ForwardHealth’s Dual-Track Dental Billing Structure
BadgerCare Plus HMO Dental in Southeast Wisconsin
DSO Expansion and Market Pressure in Milwaukee and Madison
HIPAA and Wisconsin’s Wis. Stat. § 146.81
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 real judgment. In Wisconsin’s split ForwardHealth and HMO environment, that judgment is needed on every claim originating from the six southeast counties.
Every payment is reconciled against your contracted rate, line by line, across every payer. When Delta Dental of Wisconsin or any commercial carrier 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 EOB reconciliation.
Before every ForwardHealth or BadgerCare Plus dental claim goes out, we confirm the patient’s current coverage track, verify whether the patient’s county places them under an HMO or the state fee-for-service system, identify the correct HMO if applicable, format the claim accordingly, and attach whatever prior authorization documentation that payer requires. When a patient moves between counties mid-treatment, which changes their billing pathway entirely, 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 |
Every Wisconsin 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.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Wisconsin’s Wis. Stat. § 146.81 health information protection 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. Under Wis. Stat. § 447.063, any entity managing or controlling a dental practice bears direct responsibility for proper records preservation and transfer.
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 Wisconsin practice measurably reduced liability exposure from the moment our partnership begins.
Customized billing solutions based on your specialty
Average WI biller salary
*Salary benchmarks based on Wisconsin 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.
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
