Every dental practice relies on a smooth billing and payment process to grow and thrive. Unfortunately, even minor billing mistakes can seriously slow down claims and prevent you from getting the right payment in a prompt manner. Here are some of the common mistakes your dentists and billing staff should watch out for. 


Upcoding is one of the most serious billing mistakes that you can make, as it is fraudulent. However, it can occur unintentionally when inexperienced coders are completing your billing. Upcoding occurs whenever a procedure is coded with a more severe or serious procedure or diagnostic code, or when more services are billed for than are actually done. Make sure that your coding department is able to read and understand your notes so that they always bill accurately.

The Wrong Coverage Information

Whether your patient provides you with an outdated insurance card, your benefits specialist pulls information for the wrong plan, or your patient forgets their insurance card entirely, mixing up coverage information is the most common of these billing mistakes. In order to get prompt payment, you must ensure that you have 100% accurate information from the start of the patient relationship and claims process.

Using the Wrong Codes

CDT codes are updated annually, and some offices or coders make mistakes and submit the wrong diagnostic or procedural codes. Make sure that you immediately update codes in your system and ensure everyone on your team understands what to use. Working with the right partners can also ensure that code errors are caught before things are submitted.

Unbundling Procedures

Unbundling is the process of breaking down a procedure into different parts so that the reimbursement for the components is higher than the charge for the same procedure. When you perform a procedure, you should always use one code whenever possible. What does unbundling look like in practice? It could be taking a procedure like a crown and billing it as impressions, anesthesia, prep, the temporary crown, and more instead of just billing a single code. Unbundling is sometimes done as an accident, but insurance companies may think that you are trying to intentionally increase reimbursement.

APEX Reimbursement Specialists Is Here to Help Your Practice Grow

Whether you’re preparing for the recredentialing process or looking to explore automating your dental practice, APEX Reimbursement Specialists is here to help. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.