If your practice is losing revenue to denials, downcoding, or Mountain Health Trust MCO errors, it is because West Virginia dental billing carries real complexity that most out-of-state billing vendors never fully grasp. TransDontics’s 1,100+ certified dental billing specialists manage your complete revenue cycle, so you can stay focused on your patients and your practice.
Mountain Health Trust and the Four-MCO Medicaid Maze
WV Adult Dental Benefit and the $2,000 Biennial Cap
DSO Expansion and the Charleston Market Pressure
HIPAA and West Virginia W.Va. Code § 16-29
Billing companies are typically either fully manual or heavily automated. TransDontics uses a deliberate combination of both. Our RPA handles high-volume, repetitive tasks like claim scrubbing, eligibility checks, and payment posting, while our billing specialists handle anything requiring clinical or contractual judgment. In West Virginia's payer environment, that combination is not optional; it is what keeps the first-pass rate where it needs to be.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of West Virginia or any commercial payer pays below the agreed fee on certain plan types, we flag it and file the appeal within 14 days. Most practices only catch outright denials because that is where the process stops. We go further, because underpayments are just as real as denials and far less visible without systematic reconciliation.
Before every Mountain Health Trust claim goes out, we confirm the patient's current MCO enrollment, verify whether their dental benefit falls under the MCO or under the LIBERTY Dental Plan carve-out, format the claim for that specific plan's portal, and include the documentation that MCO requires for clean first-pass acceptance. When a patient switches MCOs mid-treatment, which happens regularly in West Virginia's Medicaid population, we catch it before it becomes a rejection.
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 |
Not-for-profit MCO serving northern West Virginia Medicaid and WVCHIP members; SKYGEN portal submissions, fee schedule compliance, and appeal workflows managed as standard billing workflow.
Every west virginia 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 Kanawha County or Pendleton 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.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and West Virginia’s W.Va. Code § 16-29 health records requirements. Every data transmission meets the highest applicable standard, not just the minimum required under either framework.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability. Most West Virginia practice owners do not realize how much exposure they are carrying until an audit or a staffing event makes it visible. We eliminate that risk from day one.
Our AICPA SOC 2 Type II certification is independently audited and renewed annually. Everything is documented and third-party verified proof of our security posture, giving your West Virginia practice measurably reduced liability exposure from the moment our partnership begins.
Customized billing solutions based on your specialty
Average WV biller salary
*Salary benchmarks based on West Virginia 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.
RPA handles volume tasks automatically and continuously, such as eligibility checks, MCO enrollment verification, claim scrubbing, status tracking, and payment posting. Billing specialists handle what requires judgment, such as appeals, EOB reconciliation, prior authorization follow-up, and payer escalations. The combination is what keeps the first-pass rate at 96–98%. Either layer alone does not achieve that consistently across West Virginia’s four-MCO environment.
Before every Medicaid claim is submitted, we confirm the patient’s current MCO enrollment, verify whether their dental benefit falls under the active MCO or under the LIBERTY Dental Plan pediatric carve-out, select the correct submission portal, and attach whatever prior authorization documentation that MCO requires. This confirmation step runs on every claim, every time, not as an exception workflow but as our standard process for all West Virginia Medicaid patients.
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
