Dental Claims and Billing in 2025 and Beyond
July 2025
The evolution of billing and claims management has progressed from fully paper-based processes in the 1980s to real-time, automated digital workflows. Today, in 2025, cloud-based practice management software, API integrations, and AI are redefining dental billing efficiency and security. Revenue Cyle Management (RCM) is no longer just about submitting claims—it's about creating smart integrated systems that optimize cash flow, reduce administrative burden, and improve the patient financial experience.
Dental Billing & Consulting Professionals is excited and ready for this new era! We understand the power of having instantaneous data access with financial health analytics that help practice managers and doctors make proactive decisions. Call or text us anytime at (860) 435-7344 for a free consultation on how we can customize services for you and your goals. And, stay tuned for what’s coming next in what we offer!
Timeline of Dental Claims and Billing: Evolution of Technology
Pre-1980s: Paper-Based Era
All medical and dental claims submitted via mail using pre-printed claim forms.
Manual reviews, long processing times, and high administrative overhead.
1980s–1990s: Digital Foundations & Early Practice Management Software
EDI (Electronic Data Interchange) begins in medical billing.
1985: Dentrix Dental Systems is founded and a few years later releases Dentrix—one of the first dental PMS to offer digital charting, scheduling, and billing tools for general dentists. Dentrix was later acquired in 1997 by Henry Schein.
1991: ADA standardizes its dental claim form (ADA J400), paving the way for electronic claims.
1993: EagleSoft launches as a PMS solution for its user-friendly interface, later acquired in 1997 by Patterson Dental.
1993: DSN (Dental Software Network) launches its first oral surgery PMS platform—popular with oral maxillofacial surgery groups and early adopter DSOs.
Late 1990s: Governance, E-Claims, Specialty Software
1995: The NUCC was formed in 1995 taking over for the Uniform Claim Form Task Force that initially developed the standard professional claim form (HCFA 1500 and then CMS 1500).
1996: Health Insurance Portability and Accountability Act (HIPAA), governs how providers, health plans, and clearinghouses must conduct electronic, administrative transactions and set privacy and security standards for transmitting electronic health information.
1998: WinOMS launches, tailored specifically for oral and maxillofacial surgeons, with robust clinical, billing, and imaging integrations.
1999: Open Dental (originally “Free Dental”) is developed as open-source PMS, gaining popularity for affordability and customization.
Late 1990s: NEA and DentalXChange emerge, enabling electronic dental claims and attachments.
2000–2010: Electronic Attachments & Practice Software Growth
CDT/CPT cross-coding begins the journey of becoming standard practice in oral surgery offices including in many software and clearinghouse services.
2004: NEA introduces FastAttach® for secure electronic submission of radiographs, narratives, and perio charts. NEA was later acquired by Vyne and now operates under the Vyne Dental brand.
2006–2009: All major PMS platforms (Dentrix, Eaglesoft, Open Dental, WinOMS, DSN) integrate e-claims and attachment modules.
2011–2020: Automation & Integration
Cloud-based versions of PMS software begin gaining traction.
Real-time eligibility checks, electronic remittance advice (ERA), and payment posting become standard.
Technical tools help validate claims, detect errors, and auto-generate rejections and denials.
2017: Carestream (which owns WinOMS) launches Sensei Cloud®, a modern, cloud-based PMS with integrated imaging and billing.
💛2017: Dental Billing & Consulting Professionals emerges as a boutique-style dental billing and revenue cycle consultants that specialize in oral and maxillofacial surgery. No overseas out-sourcing, an easily accessible dedicated team working remotely for your practice.
2024-2025: Change Healthcare Cyberattack & Strategic Responses
Feb 21, 2024: Ransomware attack on Change Healthcare halts claim submissions for thousands of medical and dental providers. Claims, remittance, eligibility services are all disrupted. Dental providers using PMS linked to Change Healthcare (e.g., Open Dental, DSN, Eaglesoft) are affected.
A Renewed focus on cybersecurity, redundancy reduction, and payer-direct workflows begins.
Strategic Responses:
Optum (UnitedHealth Group) steps in to provide guidance and support amidst outage and takes foothold as premier medical clearinghouse forging new pathways and integrations with affected practice management software.
Vyne Dental rapidly onboards clients and increases staff to address urgent need for dental clearinghouse support.
DentalXChange broadens their scope of portal integration and claims and eligibility services to address urgent dental clearinghouse needs and increased demand.
2025 and Beyond
Rise of payer-direct submissions, multi-clearinghouse workflows and integrations, and fully cloud-native PMS solutions.
Legacy Software (Dentrix, WinOMS, DSN) continue evolving offering more robust reporting and security, while Open Dental grows rapidly due to flexibility and open-source API access.
💛 Dental Billing & Consulting Professionals brainstorms new smart, secure, streamlined workflows and systems that leverage the ever-changing landscape of billing – stay tuned!