Imagn Billing Feature Case: Implant

In this example Imagn Billing case you will see how a dental office in North Carolina successfully billed for an endosteal implant. Our Imagn Billing team processed this claim on 08/13/2020 to BCBS of NC insurance and it was paid on 09/17/2020.

The 61-year-old male patient presented for an emergency appointment with symptoms of pain levels higher in the evening and non-reactive to medication.  Radiographs showed radiolucency surrounding tooth 29 with significant caries lesions.  The patient agreed that an endosteal implant would be the best course of treatment to maintain bone in the mandible.   

Proving Medical Necessity 

The active infection along with the caries lesion makes this procedure urgent and medically necessary.  The abscess has already started to deteriorate the bone, causing atrophy.  Failure to remove the tooth, which is the source of the infection, could result in numerous health outcomes along with irreversible bone atrophy. The only treatment option, to prevent further atrophy and restore function is an extraction, implant placement, and final restoration with abutment and crown.

Example Clinical Note

John Doe DOB – 2/12/1958

Clinical Assessment 1/10/2020: Emergency Visit


S: Patient has been experiencing pain with the highest level of 7 mostly at night with a level of 4 during the day.  It has affected his sleep to the point of not being able to rest even using over the counter Anbesol anesthetic and ibuprofen 1000mg for the last 3 nights. 


O: Radiographs taken today with radiolucency and infection surrounding and through mandible in the area of 29. 


BP 130/90 P 88


Health review:                      Medication review:

Hypertension                        Lisinopril

Dry Mouth                           Prescription Omeprazole



Intraoral: Erosion due to GERD with added Xerostomia from long term use of Lisinopril which also explains the inflammation.

Dr reviewed procedure with patient and results of x-rays w/ patient.



Medical Indication for removal of 29:

extensive decay dx clinically with infection and caries lesions.  Gave patient options and wanted to proceed with implant.

Medical Indication for BG: Prepare site for future implant placement, maintain healthy bone level to support existing dentition.

Medical Indications for Membrane: protect bone graft and allow bone to mature uninterrupted.





3.Implant abutment and crown

Reviewed effects of bone and soft tissue loss after extracting the tooth/teeth and the need for socket preservation grafting to help prevent bone and soft tissue loss.


Reviewed and signed:

Dr. Sarah Smith

Billing Medical Insurance 

The practice collected all required documentation and clinical SOAP notes. After completing the verification of benefits, it was determined that coverage was available after the deductible is satisfied.  Pre-Authorization was required and was completed with approval along with a Gap exception.

Dental Comparison

Without medical insurance contribution, the practice would be writing off approximately 32% and using almost half of an annual $2000.00 maximum.  Medical insurance saved the patient and the practice approximately $1500, whereas dental insurance would be almost exhausted. The patient also completely satisfied their deductible, so moving forward they will have less out of pocket expenses if a healthcare issue arises.  

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Imagn Medical Billing Service

Due to the complex nature of medical insurance billing, most dental offices are not equipped with the knowledge to properly credential national payers, submit successful claims, or handle aging and appeals. Imagn Medical Billing Service performs the proper credentialing and billing for you, which results in fewer denials and time well saved as you rely on expert help.

One-Time Credential Fee

$795/per dentist

The key to more successful payments

Our experts complete the process so you can start billing medical insurance. Each dentist billing medical insurance needs to be credentialed.

Pay Per Case

Verification of Benefit

$35 per vob

We get your patient’s insurance information so you can set proper expectations with the patient regarding the specific coverage available and any out of pocket fees. This is the most critical step in all of medical billing.

Per Authorization

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All procedures require pre-authorization in order for your practice to get paid. Gaining appropriate authorization can be challenging, let our experts get the job done for you.

Claim Submission

8% of successful claim

You don’t have time to sit on hold. Let us sit on hold and handle the claim submission work for you  We also handle the aging and appeals so you can focus on your practice.

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What most dentist don’t know is that medical billing can increase your case acceptance rate and ensure your patients get the care they need.

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Patients can no longer afford to have dentists ignore the responsibility of providing care for sleep disorders. Two out of every three Americans report poor sleep; the ability to breathe well is the most important factor in determining a person’s sleep quality. 

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