Advanced Professional Certificate in Dental Revenue Cycle Management
For billers who already know the basics and now run the money. Twelve modules go deep on PPO contracts and fee negotiation, claim types and splitting, DHMO and capitation, medical billing for dental, denials and appeals, A/R and owner reporting, audits and recoupments, state and payer rules, and leading a billing team. A multi-location capstone case and a final exam finish the program.
Certificate of completion. Not continuing-education (CE) credit.
- 12 modules · 58 lessons + capstone + final exam · about 19 hours
- Short narrated video lessons with full text. Progress saves as they go.
- $649 one-time
- Includes 12 months of access.
- English and Spanish
- Every lesson, quiz, the capstone and the exam, in either language. Each learner chooses.
- Built for experienced billers
- Recommended: 2 or more years in dental billing, or our Billing Pro certificate. Not required.
- Verifiable certificate
- Valid for 2 years. Certificate of completion, not continuing-education credit.
Before you buy: what’s included, and who it’s for
How it works: self-paced online lessons with narrated videos and full text, a quiz after each lesson, worked examples with real numbers and real documents (EOB and ERA lines, contract clauses, rosters, aging reports), a capstone case, and a final exam of 60 questions drawn from a bank of 120. There is no live class. Learners can send a question to our trainers from any lesson (we answer within 2 business days) or call (916) 770-4050, Monday to Friday, 8am to 6pm Pacific.
Who should take it: this program does not re-teach the basics. It assumes the learner already handles plan types, verification, CDT basics, the claim form, posting and routine denials. We recommend 2 or more years of dental billing experience, or our Professional Certificate in Dental Billing and Insurance first. There is no entry test; anyone can enroll.
Who it’s for
- Experienced dental billers and insurance coordinators ready to move into a lead role.
- Billing leads, revenue cycle managers and office managers who own collections and report to the owner.
- Billing staff at group practices and multi-location offices handling several providers, locations and tax IDs.
- Graduates of our Billing Pro certificate who want the next step.
Is a license required?
No license or certification is required by law to work as a dental biller or billing manager. This program awards a certificate of completion from Comodo Technology. It is not an industry certification and it does not carry continuing-education (CE) credit.
What it gives you is a structured, advanced course of study, current to October 2026 rules, and a dated certificate with a serial number that an employer can verify online. Lessons explain what laws and payer rules say; they are not legal advice, so confirm your specific situation with counsel.
What you’ll be able to do
- Read a PPO agreement and its fee schedule, analyze write-offs by carrier, and build a data-backed fee request or a keep, renegotiate or drop recommendation.
- Choose the right claim type every time: replacement, void, appeal or resubmission, and split multi-stage, multi-year and multi-provider cases honestly.
- Reconcile DHMO rosters, encounters and capitation checks, manage specialist referrals, and apply California’s DMHC rules and AB 3275.
- Bill medical plans for dental cases: payer order, ICD-10-CM specificity, the CMS-1500 and 837P, CBCT imaging and oral appliance therapy.
- Group denials by root cause, write appeals that cite the plan’s own language, and know when to escalate to a regulator.
- Define KPIs that survive scrutiny, triage the aging report, and give the owner a one-page dashboard with variance explained.
- Respond to payer audits and recoupment demands, manage credit balances and refunds, and keep payment methods compliant.
- Track the state and payer rules that apply to your offices, and design, staff and audit a billing team, in-house, remote or outsourced.
Built for the work after the basics
The whole revenue cycle in one program
PPO economics, claim splitting, DHMO, medical billing, denials, A/R, audits, state rules and leadership, instead of a single topic or a set of unrelated clips.
DHMO and California depth
A full module on capitation billing and rosters, plus California rules: Knox-Keene and the DMHC, AB 3275 and Medi-Cal Dental Managed Care.
Current to 2026
Covers recent state laws on assignment of benefits, virtual card and EFT payments, recoupment limits and network leasing. More states are enacting these laws, and some take effect in 2027 and 2028, so a lesson shows how to keep your own state tracker current.
Real documents, real numbers
Every lesson walks through an artifact (an EOB line, a contract clause, a roster, an aging report) and two judgment-call scenarios worked step by step.
Tools you keep
A working checklist at the end of every lesson: write-off analysis, claim-splitting decisions, DHMO reconciliation, appeals, a state rule tracker, a KPI dashboard and a year-end plan.
Any practice software
Software-neutral on purpose. Lesson 12.2 shows the settings that act as financial controls in any desktop or cloud system: fee schedule linkage, plan setup, ERA rules and adjustment types.
What’s covered
12 modules · 58 lessons + capstone + final exam · about 19 hours. Each lesson ends with a short quiz.
| # | Module | Minutes |
|---|---|---|
| 1 | The Revenue Cycle Leader’s ViewThe Revenue Cycle as a System · Fee Schedule Architecture · Production vs Collections · The 2026 Landscape | 73 |
| 2 | PPO Billing Done RightPPO Contracts Decoded: Allowances, Hold Harmless and the Contract Behind the Contract · Billing and Posting PPO Claims: Full Fees, Write-Off Types and Payment Variances · Covered, Non-Covered or Nonpayable: State Non-Covered Services Laws in Practice · Downgrades and Alternate Benefits: The Math, the Limits and When to Appeal · Network Tiers and Leased Networks: Delta PPO vs Premier vs Non-Participating, and Rented Fees · Out-of-Network Done Right: Assignment of Benefits, Patient Checks, No Waivers and Payment Method Rights | 105 |
| 3 | PPO Strategy: Analysis, Negotiation, Credentialing and ExitWrite-Off Analysis: What Each PPO Really Pays · Negotiating PPO Fees with Data · Credentialing at Scale: Providers, Locations and Tax IDs · Dropping a PPO or Changing Tiers · Contract Hygiene: Amendments, Network Access and the Contract Library | 89 |
| 4 | Claim Types, Corrections and Splitting ClaimsEvery Claim Type: Original, Predetermination, Secondary, Replacement and Void · Correct, Appeal or Resubmit: Choosing the Right Path · Date-of-Service Rules: Seat, Insertion, Fill Date and Coverage That Ends Mid-Treatment · Splitting Multi-Stage and Multi-Year Treatment: Implants, Ortho, Prosthetics and Benefit-Year Phasing · Mechanical Splits: Line Limits, Providers, Locations, Medical Lines and COB · The Fraud Line: Date Changes, Unbundling, Provider Substitution and Copay Waivers | 107 |
| 5 | DHMO and Capitation BillingHow Capitation Really Pays: PMPM, Copay Schedules, Supplementals and Plan Profitability · Rosters and Eligibility: Assignment, Effective Dates, Retro-Adds and Retro-Terms · Specialist Referrals and Authorizations: Workflow, Emergencies and Patient-Responsibility Traps · Encounters, Posting and Reconciling the Capitation Check, and Finding Revenue Leaks · California Rules: Knox-Keene and DMHC, AB 3275, Provider Disputes, Timely Access and Medi-Cal Dental Managed Care | 85 |
| 6 | Medical Billing for Dental, AdvancedWhen Medical Pays First: Payer Order, Verification and the Dental Finish · Coding to Medical Standards: Specificity, Pathology Timing and Surgical Packages · CMS-1500 and 837P Mastery for Dental Cases · CBCT and Imaging on Medical Claims: Indications, Codes, Components and Reports · Oral Appliance Therapy for Sleep Apnea: Medicare Criteria, Codes and Supplier Enrollment · Medicare for Dental Offices: Enrollment Choices, Medicare Advantage and Linked Dental Coverage | 109 |
| 7 | Denial Management and Winning AppealsDenial Taxonomy, CARC/RARC Grouping and Root Cause · Medical Necessity and Frequency Denials · Appeal Craft: Levels, Representation, Plan Language and Peer-to-Peer · Escalation: Regulators, Provider Complaints and Batch Appeals · The Prevention Loop: Front-End Edits, Pre-Authorization Policy and the Monthly Denial Review | 91 |
| 8 | A/R, KPIs and Reporting to OwnersThe Leader's KPI Set: Definitions That Survive Scrutiny · Aging Report Triage: Deadlines, Dollars and Capacity · Patient A/R as a Managed Portfolio · Building the Owner Dashboard and Explaining Variance | 73 |
| 9 | Audits, Recoupments and Money CompliancePayer Audits: Reading the Letter, Challenging the Sample, Building the Defense File · Recoupments: State Windows, Offsets and Disputes · Refunds, Credit Balances and Unclaimed Property · Payment Method Compliance: EFT Enrollment, Virtual Cards and Vendor Fees · Fraud and Abuse Risk: Patterns, Provider Substitution and a Working Compliance Program | 91 |
| 10 | State and Payer Rules PlaybookThe Eight Rule Families Every Billing Lead Tracks · Fully Insured vs Self-Funded: Who Regulates and Where You Complain · Building and Maintaining Your State Rule Tracker · California Playbook: NCS, DMHC vs CDI, AB 3275 and Medi-Cal | 74 |
| 11 | Leading a Billing TeamWorkflow Design: SOPs, Role Splits and Segregation of Duties · Productivity Standards, QA Sampling and Error-Rate Scorecards · Overseeing Remote Staff and Outsourced Billing Vendors · Automation and AI Tools: What to Automate and What to Keep Human · Hiring, Onboarding and Competency-Based Training | 87 |
| 12 | Annual Update and Any-Software MasteryThe Annual CDT Rollout: New, Revised and Deleted Codes · Universal PMS Controls: Fee Linkage, Plan Setup, ERA Rules and Adjustment Types · Year-End and New Year: Benefit Resets, Maximum Tracking and the Reverification Blitz | 55 |
| 13 | Capstone: Multi-Location Revenue RescueA three-location case packet: aging, denials, three PPO fee schedules, a DHMO capitation report, two medical cases, a recoupment letter and owner KPIs | 26 |
| 14 | Final exam60 questions from a bank of 120 · 80% to pass · unlocks after every lesson is passed | 75 |
| Total | about 19 hours |
Prove it on a real-world case
The capstone
Learners work a fictional three-location group’s packet: aging and denial logs, three PPO fee schedules, a DHMO capitation report and roster, two medical cases, a recoupment letter and the owner’s KPIs. Case questions cover KPI diagnosis, corrected and split claims, appeals, DHMO reconciliation, a PPO recommendation and a 90-day plan.
The final exam
60 questions drawn at random from a bank of 120, most of them built on documents and cases from across all 12 modules. The pass mark is 80%. It unlocks after every lesson is passed.
How the lessons work
Each lesson is a narrated video with the full text beside it, in English or Spanish, followed by a short quiz. Learners can pause, rewind and come back; progress saves automatically.
A dated certificate anyone can verify
Dated, with a serial number
Each person who passes gets a certificate showing their name, program, score and date. Valid for 2 years.
Anyone can check it
An employer can confirm a certificate is genuine at hipaa.comodotechnology.com/verify, with no account and without contacting us.
A certificate of completion
It is proof the training happened and the exam was passed. It is not continuing-education credit and not a license.
Price and how to buy
Add the Advanced Certificate to your cart, choose “just for me” or the number of staff, and pay online. Your sign-in link arrives by email.
Just for yourself
Includes 12 months of access to every lesson, the capstone, the final exam and your certificate.
For your practice
For up to 4 staff. One-time, with 12 months of access each.
5 or more staff
When you train 5 or more. One-time, with 12 months of access each.