How much does a dental billing company cost?

Most charge a percentage of monthly collections, commonly 3 to 5 percent, sometimes with an onboarding fee or a minimum monthly. A few charge per-claim or use a hybrid of a base fee plus per-claim. The right number depends on your monthly claim volume and specialty mix, so compare total cost at your actual volume, not just the headline rate.

Is percentage-of-collections or per-claim pricing better?

Percentage of collections ties what you pay to what the billing company actually collects, so the incentive is aligned: they get paid when you get paid. Per-claim charges you for every claim submitted whether or not it's ever collected, which can reward volume over outcomes. Percentage of collections is the more common and usually the more aligned model for outsourced dental billing.

Should I worry about offshore billing teams?

It's worth asking where the work happens and who does it. Offshore teams can be cheaper, but they can also mean call-center turnover, time-zone gaps, and less context on US payer behavior. The questions that matter: who specifically works your account, are they US-based, and do you get named contacts or a ticket queue. Cheaper per-claim costs can disappear into denials nobody worked.

Can I keep my current practice management software?

A good billing company works inside the PMS you already use, whether that's Open Dental, Dentrix, Eaglesoft, or another system, by logging into your instance. You shouldn't have to switch software to outsource billing. Confirm they support your PMS and how they access it (direct login versus you exporting data to them) before you sign.

How long does it take to switch billing companies?

Onboarding commonly runs one to a few weeks before claims are going out under the new team, depending on PMS access, credentialing handoff, and the size of any existing AR backlog. Ask for the specific timeline, whether they run in parallel with your current process during the switch, and how they handle the backlog of claims and denials already in flight.

Will I lose control of my accounts receivable?

You shouldn't. The billing company works your AR, but the data stays in your software and the reporting should show you exactly what's collected, what's outstanding, and how AR is aging. Insist on a regular report you can read without a meeting. If you can't see your own AR aging on demand, that's a reason to keep looking.

What should a dental billing company include in its base service?

At minimum: insurance verification, claim submission, payment posting, denial management, and AR follow-up. Patient billing and insurance credentialing are sometimes included and sometimes add-ons. Get the scope in writing. The gap between what you assume is included and what's actually included is where surprises live in month two.

How to Choose a Dental Billing Company

Hiring a dental billing company comes down to five things: how they price, what’s actually included, who does the work, how you’ll see what’s happening, and how hard it is to leave. Most billing-company websites blur all five behind the same language about maximizing collections and being your trusted partner.

This guide is the buyer’s version. It’s the checklist a practice owner or office manager can take into a demo, ask plainly, and get straight answers to. Run any vendor, including us, through it.

Start with the pricing model

Billing-company pricing is confusing on purpose. The headline rate is rarely the whole cost. Three models cover almost all of the market.

Model	How it works	Typical range	Watch for
Percentage of collections	You pay a percent of what they collect	3–5% of collections	Onboarding fees, minimum monthlies, ”% of production” vs collections
Per-claim	A flat fee for each claim submitted	A few dollars per claim	You pay whether or not the claim is ever collected
Hybrid / flat monthly	A base fee, sometimes plus per-claim or a percent	Varies	Scope creep; run the math at your real volume

Percentage of collections means the billing company only gets paid when you do, so working the denial and chasing the secondary is in their interest. Per-claim pays them for submitting, collected or not, which can reward pushing volume over actually getting claims paid.

Ask directly: is the fee a percentage of collections or of production? Is there an onboarding fee? Is there a minimum monthly? Our own answer lives on the pricing page, and it’s the same one we’d want a vendor to give us.

Pin down the scope

“Full-service billing” means different things to different companies. Get the line items in writing. The common pieces:

Insurance verification. Eligibility and benefits checked before the visit.
Claim submission. Coding review and clean claims out daily.
Payment posting. Insurance payments and adjustments posted from the EOB or ERA.
Denial management. Denials worked, corrected, and appealed.
AR follow-up. Aging claims chased on a schedule.
Patient billing. Statements sent after insurance processes. Sometimes included, sometimes extra.
Credentialing. Getting providers in-network with payers. Usually a separate service.

The trap is assuming the base price covers everything. If patient billing or AR cleanup is an add-on, you want to know that before month two, not after. A vendor that itemizes scope clearly is easier to trust than one that answers “we do it all.”

Who actually does the work

Find out who sits behind the service. There’s a real difference between a named team that knows your account and a rotating call-center queue.

The questions that matter: Is the team US-based or offshore? Do you get named contacts or a ticket number? Are the people working your denials experienced billers or first-line staff reading a script? None of these have a single right answer for every practice, but you should know which one you’re buying. Per-claim costs that look cheap can disappear into denials nobody worked.

How they access your practice management software

You should not have to change software to outsource billing. A good billing company logs into the practice management system you already run, Open Dental, Dentrix, Eaglesoft, Curve, or another, and works inside it.

Confirm two things: that they support your PMS, and how they access it. Direct, role-based login to your instance is normal. Be wary of any setup that requires moving your data wholesale to their system, which makes leaving harder later.

Reporting and transparency

Outsourcing billing should make your numbers clearer, not murkier. The test is simple: can you see what’s collected, what’s outstanding, and how your AR is aging, without scheduling a call?

Ask to see a sample weekly or monthly report. A real report shows collections, AR aging by bucket, denial counts and reasons, and what’s been resolved. A dashboard you can’t read, or a “we’ll update you as needed,” is a flag. You’re handing over the revenue cycle; you should still be able to watch it.

Contract terms

Three contract terms to check before you sign:

Month-to-month vs. an annual lock-in. Month-to-month keeps the vendor earning your business every month.
Notice period. How much warning you have to give to leave.
Data ownership. Your patient and claims data is yours. Confirm you keep full access if you go.

A company confident in its work tends to offer flexible terms, because it expects you to stay because the collections are good, not because the contract traps you. A long lock-in with a stiff exit penalty is worth questioning.

Onboarding and the switch

Switching billing companies feels risky because a botched transition means claims stop going out. Ask how they de-risk it.

Good answers include a defined onboarding timeline (commonly one to a few weeks before claims flow under the new team), a parallel run during the switch so nothing drops, and a plan for the existing backlog of unworked claims and denials. If there’s a pile of aging AR, ask whether cleaning it up is part of onboarding or a separate AR cleanup engagement.

Questions to ask in a demo

Take this list in and ask all of it:

Is your fee a percentage of collections or production? Any onboarding fee or minimum monthly?
What’s included in the base price, and what’s an add-on?
Who specifically works my account, and are they US-based?
Do you work inside my current PMS, and how do you access it?
What report do I get, how often, and can I see a sample now?
Is this month-to-month, and what’s the notice period to leave?
How do you handle my existing AR backlog during onboarding?
How fast do claims go out after treatment, and how often are denials worked?

How we’d answer it

We’ll save you the suspense on our own answers. We charge a percentage of collections, with no onboarding fee and no minimum monthly, month-to-month. A US-based team runs verification, claim submission, posting, denials, and AR follow-up on a daily cadence, working inside the software you already use. You get a weekly report that shows collections and AR aging without a meeting.

If you want the longer version, see what we do and how outsourced dental billing works. New to the basics, start with what dental billing is. When you’re ready to compare us against the checklist above, book a 30-minute call and we’ll walk your numbers.