Resources
Practical, sourced guides to dental claim denials — the codes, the appeals, and the revenue most practices quietly write off.
HIPAA compliance by design
How a deterministic, signed architecture turns the HIPAA Security Rule’s technical safeguards — audit controls, integrity, accountability — into structural guarantees, and what compliance still requires beyond software.
What to ask a vendor about HIPAA
A buyer’s checklist for vetting any RCM service, PMS, clearinghouse, or AI tool that will hold your PHI — the questions that separate real safeguards from a badge.
Business Associate Agreements, explained
What a BAA is, when your practice legally needs one, what it must contain, who counts as a business associate — and the common places practices get exposed.
AI and PHI: staying on the right side of HIPAA
Using AI on patient data isn’t a violation — using it without a BAA, containment, and auditability is. Where the line is, and how to keep models on the right side of it.
HIPAA audit trails & tamper-evidence
Audit controls and integrity are where software most often fails quietly. What a tamper-evident trail looks like — and why a log you can edit isn’t evidence.
Dental claim denial codes explained: CARC & RARC
What the common dental denial codes mean — CO-18, CO-29, CO-45, CO-97, CO-197, PR-1, PR-45 and more — which are appealable, and how to respond to each.
How to appeal a dental insurance claim denial
A step-by-step process for overturning a wrongful denial — reading the EOB, gathering proof, meeting the deadline — plus the mistakes that get appeals rejected.
Timely filing limits by dental payer & how to fight CO-29
Common filing windows for Delta Dental, Cigna, Aetna, UnitedHealthcare, Medicare and more — and how to overturn a CO-29 denial when you filed on time.
Dental claim underpayments & downcoding
The quietest lost revenue: claims that get paid, just for less. How below-contract payment, downcoding, and bundling happen — and how to recover the difference.
CO-197: prior-authorization denials
What "authorization absent" means, when the payer is wrong, and how to overturn a CO-197 denial — including when the auth was on file all along.
CO-18: duplicate claim denials
"Exact duplicate" only holds if there are two. Why single-submission claims get flagged as duplicates — and how to prove there's only one.
PR-45 & balance billing
The group code in front of "45" decides who pays. When a contractual write-off gets billed to the patient by mistake — and how to correct it.
How to read a dental EOB / ERA
A field-by-field guide to the remittance — billed, allowed, paid, patient responsibility, write-off — and how to spot denials and underpayments at a glance.
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