Dental patient statements

Dental invoice FAQ

What should a dental invoice include?

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.

How do I show insurance vs patient responsibility?

List the procedure at its full fee (e.g. "D2391 Resin-based composite (one surface, posterior) $185") and put the split in the notes: "Estimated insurance benefit: $148. Patient share: $37." Issueable has no negative or credit lines, so the total shows the full fee. If you want the total to be the patient's share, enter the line at $37 and name the full fee and the insurance estimate in its description. Once the EOB lands and the actual benefit is known, send a corrected statement if the estimate was off.

Should I bill before or after the insurance EOB?

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.

How do I list procedures by CDT code?

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.

Can I offer a payment plan on the invoice?

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.

Are dental services taxed?

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.

How do I handle uncollectible balances and write-offs?

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 treats billing and collection as payment activities, so you can disclose what collection requires. Limit it to the minimum necessary.

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

Invoices can reference procedures and CDT codes. A statement that identifies the patient and lists procedures or payments is protected health information, and HIPAA permits using it for billing. Share only the minimum necessary, and 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.