Dental A/R recovery services
Dental A/R recovery is the recovery of aged dental insurance claims: claims pended for radiographs or narratives, denied under frequency or missing-tooth limitations, stalled in coordination of benefits, or underpaid against a PPO fee schedule. MARR Partners works these claims for dental groups, DSOs, and oral surgery practices on a contingency fee, without replacing the front-office team.
What dental A/R recovery includes
Aged dental insurance claims
Claims past 60 or 90 days with a dental carrier: not on file, pended for information, or paid at the wrong benefit level.
Denied and pended claims
Missing radiographs, narratives, or periodontal charting; frequency and age limitations; missing tooth clauses; waiting periods. Each is corrected, documented, and resubmitted or appealed.
Coordination of benefits
Claims stalled because the primary and secondary carriers disagree, or because the secondary was never billed with the primary EOB attached.
Medical-dental cross-coding
Oral surgery, TMJ, sleep appliances, and trauma cases billed to medical plans with CPT and ICD-10 codes, where dental offices often lack the medical-billing workflow.
Underpayments
Fee-schedule and PPO contract disputes, bundled procedures, and downgraded allowances (for example, composite paid at amalgam).
How dental A/R differs from medical A/R
Dental claims use the ADA claim form and CDT procedure codes rather than CPT codes, and dental plans apply benefit rules that medical plans rarely use: annual maximums, frequency limits (for example, two cleanings a year), waiting periods, missing-tooth clauses, and downgrades that pay a less expensive alternative procedure. A large share of dental denials are therefore documentation and benefit-rule problems, not medical-necessity disputes, and they are recoverable with the right attachment or narrative.
Dental offices also bill medical plans for oral surgery, trauma, TMJ, and sleep-apnea appliances. Those claims follow medical rules, including Medicare's one-calendar-year filing limit and medical appeal deadlines, which many dental offices are not staffed to track.
| Denial reason | Recovery path |
|---|---|
| Missing radiograph, narrative, or perio charting | Attach and resubmit; appeal if the resubmission window has passed |
| Frequency or age limitation | Verify history; bill the patient portion correctly or appeal with clinical rationale |
| Missing tooth clause or waiting period | Confirm eligibility dates; appeal exceptions where the plan allows |
| Coordination of benefits | Bill secondary with primary EOB; resolve primacy with both carriers |
| Downgrade or bundling | Dispute against the PPO contract; bill the allowable patient difference |
| Medical cross-coded claim denied | Rebill with correct CPT/ICD-10 pairing and documentation; medical appeal |
How the recovery process works
- PracticePractice provides its aging report through a secure link under a BAA.
- MARRMARR analyzes every claim by age, payer, balance, denial reason, and filing deadline.
- MARRClaims are prioritized by recoverability and deadline; unrecoverable balances are documented for write-off.
- MARRThe recovery team works the payer: corrections, resubmissions, documentation, appeals, and underpayment disputes.
- PayerThe payer remits to the practice through its normal channels. Money never passes through MARR.
- MARRMARR invoices its contingency fee, calculated only on remittances actually received, with a monthly report.
Who it is for
Multi-location dental groups, DSOs, oral and maxillofacial surgery practices, periodontal and endodontic specialists, and pediatric dental groups carrying $150,000 or more in insurance A/R over 60 days. Single-location offices are welcome when the aged balance justifies a contingency engagement. Fee: 12–18% of recovered revenue by claim age (about 15% blended), invoiced after the carrier pays the practice. No setup fee, no minimum, no long-term contract.
Sources
- American Dental Association, dental insurance and claims resources — CDT code set, claim form, and dental benefits guidance
- CMS, Administrative Simplification: HIPAA standard transactions (837, 835, 276/277, 270/271)
- CMS, Medicare timely filing requirements — Applies to Medicare-covered dental and oral surgery services
Figures attributed to a source are that source's; commonly used benchmarks are labeled as such. Verify deadlines against your own payer contracts.