Diploma in Dental Billing & Insurance & Claims

Foundation of all dental billing. Learn tooth numbering (Universal & FDI), surfaces, quadrants, common procedures, restorative/endo/perio/prosth terminology and oral surgery terms.

Understand how dental insurance works in the USA — PPO, HMO, Indemnity plans, COB, deductibles, copayments, coinsurance, annual maximums, frequency limitations, missing tooth clause, and downgrades.

Learn to perform complete, error-free insurance verification including patient demographics, member ID, group number, plan status, benefits remaining, frequency limits, ortho benefits, and preauthorization requirements.

Master all CDT code categories — from diagnostic and preventive to endodontics, prosthodontics, implants, orthodontics, and oral surgery. Learn code selection, documentation requirements, and common coding errors.

Learn ICD-10-CM fundamentals for dental/oral conditions, selecting primary and secondary diagnoses, medical-dental cross coding, and linking diagnoses with procedures for clean claims.

Master the ADA Dental Claim Form — every field including patient info, provider info, CDT codes, tooth numbers, surfaces, fees, attachments, narrative, and prior authorization. Learn electronic vs paper claim submission and claim tracking.

Hands-on training in real dental software workflows — patient registration, insurance entry, treatment planning, procedure entry, claim creation and submission, payment posting, account reconciliation.

Learn to identify and fix claim errors before submission — missing information, incorrect CDT codes, incorrect tooth/surface, duplicates, eligibility issues, and invalid provider info. Master claim resubmission processes.

Learn EOB and ERA interpretation, insurance payment posting, patient payment posting, adjustments, write-offs, contractual adjustments, secondary insurance coordination, refunds, credit balances, and reconciliation.

Deep dive into all major denial categories — eligibility, non-covered services, missing info, bundling, timely filing, medical necessity, frequency limitations, preauthorization. Includes 25+ practical denial cases with corrective action and appeal preparation.

Master AR aging buckets (0-30, 31-60, 61-90, 90+ days), insurance vs patient AR, aging reports, AR follow-up workflows, collection strategies, and AR productivity metrics.

Understand the complete end-to-end RCM cycle: Patient Registration → Eligibility → Verification → Treatment → Coding → Claim Creation → Submission → Adjudication → Payment Posting → Denial Management → AR Follow-up → Patient Collections → Reconciliation.

Learn HIPAA fundamentals, PHI definition, patient privacy rules, minimum necessary rule, data security requirements, authorization, fraud and abuse laws, false claims, and proper documentation standards.

Voice process training for insurance calls, verification scripts, claim follow-up scripts, denial appeal communication, professional US English, email communication, resume preparation, mock interview preparation, and 5 mock interviews.