You do the dentistry.
We do the insurance.
What we do
Claims filed daily out of your practice management software, with the attachments checked before they go. Payments posted daily with the EOB documentation. Rejections corrected and resubmitted by us rather than sent back to your front desk as homework. Denials investigated and appealed. Aged claims worked. Benefits verified before the patient arrives.
Nobody on your team on hold. Nobody resubmitting the same claim a third time. Nobody explaining to a patient why a benefit they were promised does not exist. Your front desk spends its day on patients, while we take care of business.
Our Services
How Smile Care Claims helps you get paid
Claims Service
Dental insurance billing, follow up and payment posting is the core, and it is where most practices start. We file daily, post daily, follow up on claims, handle rejections, and appeal denials, downcoding, and bundling without waiting for you to spot them.
Claims Services »A/R Recovery
Accounts Receivable (A/R) analysis and recovery begins about two weeks after you go live. We audit what is genuinely collectible in your aging report, work it, and tell you why each claim aged in the first place.
A/R Recovery »Benefit Verification
Insurance verification includes two service levels, four types of verifications, built around the codes your practice actually uses. Runs three days to a week ahead of the appointment (with ASAP service also available).
Benefit Verification »What it’s like working with us
You get one account manager. One person. The same person. They learn your office, your software, your payer mix, and your team. You reach them directly, by phone or email, not through a portal or a ticket system.
You also get a daily report, so you can see the work as it happens rather than hearing about it later. Claims submitted and the dollar amount. Payments posted and the dollar amount. Verifications completed and what type. Your insurance aging buckets are reported every Friday.
And you meet with your account manager on a schedule you set. Weekly at the start, then every other week or monthly once things are running. Your choice.
Getting Started
Five to ten days is all it takes to get you rolling.
We gather the basic information we need to get into your systems. Then a short questionnaire, about fifteen minutes, and a call to go through it. Workflows, verification preferences, and any questions you have. By the end of that call we set your rollout date.
While all of this is going on, we're building your insurance portals in the background.
Then you go live. We start filing your claims and running verifications if that's part of your plan. About two weeks in, we begin analyzing and cleaning up your old A/R alongside the current work.
That's it. Nobody has to clear a week off their schedule for any of this.
See if we can help.
Let us deal with the insurance companies. Your team can focus on patients.
What we do not do
We don't currently offer patient billing, although we will be adding it.
We also don't do credentialing or fee negotiation, and we don't plan to. Why? Because we encourage our clients to get out of network, and both of those services are about becoming more involved.
Now, it may seem counterintuitive for a billing company to tell you to get out of network. Not really. In network or out, you can still file a patient's insurance and accept assignment, if the plan allows it for out-of-network providers. And you should still verify benefits whether you are in a specific patient’s plan or not.
The issue isn't whether you deal with insurance. It's what you're charging and what you're getting paid. Inflation from March of 2020 through July of 2026 is close to 30%! While during this same period, many insurance carriers have not increased (or in some cases decreased) reimbursement. Both of which are making getting out of network more of a necessity.
If you want to stay in network, that's your decision and we'll bill it either way. If you want out, ask your account manager and we'll provide you with resources to help you make this happen.
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Five to ten days in most cases. Once you are signed up we gather some basic information so we can get into your software, and while that is happening we start building your insurance portals in the background.
Then you fill out a short onboarding questionnaire, about fifteen or twenty minutes, and we do an onboarding call to go through your insurance workflows, your verification preferences, and any questions you have. By the end of that call we set your rollout date.
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You create the claim in your practice management software. That’s it. Everything after that is us, including attachments, submission, rejections, follow-up, appeals, and posting.
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No. Billing and A/R remediation are the required services, which covers claim submission, follow-up, payment posting, and cleaning up your A/R and old claims. Verification is optional and priced separately.
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Nope. While you do sign a contract to work with us. you can opt out any time with 30 days notice.
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It’s a fairly simple process. While you’re wrapping up with your previous provider, we set things up (your portals, preferences, etc.), so that the transition is seamless and your billing doesn’t skip a beat. For more information, discuss this during your initial consult.
I keep hearing about Revenue Cycle Management, or “RCM.” Is that what Smile Care Claims does?
Short answer: yes. Longer answer: RCM is what happens when a corporate marketing department gets involved. They looked at a claim being filed, followed until it is paid, and posted, and decided that needed a fancier name. We have seen this before. A “wardrobe malfunction.” A “service interruption.” Give them long enough and they will call a puddle a “temporary aquatic feature.”
So yes, we do Revenue Cycle Management. We just call it getting you paid.
Questions?
Still have a question? Call (800) 677-7142 or book a consult.
See if we can help.
Book a consult with one of our billing specialists. We will find out what you need help with and what you are hoping to achieve. And if we are a fit, we will walk you through exactly what we would do, what it costs, and what you can expect.
You will get a straight answer, including if the answer is no.