Orthodontics Billing Services Built for Long Treatment Contracts
ClainetRCM delivers revenue cycle management built for orthodontic practices. Stop losing revenue to contract accounting errors, lifetime maximum surprises, and stalled monthly claims.
Certified specialists verify lifetime orthodontic maximums and set up the contract schedule before banding so every payment posts correctly
Why Orthodontics Billing Demands a Specialist
Orthodontics is the only dental specialty billing multi-year treatment contracts. Payment arrives in an initial amount plus monthly continuation, against a separate lifetime maximum, and small setup errors compound silently across years of treatment.
Lifetime Orthodontic Maximums
Orthodontic coverage carries a separate lifetime maximum, not an annual one. Verifying the remaining balance before banding prevents large uncollectible amounts.
Initial and Continuation Billing
Plans pay an initial amount at banding and continuation payments over the treatment term. Missed continuation claims are lost revenue nobody notices.
Contract Accounting Accuracy
Long treatment contracts require accurate tracking of patient payments, insurance payments, and remaining balance across years.
Medically Necessary Orthodontics
Cleft palate, craniofacial anomalies, and severe functional cases may qualify under medical or Medicaid programs with specific scoring criteria.
Complete Orthodontics RCM Solutions
From charge capture to final payment posting, ClainetRCM manages every step of your orthodontics revenue cycle so you can focus on patient outcomes.
Orthodontics Medical Billing
Complete billing management built specifically for orthodontists and orthodontic group practices.
- Charge entry and claim scrubbing
- Electronic and paper claim submission
- ERA/EOB posting and reconciliation
- Denial management and appeals
- Patient statement and balance collections
Orthodontics Medical Coding
Certified coders with deep orthodontics coding expertise capture every procedure at the correct, compliant level.
- Comprehensive orthodontic treatment coding by dentition
- Initial banding and continuation claim setup
- Lifetime maximum verification and tracking
- Medically necessary orthodontic documentation
- Retention and post-treatment service coding
Healthcare Credentialing
Fast payer enrollment and re-credentialing so you never miss a payment because of a lapsed credential.
- Insurance enrollment and re-credentialing
- CAQH profile management
- Medicare and Medicaid enrollment
- Payer contracting and fee schedule review
- Ongoing status tracking and follow-up
Virtual Medical Assistant
Dedicated remote assistants to absorb your front-desk workload so your staff stays focused on patients.
- Prior authorizations and referrals
- Appointment scheduling and reminders
- Insurance eligibility verification
- Patient follow-up calls
- EHR data entry and documentation support
Accounts Receivable Management
Dedicated AR follow-up to recover outstanding claims and pull down aging balances across every payer.
- Aging AR review and prioritization
- Payer follow-up and escalation
- Patient balance collections
- Write-off and adjustment analysis
- Monthly AR performance reporting
Revenue Cycle Audit
A thorough audit of your orthodontics billing to surface revenue leakage and compliance risk before it escalates.
- Billing workflow assessment
- Coding accuracy and payer policy audit
- Denial pattern analysis
- Payer contract review
- Custom revenue improvement roadmap
Orthodontics Billing Challenges We Solve Every Day
Orthodontic practices face billing obstacles that generic billing companies consistently get wrong. We know them all, and we fix them.
Missed Continuation Claims
Monthly continuation payments never billed after the initial claim. This is silent, recurring revenue loss. We bill the full schedule.
Lifetime Maximum Surprises
Treatment started against a maximum already partially used elsewhere. We verify remaining benefits before banding.
Contract Accounting Errors
Multi-year contracts with misapplied payments create disputes and inaccurate receivables. We reconcile continuously.
Cosmetic Exclusion Denials
Cases denied as cosmetic where functional impairment was not documented. We build the clinical record where it exists.
Medicaid Scoring Requirements
Public program orthodontics requires specific severity scoring and documentation. We prepare submissions to those standards.
Patient Payment Plan Drift
Long payment plans drift without structured follow-up. We monitor and pursue delinquent contracts.
Transfer and Mid-Treatment Cases
Patients transferring in or out mid-treatment create complex proration. We handle the accounting cleanly.
Slow Reimbursements
Orthodontic claims age quietly because no one is watching the continuation schedule. We work them every cycle.
Get Started in 5 Simple Steps
Onboarding with ClainetRCM is fast and seamless. Most orthodontics practices go live within one week with no disruption to daily operations.
Free Consultation
We analyze your current billing setup and identify orthodontics revenue gaps at zero cost.
Custom Onboarding
We integrate with your EHR and PM system and configure orthodontics billing workflows.
Team Assignment
A dedicated billing team with real orthodontics experience is assigned immediately.
Claims Submission
Clean, policy-compliant claims submitted within 48 hours with real-time tracking.
Revenue Growth
Watch collections climb with transparent monthly performance reporting.
What We Commit To on Every Orthodontics Claim
These are the standards we control and hold ourselves to, written into every engagement.
From charge capture to claim submission, on every working day
Business days to onboard your orthodontics practice end to end
Between full accounts receivable reviews, every single cycle
Starting rate on monthly collections. No setup fee, no contract
Orthodontics Billing for Every Practice Size
Whether you are a solo orthodontist or a multi-location orthodontic group, ClainetRCM manages contracts, claims, and collections.
Solo Orthodontists
Independent orthodontists who need accurate contract accounting and reliable continuation billing.
Orthodontic Groups
Multi-location orthodontic practices needing standardized contract setup and collections across offices.
Institutional and Public Programs
Community and institutional orthodontic programs requiring compliant public program billing and reporting.
Frequently Asked Questions
Most plans pay an initial amount when appliances are placed, then continuation payments over the treatment term, all applied against a separate lifetime orthodontic maximum rather than an annual maximum. The setup at banding determines whether those continuation payments arrive automatically or never arrive at all, which is why we build the schedule correctly at the start rather than discovering the gap two years later.
The remaining balance is all you can collect from the plan, and the patient owes the rest. This comes up constantly with patients who had earlier treatment or changed employers. We verify the remaining lifetime orthodontic benefit before banding so the contract and the patient estimate reflect reality instead of the full maximum.
In specific circumstances. Cleft palate, craniofacial anomalies, and severe functional impairment can qualify under medical benefits or state Medicaid programs, usually with defined severity scoring and documentation requirements. These cases need to be built and submitted to that standard from the beginning, since a case denied as cosmetic is difficult to reverse afterward.
Transfers require prorating what has been paid against what remains, coordinating with the prior practice records, and resetting the continuation schedule with the plan. Handled poorly this produces both billing disputes and lost insurance payments. We reconcile the contract accounting so the remaining balance is accurate for the patient and the plan.
ClainetRCM integrates with the platforms orthodontics practices already use, including Dolphin Management, Ortho2 Edge, tops Ortho, Cloud 9, Dentrix Ascend, and OrthoTrac. We adapt to your existing technology rather than forcing a migration, so onboarding does not disrupt your clinical workflow.
Pricing starts at 2.29% of monthly collections, so we are only paid when your practice is paid. There are no setup fees, no long-term contracts, and no hidden charges. Book a free consultation for a quote based on your volume and payer mix.
Ready to Grow Your Orthodontics Revenue?
Talk to an orthodontic billing specialist about your continuation claims, your contract accounting, and your outstanding balances.
Request Your Free Audit TodayLet's Grow Your Orthodontics Practice
No obligation. Our orthodontics billing specialists will review your current setup and identify exactly where you are losing revenue.
Why Consult With ClainetRCM?
In a single free session, our orthodontics RCM experts will uncover hidden billing gaps and give you a clear roadmap to increase collections starting immediately.
Free Revenue Audit
We review your billing performance and identify gaps at zero cost to you.
Dedicated Orthodontics Billing Expert
You will speak directly with a specialist who understands orthodontics billing deeply.
100% Confidential
All information shared is protected by HIPAA and never shared with third parties.
Fast Onboarding
Practices go live within 7 to 14 business days of signing on.
No Long-Term Contracts
Pricing starts at 2.29% of collections. No setup fee, no lock-in.