Question 1

What should a dental invoice include?

Accepted Answer

Patient name and account number, procedures itemized with their CDT code (ADA's Code on Dental Procedures and Nomenclature), tooth/quadrant where applicable, insurance estimated contribution, patient responsibility, and any prior balance. Most patients receive this as a "patient statement" rather than a traditional invoice — but the structure is the same.

Question 2

How do I show insurance vs patient responsibility?

Accepted Answer

Three lines: (1) procedure cost (e.g. "D2391 Resin-based composite — one surface, posterior — $185"), (2) insurance estimated payment ("Estimated insurance benefit: -$148"), and (3) patient responsibility ("Patient share: $37"). Once the EOB lands and the actual benefit is known, send a corrected statement if the estimate was off. Issueable invoices handle this with line-item discount/credit lines.

Question 3

Should I bill before or after the insurance EOB?

Accepted Answer

Both, depending on practice policy. Many practices estimate at the appointment and collect the patient's estimated share that day, then send a final statement after the EOB if there's a balance or refund. Others wait for the EOB before billing the patient at all — slower cash flow but cleaner statements. The estimate-then-reconcile model is more common; bill the estimated patient share at point of service to reduce A/R.

Question 4

How do I list procedures by CDT code?

Accepted Answer

Each line item should include the five-digit CDT code (e.g. D2391, D7140, D2740) and a plain-English description. Codes are public and updated annually by the ADA. Patients with HSA/FSA accounts and insurance reviewers both look for the codes; without them, claims and reimbursements get held up. Tooth number / quadrant goes in the description for restorative and surgical procedures.

Question 5

Can I offer a payment plan on the invoice?

Accepted Answer

Yes — for larger procedures (orthodontics, implants, full-mouth reconstruction) most practices offer in-house payment plans or finance through CareCredit / LendingClub. State the plan terms in the notes section: "3-month interest-free payment plan: $X due monthly, beginning [date]." If you finance through a third party, they handle the patient billing; your invoice just shows the procedure cost.

Question 6

Are dental services taxed?

Accepted Answer

Generally no — dental services are exempt from sales tax in nearly every US state because they're considered medical/healthcare services. A few states tax cosmetic dental work (whitening, veneers, implants for cosmetic purposes) differently from medically necessary care. Confirm with your state's department of revenue. The over-the-counter products you sell (electric toothbrushes, whitening trays for home use) are usually taxable as tangible goods.

Question 7

How do I handle uncollectible balances and write-offs?

Accepted Answer

Issue the patient statement first; if 60–90 days pass without payment, send a final notice referencing the original. After 120+ days, write off the balance as bad debt or assign to a collections agency (subject to your state's medical-debt collection rules — many states cap interest and require notice periods). Document write-offs as a credit on the patient ledger; HIPAA prevents you from pursuing collection through means that disclose patient health information.

Question 8

What about HIPAA and what I can put on an invoice?

Accepted Answer

Invoices can reference procedures and CDT codes — these are part of the financial relationship and not protected health information in this context. But avoid describing diagnoses or detailed clinical findings on the invoice itself, especially if it might be seen by a third party (employer's HSA administrator, a parent/guardian for an adult dependent, etc.). The CDT code is sufficient for billing; clinical detail belongs in the chart, not the statement.

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Dental Invoice FAQ