Dental Billing Outsourcing: The Complete Guide to Choosing, Onboarding, and Measuring the Right Partner

By Medtransic | February 11, 2026 | 14 min read

Quick Summary: Should you outsource your dental billing? This guide covers pricing models (percentage, flat fee, per-claim), what services to outsource vs. keep in-house, how to vet a billing partner, 9 red flags to avoid, a 90-day onboarding timeline, and the KPIs that separate a good partner from a great one.

What Is Dental Billing Outsourcing?

Dental billing outsourcing means handing the insurance billing workload — claim submission, payment posting, denial management, and AR follow-up — to an external team that works in your practice management software remotely. They connect through a HIPAA-compliant VPN or remote desktop, work your accounts in real time, and handle the hours of phone calls and paperwork that keep your front desk from focusing on patients.

The outsourced team doesn't replace your staff. Your front desk still checks patients in, presents treatment, collects copays, and runs day-to-day operations. What changes is that the tedious, time-consuming backend of insurance billing — the part that requires specialized knowledge and relentless follow-up — moves to people whose entire job is getting claims paid.

This isn't new. Outsourced dental billing has been growing steadily since the mid-2010s, and the shift to remote work accelerated it further. Today, thousands of dental practices across the country use outsourced billing partners, from solo practitioners to multi-location DSOs.

6 Signs Your Practice Is Ready to Outsource

Not every practice needs outsourced billing. But these patterns consistently indicate that your current billing setup is costing you money.

  1. Your over-30-day insurance AR keeps climbing.
  2. Your denial rate is above 10%.
  3. You have lost a billing person and cannot afford the gap.
  4. Your front desk is overwhelmed.
  5. You are expanding.
  6. You do not know your numbers.

What to Outsource (and What to Keep In-House)

OutsourceKeep In-House
Insurance claim submission and trackingPatient check-in and checkout
Payment posting and EOB reconciliationTreatment presentation and financial case acceptance
Denial management and appealsSame-day copay and patient payment collection
Insurance AR follow-upScheduling and appointment confirmation
Insurance verification and eligibilityIn-person patient billing questions
Patient statement generation and mailingClinical documentation
Pre-authorization and pre-determinationProcedure coding accuracy review
Credentialing and fee schedule analysisDay-to-day office management

Pricing Models Explained

ModelRangeBest ForWatch Out For
Percentage of Collections4%-9%Established practicesPercentage on gross charges vs actual collections
Flat Monthly Fee$1,200-$3,500/monthCost predictabilityScope creep
Per-Claim Pricing$4-$8 per claimHigh-volume practicesExcluded services

Domestic vs. Offshore: What Actually Matters

US-based teams generally have deeper familiarity with regional payer rules, Delta Dental plan variations, state Medicaid dental programs, and CDT nuances.

Offshore teams can be significantly less expensive but quality varies widely.

How to Vet a Dental Billing Company

Questions to Ask Before You Sign

  1. Do you specialize in dental, or is dental one of many specialties?
  2. What practice management systems do you support?
  3. What is your denial management process?
  4. How do you handle reporting?
  5. What is your average client retention rate?
  6. Can I speak to current dental clients as references?

9 Red Flags That Should Make You Walk Away

  1. No signed Business Associate Agreement (BAA)
  2. They guarantee specific collection percentages
  3. No transparency on staffing or team structure
  4. Long-term contracts with no performance clauses
  5. They cannot explain their denial management process
  6. No experience with your PMS
  7. They do not provide regular reporting
  8. High upfront fees
  9. They push you to switch PMS or clearinghouse

The Onboarding Timeline: What to Expect in the First 90 Days

  1. Days 1-7: Access and Assessment
  2. Days 8-14: Workflow Setup
  3. Days 15-30: Stabilization
  4. Days 31-60: Optimization
  5. Days 61-90: Steady State

KPIs That Actually Tell You If It Is Working

Frequently Asked Questions

How much does outsourced dental billing cost?

Most outsourced dental billing companies charge between 4% and 9% of monthly insurance collections.

What dental billing tasks can be outsourced?

Insurance verification, claim submission, payment posting, denial management, AR follow-up, patient statements, pre-authorizations, and credentialing support.

Will outsourcing dental billing replace my front desk staff?

No. Outsourced dental billing complements your existing team by handling backend insurance billing work.

How do outsourced dental billers access my practice management software?

Through a HIPAA-compliant VPN or secure remote desktop connection.

How long does it take to see results?

Most practices see measurable improvements within 30 to 60 days.

Is outsourced dental billing HIPAA compliant?

Reputable companies are fully HIPAA compliant with signed BAAs and encrypted connections.

Should I outsource to a domestic or offshore company?

Domestic companies offer deeper knowledge of regional payer rules. Offshore teams can be less expensive but quality varies.

Ready to see what outsourced billing can do for your practice? Contact Medtransic today for a free AR assessment. Call 888-777-0860 or visit our contact page.