Specialties/Orthodontic
Orthodontic billing
Orthodontic billing services built for long treatment plans.
Outsourced orthodontic billing and insurance verification for orthodontic practices. Lifetime maximums, age limits, waiting periods, and multi-month cases are checked up front and tracked through retention.
What it involves
Orthodontic billing is different because treatment lasts many months.
Orthodontic billing is different from general dentistry billing because treatment lasts many months and payment is spread over time. A single case can involve an initial payment, ongoing payments, and a lifetime maximum that follows the patient from plan to plan.
Many orthodontic insurance benefits are limited by a lifetime maximum, and many plans also set age limits and waiting periods. Verifying these before the case starts lets the practice set the right patient payment plan and avoid surprises halfway through treatment.
What gets billed
The services behind orthodontic claims.
Orthodontic services sit in the D8000 series of the dental code set, plus the records that support them.
Short-course treatment
A brief round of care aimed at one concern, rather than a full set of braces.
Full treatment
Braces or clear aligners for the whole bite, usually billed as one case with a start date and an expected length in months.
Growth and habit appliances
Devices that steer a child’s jaw growth or help break habits like thumb sucking.
Retainers
Devices worn after braces come off to keep teeth in place. Coverage varies by plan.
Records and imaging
Wide-view and side-profile X-rays, photos, and models that back up the treatment plan and the claim.
Repairs and replacement appliances
Fixing broken parts or replacing a lost retainer, which many plans do not pay for.
Where claims go wrong
Common orthodontic billing problems, and how to prevent them.
Lifetime maximums and age limits
Many orthodontic benefits end at a set dollar amount or at a certain age. If these are not verified first, the practice may start a case that insurance will only partly pay.
Waiting periods
Some plans make a new member wait before orthodontic benefits begin. Starting treatment too early can mean a denied claim.
Payments over many months
Payers may pay an initial amount and then continue payments across the treatment period, while the patient pays monthly. Each stream has to be tracked so nothing is missed.
Plan changes during treatment
When a family changes insurance or a patient transfers in, remaining benefits and payments must be re-checked and the case reported correctly.
How ZenHub supports you
Orthodontic billing support from first visit to retainers.
ZenHub services that apply to an orthodontic practice, working inside your practice software.
Insurance verification
Eligibility, maximums, waiting periods, and coverage history are confirmed before the case starts, so the patient payment plan is based on real benefits.
Learn about insurance verification Claims & paymentsDental billing & RCM
Claim submission, payment posting, and coordination of benefits for families with more than one plan, with denials triaged and appealed.
Learn about dental billing & rcm Every business dayAR follow-up
Aging is worked every business day so insurance payments and open balances stay visible and current.
Learn about ar follow-up Payer enrollmentCredentialing
New orthodontists and new locations are enrolled with payers, and re-credentialing and CAQH are kept up to date.
Learn about credentialing Schedule & patientsVirtual front desk
Consult scheduling, confirmations, and treatment estimates are handled so new starts move forward.
Learn about virtual front deskWe work inside the software you already use — Open Dental, Dentrix, Eaglesoft, Curve, and more. See the software we support
Questions
Orthodontic billing — common questions.
What is orthodontic billing?
Orthodontic billing is the process of verifying orthodontic benefits, submitting claims for treatment that lasts many months, posting insurance and patient payments over time, and following up on open balances.
Why are orthodontic insurance benefits harder to verify?
Many plans use a lifetime maximum, an age limit, and a waiting period instead of a yearly maximum, so each one has to be confirmed before treatment starts.
Can you track insurance payments and monthly patient payments?
Our team posts payments and works the aging report every business day, so insurance payments and open balances stay visible and current inside your practice software.
Do you handle orthodontic coverage for families with two plans?
Yes. Coordination of benefits is part of our billing service, so primary and secondary coverage are set up correctly the first time.
Keep exploring
Billing for other dental specialties.
- General Dentistry Billing Services
- Oral Surgery Medical Billing Services
- Pediatric Dental Billing Services
- Endodontic Billing Services
- Periodontal Billing Services
- Prosthodontic Billing Services
- Dental Anesthesia Billing Services
- Oral Medicine Billing Services
- Dental Implant Billing Services
- Cosmetic Dentistry Billing Services
- Sedation Dentistry Billing Services
Ready when you are
Let’s look at your orthodontic claims.
Book a call. We will walk through your payers, your procedures, and where claims are getting stuck.
Replies within one business day · during your practice hours