Specialty RCM General & Oral Maxillofacial Surgery Seattle, WA (6 Dental Clinics)
Gentle Dental Group: Unlocking $420K in Medical Insurance Billing for Oral Surgeries
Cross-coding CDT dental procedures to major medical CPT insurance claims for sleep apnea and bone grafting.
Published May 2026 5 min read
+$420K
Medical Revenue
New revenue unlocked from medical plans
98.2%
Clean Claim Rate
For cross-coded medical claims
96%
Patient Satisfaction
From lower out-of-pocket expenses
The Challenge
- Dental claims hitting annual maximum benefit caps leaving patients with high out-of-pocket bills.
- Surgical tooth extractions, TMJ procedures, and sleep apnea appliances billed strictly to dental plans.
- In-house dental staff lacked medical CPT coding knowledge.
The Solution & Strategy
- Crosswalked CDT codes to medical CPT codes (e.g. sleep apnea appliances to CPT E0486).
- Submitted primary claims to commercial medical insurance before billing secondary dental plans.
- Provided patients with clear pre-treatment medical insurance coverage estimates.
Quantifiable Key Results
Medical Revenue Unlocked
$420,000
Net new practice revenuePatient Out-of-Pocket
50% Cut
Lower patient financial burdenMedical Clean Claim Rate
98.2%
First-pass acceptance"Cross-billing medical insurance unlocked $420,000 in revenue while saving our patients thousands in out-of-pocket costs."
Dr. William Zhang, DDSChief Medical Officer at Gentle Dental Group
Actionable Takeaways for Practice Leaders
1
Identify qualifying surgical dental procedures (sleep apnea, TMJ, trauma) to cross-bill commercial medical insurance2
Submit primary claims to medical insurance first before utilizing patient dental annual maximum benefitsReady to Achieve Similar Results?
Schedule a complimentary Revenue Cycle Audit for your practice to pinpoint billing leaks and clean claim opportunities.
Organization Profile
Organization:Gentle Dental Surgical Group
Specialty:General & Oral Maxillofacial Surgery
Location & Scale:Seattle, WA (6 Dental Clinics)
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