If your practice is losing revenue to denials, downcoding, or BadgerCare Plus HMO routing errors, it is because Wisconsin 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 practice.
Wisconsin Medicaid runs two tracks, ForwardHealth fee-for-service statewide and BadgerCare Plus HMOs managing dental in six southeast counties under a completely separate submission framework. Milwaukee, Waukesha, Racine, Kenosha, Washington, and Ozaukee practices face HMO-specific credentialing and portals.
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
TransDontics’s 1,100+ in-house dental billing specialists are supported by RCM automation engineered for Wisconsin’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. Automation handles claim scrubbing, eligibility checks, and payment posting while specialists handle real judgment calls. In Wisconsin's split ForwardHealth and HMO environment, that judgment is needed on every claim.
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. We go further.
Before every Wisconsin Medicaid claim, we confirm coverage track, verify HMO or fee-for-service status by county, format accordingly, and attach required prior authorization documentation. Mid-treatment county changes, which alter billing pathways entirely are caught.
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.
Expert CDT coding, clean claim submission, and aggressive denial management by specialty-certified billers. 98% first-pass clean claim rate.
Get in-network faster. We handle all payer paperwork, CAQH maintenance, renewals, and compliance tracking so you start seeing insured patients.
Robotic process automation eliminates manual repetitive tasks. Eligibility checks, reminders, and daily reports run without human intervention, 24/7.
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 BadgerCare Plus HMO versus ForwardHealth routing, Molina versus UnitedHealthcare prior auth differences, or Delta Dental fee tier distinctions. TransDontics knows all three.
Most billing companies submit claims. They will not reconcile every EOB against your contracted rate, verify HMO county routing before every ForwardHealth submission, or chase uncollected revenue.
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 Milwaukee practice came to us with a 10% denial rate, 35% of A/R past 90 days, and BadgerCare Plus claims submitted through ForwardHealth instead of the patient’s assigned HMO portal with 2–3 hours daily of inconsistent billing follow-up.
Our specialists know every Wisconsin payer’s rules and appeal processes. National billing companies stumble on Wisconsin’s dual ForwardHealth and BadgerCare Plus structure, missing Molina versus UnitedHealthcare prior authorization differences. We don’t.
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.
TransDontics handles Wisconsin claims daily; knowing Delta Dental’s plan reimbursement differences, separate Molina and UnitedHealthcare BadgerCare Plus prior auth pathways, and ForwardHealth 837D versus HMO portal differences.
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.
Wisconsin practices carry HIPAA obligations alongside Wis. Stat. § 146.81 and Dentistry Examining Board record-preservation requirements under Wis. Stat. § 447.063. TransDontics is independently certified under all applicable frameworks statewide.
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
Benefits + Payroll Taxes
Software + Training
Turnover Cost
Average Denial Rate
First-Pass Clean Claims Rate
Setup Fee
Contract
~$43,000/yr
~$12,900/yr
~$5,000/yr
~$64,500/replacement
8–12%
70–80%
—
—
Included
None
Included
None
Under 2.3%
98%
$0
Cancel Anytime
*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.
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
RCM automation handles volume tasks automatically and continuously, such as eligibility checks, HMO county verification, ForwardHealth 837D 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 98% across Wisconsin’s dual billing environment. Either layer alone does not achieve that.
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
