rule request, and attach required clinical documentation. LE and ETR workflows include documentation at submission.
Claims processed within 48 hours of receipt. No setup fee, no monthly minimum, no long-term contract, and no hidden costs. Our fee is a nominal percentage of what we successfully collect from payers on your behalf. We only earn when you get paid; which means our incentives are aligned with yours.
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 ProviderOne Limitation Extensions, Delta Dental TotalHealth EOB differences, or Premera’s SEBB versus commercial plan distinctions. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t reconcile EOB against your contracted rate, flag Apple Health Limitation Extension documentation gaps, or chase uncollected revenue. 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 Seattle practice came to us with a 10% denial rate, 35% of A/R past 90 days, and Apple Health claims rejected for prior authorization sent to the wrong pathway; standard PA submissions for procedures requiring a Limitation Extension.
Our specialists know every Washington payer’s rules and appeal processes. National billing companies stumble on ProviderOne Limitation Extensions, miss Premera versus Regence FEP splits, and underhandle TRICARE in Pierce, Kitsap, and Spokane. We don’t.
Covers 2 million Washingtonians through HCA’s statewide FFS program. Children receive unlimited EPSDT benefits; adults receive coverage. We handle eligibility, prior auth, Limitation Extensions, and Exception to Rule submissions through ProviderOne.
Washington’s leading commercial plan covering 2.8 million members including SEBB school employees and Federal Employee Program coverage. Custom benefit designs generate above-average EOB complexity. We manage all Premera plan types .
TransDontics handles Washington claims daily; knowing ProviderOne quarterly updates change covered codes without notice, Premera SEBB versus commercial frequency differences, and Pierce County and Kitsap’s high TRICARE and FEDVIP concentrations.
Every Washington 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.
Washington practices carry HIPAA obligations alongside WAC 246-817 and Apple Health documentation standards; six-year record retention, commonly 21 years from birth for minors. TransDontics is independently HIPAA certified and SOC 2 Type II compliant.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Washington’s patient health information privacy standards under Chapter 70.02 RCW. 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 Washington practice owners do not 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, providing proof of our security posture. Your Washington practice’s liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
Average Washington salary
*Salary benchmarks based on Washington BLS and ZipRecruiter market data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, MCO routing errors, and underpayments, no obligation, no pitch.
RPA handles ProviderOne eligibility checks, claim scrubbing, status tracking, and payment posting automatically. Specialists manage appeals, EOB reconciliation, Limitation Extension documentation, prior authorization follow-up, and payer escalations. That combination drives a consistent 98% first-pass acceptance rate neither layer achieves alone.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
Pay only a percentage of what we collect for you
