We offer verification of dental treatment plans and responsibilities, as well as relay this information to the practice and patient.

No matter what brings your patients through our doors, our knowledgeable team will draw on their wealth of experience to properly bill and collect quickly and accurately. To meet the diverse needs of our dental patients from the North East and beyond, Optimal Billing Solutions offers our expertise in billing and is uniquely qualified to handle Dental Services such as:

  • General Dentistry - Routine and preventive care, such as cleanings and fillings.
  • Orthodontics - This branch of dentistry addresses the positioning of the teeth and jaws, including issues such as crooked teeth, underbites, irregular gaps or spaces, and more.
  • Endodontics - This area addresses the dental pulp, which is located in the center of each tooth and contains connective tissue, blood vessels, and nerves. Root canals and dental tissue problems fall under this category.
  • Facial and/or Oral Pain - When patients experience chronic headaches, toothaches, or pain in their faces or jaws, this branch of dentistry can help.
  • Oral Medicine - When patients come to us with chronic oral health conditions, our team can help. Oral medicine focuses on medically complex patients and helps them recover comfortably.
  • Oral Pathology - With this branch of dentistry, our team treats oral lesions, which are ulcers that develop in the mouth.
  • Periodontics - For those who notice gum discomfort or bleeding while they floss or brush their teeth, this branch of dentistry can help prevent and treat gum disease. Our periodontics specialists address patients’ concerns with treatments like periodontal plastic surgery, dental implants, and more.
  • Prosthodontics - This dentistry branch is concerned with the restoration and proper placement of patients’ teeth. To this end, our providers offer treatments such as crowns, bridges, dentures, and more.
  • Oral Radiology - X-rays of the mouth and head help us reach an accurate dental diagnosis as quickly as possible.
  • Oral and Maxillofacial Surgery (Degraded jawbones, Cancer, Cleft lip and cleft palate issues, Facial infections, Sleep apnea or snoring, Trigeminal nerve injuries, Temporomandibular joint (TMJ) disorder, Orthognathic, Reconstructive, etc.

Dental Services

Dedicated Legal Counsel

  • Dedicated attorney who specializes in billing best practices, audits, consultation, and account reviews
  • Payor trends, government and policy changes to federal and state laws, level of care guidelines and criteria
  • Expertise in zoning and licensure

Credentialing and Account Set Up

  • Single-case agreement and in-network contracting negotiations
  • Enrollment with insurance payors to collect reimbursement
  • Onboarding and unlimited training of all financial forms for your patients to fill out upon admission
  • Dedicated Account Manager

Utilization Review

  • Optimal Billing Solutions Utilization review team works with insurance providers to obtain coverage for the entirety of your client’s treatment needs. Going beyond expectation, our educated professionals utilize their professional and inter-personal experiences which provide them the ability to address a clinical picture in its totality. In customizing a specific client process from intake; levels of care to length of stay; our highly experienced Utilization team gets its clients covered. While simplifying and effectively communicating complex information, our healthcare professionals excel under pressure. Maintaining strong medical and health science backgrounds with extensive knowledge in Mental Healthcare; Substance Abuse care; Chiropractic; and medical practices; the Utilization team's foundation is the client's needs.

Billing and Collections Management

  • Claim scrubbing software
  • Electronic claim submission for quicker reimbursements
  • UB04 & HCFA-1500 billing with appropriate ICD10 coding
  • Real time and customized reporting
  • Extensive follow-up on unpaid claims
  • 24-hour hotline and excellent customer service

Frequently Asked Questions (FAQ):

Q: Do you bill for physician groups or just treatment facilities?

A: Yes. Optimal Billing Solutions bills for doctors’ groups, physician groups and facilities including those who render services for the Detox, Residential, PHP, IOP, and Outpatient levels of care. We also bill for ancillary services like appropriate UA testing, chiropractic, wellness and acupuncture services, smoking cessation, and other services depending on your program.

Q: How soon can I start billing if I never billed insurance before?

A: We can get you started within 2 weeks.

Q: My facility admits patients on weekends and afterhours, will you still be able to verify their coverage?

A: Yes. Depending if the insurance company is open, we have full-time weekend staff who can help you. We have software that gives us a good idea based on the policy prefix information what that policy typically covers, then we can when the insurance company is open to verify on the phone with two rounds of live call checks.

Q: Do you provide training on all documents that our patients need to sign and those we are responsible for sending over to you?

A: Yes and our training is unlimited. If you have new staff or existing staff that need a refresh on their training, we can assist via online Skype and/or travel to your facility.

Q: I have an in house UR team, do I need to contract your UR services or can I just have Optimal Billing Solutions handle my billing and collections only?

A: Yes, we can customize a package for you that best suits your needs. Each facility has their own dedicated Account Supervisor who will TRAVEL to you and set you up to bill in house or you can have our team handle all the billing through us. We have customizable options for your billing needs and a la carte services.

Q: What makes Optimal Billing Solutions better than the others?

A: We know the headaches that come with finding the right billing company. Many concerns we hear is the lack of communication and timely results. While we have a very large operation and bill for numerous healthcare specialties, our Behavioral Health and Addiction Treatment Billing team is comprised of experienced staff who know the ins and outs of this industry. They will give you that interpersonal communication vs. a large overwhelming staff that do not know you on a name to name basis. Our team is the perfect mix of a having a fully equipped outside billing company to give you that in-house, personal feel.

We also have an in house Legal Affairs Attorney who handles all audits, client and insurance issues, billing best practices and consultation. This is included with your account so we can make sure you are set up the legal and proper way to bill reducing any red flags from insurance carriers.
Dental ServicesDental Services