What it costs
Our Fees
Here is what we charge for each service: claims, benefit verification, and A/R remediation. It's all below, including the monthly minimum, so you can see the numbers before we ever talk.
What your practice would pay depends on which services you want and the volume of insurance in your practice. During the consult we'll go through both and provide an accurate quote for your practice.
Claims Service
We charge a percentage of what insurance actually pays your practice, not what was billed. The minimum charge is $1,650 a month.
What's included
- Claims filed daily out of your practice management software
- Follow-up on anything aging, unpaid, or denied
- Rejections and requests for clarification handled
- Insurance payments posted with EOB documentation
- Monthly collection summaries and status reviews
Here's what we charge. Rates are tiered, so each portion of your collections is charged at its own rate. For example, a practice collecting $160,000 a month pays 3.25% on the first $99,999, 3.00% on the next $50,000, and 2.50% on the remainder.
| Monthly Insurance Collections | Rate |
|---|---|
| Up to $99,999 | $1,650 or 3.25% of insurance collections (whichever is higher) |
| $100,000–$149,999 | 3.00% of insurance collected between $100,000 and $149,999 |
| $150,000+ | 2.50% of insurance collected over $150,000 |
A/R Remediation Service
Every new client starts here. Shortly after onboarding, we go through your existing A/R and give you a report on what's actually there.
Then we work it, starting with claims older than 60 days:
- Reviewing every claim and confirming its real status
- Filing the ones that were never filed
- Resubmitting claims that were filed and never paid
- Finding claims that were already paid but never posted
- Sorting out balances that are the patient's, not the insurance company's
- Correcting and posting balances
- Final reconciliation and reporting
Nothing gets written off without your approval. If a balance needs an adjustment, we bring it to your attention first.
This runs alongside your regular claims and verification work, so current claims keep moving while we clean up the past.
Here's what we charge. The initial fee covers the audit and correction of your A/R. After that, we're paid on what we actually recover.
| Fee | Rate |
|---|---|
| Initial Fee | 0.875% of total insurance A/R over 60 days |
| Collection-Based Fee | 3.25% of insurance payments collected through SCC efforts |
Benefit Verification Service
There are two levels of service.
Basic Verification. We verify the benefits and put a PDF of the completed verification in a shared folder. Your team enters it into your practice management software.
Verification Plus. We verify the benefits and then enter the information directly into your practice management software.
We bill based on how many verifications we complete in a given month. Every type counts toward that total, whether it is a simple eligibility check or a full verification.
ASAP verifications count as two. An ASAP is any verification you request within 48 hours of the patient's appointment.
Here is what we charge.
| Verifications per Month | Basic Verification | Verification Plus |
|---|---|---|
| 1-30 | $225.00 | $250.00 |
| 31-40 | $275.00 | $325.00 |
| 41-50 | $325.00 | $400.00 |
| 51-60 | $375.00 | $475.00 |
| 61-70 | $425.00 | $525.00 |
| 71-80 | $475.00 | $600.00 |
| 81-90 | $525.00 | $675.00 |
| 91-100 | $575.00 | $725.00 |
| Over 100: billed individually, see the Per-Verification tab | ||
Verification types
- Simple eligibility. Confirms the patient's insurance is active.
- Standard. Maximum, deductible, frequencies, waiting periods, and basic benefit details.
- Full. Standard plus broader coverage, including code-specific coverage for the procedures listed on our Full Verification Form.
- Custom. Full plus up to five additional custom procedure codes. Each additional set of five codes adds $1 per verification.
- ASAP. Any verification requested within 48 hours of the appointment.
Up to five of your monthly verifications can be Custom with more than five additional codes. Beyond that, they are billed individually at the rates on the Per-Verification tab.
Per-Verification Pricing
Once you pass 100 verifications in a calendar month, everything after that is billed individually by type.
| Verification Type | Basic Verification | Verification Plus |
|---|---|---|
| Failed | $0.75 | $0.75 |
| Simple Eligibility | $2.50 | $2.50 |
| Standard | $2.50 | $4.00 |
| Full | $5.00 | $6.50 |
| Custom | $6.50 | $8.00 |
| ASAP (within 48 hrs.) | $10.00 | $12.00 |
From Our Clients
“We have 6 dental practices in our group. I started one of our offices with the Smile Care Claims a few months ago. I was so impressed with the results that I have already signed a second location up and am about to do a third office. They are quick to reconcile claims, accurate with claim submission and very flexible with the way our office operates!
I highly recommend them!”
— A.M., Operations Executive
“We started working with Smile Care Claims earlier this year after experiencing dissatisfaction with another company. We have had great communication with the team at Smile Care Claims and have been very happy with the results we continue to see with them. Our insurance A/R is at the lowest in years and the level of insurance verification and diligence with our claims has allowed my Financial Coordinator to work more on case presentations and follow-ups.We have seen a 30% increase in collections since working with them and now we will continue to see an even higher increase.”
— J.S., Office Manager