Dental Revenue Cycle Management Benchmarks: What Healthy Performance Looks Like

Many of today’s dental practices that rely heavily on insurance reimbursement continue to face frequent denials and stagnant payment rates that don’t keep pace with rising costs. In Q2 2025, a large share of dentists reported declining optimism about both their own practices and the overall economy. Fortunately, the current-day negative financial outlook in the dental industry can be reversed using the right dental revenue cycle management strategies that position practices for long-term financial health and sustainability. Strategic dental revenue cycle management strengthens cash flow, operational efficiency, and long-term financial sustainability across the organization.

What are the 3 stages of dental revenue cycle management?🔗

The three stages of dental revenue cycle management include the following:

1. Front-end dental revenue cycle management. This includes securing fee schedules, credentialing providers, performing patient information intake, verifying patient eligibility, and securing benefit details.
2. Mid-cycle dental revenue cycle management. This includes coding, claim creation, clean claim submission, and payment posting.
3. Back-end dental revenue cycle management. This includes accounts receivable (A/R) tracking and denial resolution.

Together, these three stages complete the dental revenue cycle management process, allowing dental practices to obtain accurate and complete payment for services rendered.

Common dental revenue cycle management challenges🔗

Dental revenue cycle management teams typically encounter a host of challenges that can impede payment. Consider the following common mistakes that can result in denied or delayed dental payments:

• Automation without intention. Lack of human oversight ultimately leads toerrors and inefficiencies in dental revenue cycle management.
• Inaccurate CDT codes. Not staying up to date with new, revised, and deleted CDT codes—and reporting invalid or unspecified codes—can cause payments delays and/or denials.
• Incomplete payer contracting and credentialing. When providers submit claims before they submit all the necessary paperwork or complete all the necessary steps that payers require for contracting and credentialing,payment delays and denials ensue.
• No fee schedule maintenance. Failing to update the fee schedule regularly or using another payer’s fee schedule because it’s ‘close enough’ may result in countless missed revenue opportunities, write-offs, and underpayments.
• No formal process for A/R tracking. Providers lose revenue when they don’t review each Explanation of Benefits (EOB) individually and follow up on all unpaid claims.
• Partial front-end verification. Eligibility checks alone don’t provide all of the information necessary to avoid claim denials and cashflow disruptions in dental revenue cycle management.
• Subpar clinical documentation. Denials may occur when documentation fails to support the CDT code requirements.
• Untimely filing. Denials may occur when providers don’t submit claims within a payer’s required timeframe.

Best practices to streamline your dental revenue cycle🔗

To avoid common dental revenue cycle management mistakes, successful dental practices take the following steps:

1. Calculate EOB adjustments correctly. Correct adjustments ensure clean, fair patient statements and prevent patients from being overcharged or undercharged, both of which can have negative financial and compliance ramifications for dental providers.
2. Form a dedicated claim follow-up team. Many claims are recoverable. Dedicating a team to track and resolve outstanding A/R, including denials as well as potential underpayments and appeals, prevents revenue erosion and promotes revenue integrity.
3. Formalize dental provider enrollment and credentialing. Understand each payer’s unique process (including paperwork that each one requires), follow up with each payer regularly until each contract is processed, and perform proactive audits to avoid silent contract termination. Remember: Provider credentialing will not renew automatically. Stay abreast of renewal deadlines to avoid gaps.
4. Improve front-end processes. Complete dental eligibility and benefit verification to obtain critical information about active coverage as well as frequency, exclusions, max used, and other plan coverage. When automating these tasks, ensure dedicated team members review and validate information and interpret coverage nuances prior to claim submission.
5. Maintain accurate and up to date fee schedules. Load each payer’s fee schedule into the practice management system within 10 days of receiving it. Also audit payer fee schedules annually after contract renewals to ensure accuracy.
6. Review claims prior to submission. Leverage claim scrubbers to confirm patient demographics, insurance information, codes, and supporting documentation are accurate and complete.
7. Stay up to date with CDT code changes. Provide staff education on dental code updates as well as changes to state and federal legislation and payer regulations and requirements.
8. Submit claims regularly. Daily claim submission prevents timely filing denials and mitigates cashflow delays.

How to track dental revenue cycle performance🔗

KPIs are an essential component of healthy dental revenue cycle management processes because they reveal the health of the revenue cycle in each stage. Here are a few of the most critical KPIs to monitor:

Front-end dental revenue cycle management KPIs:

• Average days to credential a new provider. Fewer than 60 days is best practice.
• Eligibility-related denial rate. Fewer than two percent of all denials should relate to eligibility.
• Percentage of patients verified before each visit. Best practice is 100%.
• Percentage of payments matching contracted allowables. Best practice is greater than 98%.
• Percentage of providers fully credentialed across all payers. The goal is to achieve 100%.

These KPIs demonstrate the strength of your front-end processes, all of which lay the foundation for strong dental revenue cycle management performance.

Mid-cycle dental revenue cycle management KPIs:

• Days to first submission after date of service. Fewer than two days is the goal.
• Dollar variance between expected and actual payments (by payer and by code). Less than two percent is best practice.
• First pass resolution rate. Greater than 95% is what providers should strive to achieve.
• Overall coding error rate. Less than two percent is best practice.
• Percentage of coding accuracy on high-volume procedures. Greater than 98% is ideal.

These KPIs demonstrate your ability to convey critical information to payers in a timely manner which is critical for optimal dental revenue cycle management performance.

Back-end dental revenue cycle management KPIs:

• A/R days greater than 90. Fewer than 15% of claims should be in the bucket.
• Bad debt/write-off percentage. Less than two percent is the goal.
• Days in A/R. Maintaining less than 40 days is ideal.
• Net collection rate. Providers should strive to achieve greater than 95%.
• Overall denial rate. Less than five percent is best practice.
• Percentage of adjustments aligned with contractual allowables. Greater than 98% is best practice.
• Percentage of denied claims appealed. Practices should ideally appeal more than 50% of denied claims.

These KPIs demonstrate your ability to collect revenue to which you are entitled, both from patients and payers. Together, all of these KPIs help providers identify areas of strengths and weaknesses to improve overall dental revenue cycle management performance.

Quick wins to implement immediately🔗

While these efforts may take some time, there are some ‘quick wins’ that can accelerate results. Consider the following:

1. Create a credentialing tracker. Use Excel, Google Sheet, or your practice management system to log expiration dates, pending applications, and payer contacts.
2. Develop a denial reason tracker. Track payer-specific denials to start building a formalized appeal process.
3. Review your last 10 EOBs. Flag adjustments that don’t match your payer contracts.
4. Set small, actionable goals. Assign one staff member to touch every claim over 30 days old by the end of each week.

Get your free dental revenue cycle KPI guide🔗

Maximize your dental practice’s revenue cycle by using our free, data-focused guide. This downloadable PDF explains the important KPIs for every part of the dental Revenue Cycle Management process—from submitting claims to collecting payments—and gives you practical steps and industry standards to increase cash flow and cut down on denials.