The Dental Billing Podcast
Dental billing is not data entry. It's the difference between a practice that collects what it earned and one that writes it off and calls it the cost of doing business.
The Dental Billing Podcast is hosted by Ericka Aguilar and Jen Lyman, RDH. Ericka has been a dental biller since 1998 and has taught billing in 31 states and Mexico. Jen came out of the operatory and now runs Lyman Revenue Solutions, handling both dental and medical billing. One of us knows exactly what the carrier is going to do with your claim. The other one knows what actually happened in that chair. You get both.
Every week we break down denials, appeals, coding, and the carrier behavior nobody warns you about, in plain language, with real sources. We teach the law before the codes, because a code doesn't win an appeal. Knowing what that carrier is legally required to do wins the appeal.
If you've ever been told you're "just the biller," this show is for you. Downloads in 114 countries and counting. Bring your coffee and your worst denial.
The Dental Billing Podcast
Ericka Aguilar Gets Interviewed (Finally)
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A lot of dental billing advice online is loud, confident, and wrong and the cost shows up months later as denials, write-offs, and clawbacks. So we flipped the mic and let you meet Erica, the person behind years of dental billing education, revenue cycle management consulting, and a whole lot of hard-won pattern recognition from inside real practices.
We talk through her path from a “natural-born geek” who literally tried to steal homework, to becoming a teen mom who needed a stable career fast, to discovering that the dental front office was where she belonged. From there, she builds a billing company at 22, partners in dental practices, and eventually creates Dental Career College after seeing how hard it is to hire and train great front office teams. Along the way we dig into what offices actually asked for most: stronger verbal skills on new patient calls and real competence with dental insurance claims and billing systems like Dentrix.
Then we get practical about the issues that keep practices stuck: denial management without a standard process, confusing “we did it” with “will insurance pay,” and letting coverage rules creep into clinical decision-making. Erica shares why billers must keep up with updated CDT codes, invest in continuing education, and prepare for diagnosis codes and AI in dentistry, because the billing landscape is changing fast and it will leave people behind.
Follow us for tips and updates, and don’t miss the upcoming live webinar: bring your denials and your questions. If this helps, subscribe, share the episode with your office, and leave a review so more dental teams can find it.
Registration Link for Diagnosis Codes on a Dental Claim Form Webinar:
https://dentiqhub-diagnosis-codes.vercel.app/
Get your Dental Billing Toolkit Here:
https://www.dentalbillingdoneright.com/the-dental-billing-toolkit
Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:
Schedule a billing chat with Ericka:
https://calendly.com/ericka-dentalbillingdoneright/30min
Email Ericka:
ericka@dentalbillingdoneright.com
Email Jen:
jen@dentalbillingdoneright.com
Switching Sides Of The Mic
SPEAKER_00Hi, Erica. Hi, Jen. We get to interview you today on the other side of the mic.
SPEAKER_01This is going to be interesting because I do not have a clue as to what you're going to ask me, but and it kind of makes it fun because I love doing things on the fly, like impromptu.
SPEAKER_00Yes. I think it'll be great for our listeners to know who you are, your credentials, how you got to where you're at today, because you interview so many people. You've had such an amazing life and career. And I know a lot of people look up to you and admire you. So I'm really excited to hear everything about who you are.
SPEAKER_01Yeah.
SPEAKER_00I'm I'm excited to be on this side of the mic. So this is gonna be fun. It will be. All right. So
Childhood Geek Energy And Drive
SPEAKER_00I want to start off with, like you always do, who was Erica as a child?
SPEAKER_01Oh my gosh. Well, I was a natural-born geek. I have always loved school. Uh I would sneak homework home over the weekend. My first grade teacher caught me stealing homework. And my mom and my first grade teacher they kind of were perplexed on like how do we discipline them? She's trying to steal homework because I always wanted to be a teacher. I would take the homework home and then put all my stuffed animals on my bed and then like teach a little class and then give them homework. Just I've always enjoyed school. I was on the newspaper in high school and the swim team. I'm very, very competitive and always been like that. I'm very hard on myself. And it's been like that since I was since I can remember. I'm just super hard on myself, like competitive with me.
SPEAKER_00Yeah, I can see that. Because you're a go-getter completely.
SPEAKER_01I didn't like dolls. If my anybody ever bought me a doll, I would get so upset because I wanted calculators that printed and paper and pens and and compasses and rulers, and I wanted that stuff. I never played with dolls. So I guess I've always been like somewhat of a business geek my whole life. Even from a kid, even as a kid. Yeah. Yeah. So that's kind of who I am at my core. And I think that that has carried into my professional career because I love helping and I love teaching.
SPEAKER_00Yeah.
Finding Dentistry By Trial And Error
SPEAKER_00So let's get into that. How did you start into dentistry? And how did that transition go from where you started to, I know there's a a lot of information from where you started to where you are now, but walk us through that first step, how you got into dentistry and then how you got into billing.
SPEAKER_01I needed a stable career early. I had my son when I was 16 years old and dental assisting. Actually, I'm gonna back up. I actually went to Concord Career College for medical assisting. And when they told me that I was gonna have to learn how to draw blood and we were gonna practice on each other. Fun fact, I faint when I see blood. So I was like, Oh man, yeah, that's not gonna work. So she's the counselor said, Well, what about dental assisting? And I said, I can do that. So I went to school to become a dental assistant, graduated in 1995. Side note, that was Concord Career College. And I was recently asked to speak at the commencement ceremony. They've expanded into hygiene and all the things, but they really they want me to do a commencement speech. Um, so that's like a really cool full circle moment. And I hated it. I hated being a dental assistant. It just was not what I wanted to do. It was for me, it was the equivalent of giving me a Barbie doll when I was a little girl. I love that analogy. I did not like it. And I always wanted to work in the front because it was like papers and staplers and pens and papers. It was like this, I wanted to go to the front. So I was given the opportunity in 1998. Dr. Ligia Blanco, she hired me as a dental biller and I never looked back.
SPEAKER_00I love that. And then from that experience, what was kind of your next step? What did you go into after that? How did you become a business
Starting A Billing Company At 22
SPEAKER_00owner? How was that transformation?
SPEAKER_01Gosh, I actually started my own billing company when I was 22. The second billing position that I had was for a large group. It was with Dr. Bot, and he had a traveling biller. And I would go hang out with Joel. Joel would sit, would tell me how much he loved his job because he didn't have to deal with all the drama from the office. And I thought, that is so cool. You just go into an office one day a week, and every day you're in a different office. I thought, I could do that. You can't tell me that I can't do something because if it's not available, I will go create it. Like, I wanted to be a cheerleader in eighth grade, but our junior high did not have a cheerleading team. So I went to my drama teacher and I was like, can you help me start a cheerleading team? And she took me to the principal, and the principal said, okay, go for it. I started the cheerleading team because I selfishly wanted to be a cheerleader. I heard that from Joel and I was like, I'm gonna do that. So I went out and I started asking dental offices if they would hire me for one day a week and I would come in and do your billing one day a week. So I have four offices at 22. The name of my company was ACU Claim. And I never registered it. I mean, I was 22. I didn't know what I was doing, but I didn't, you know, I created this company, didn't know that I was like moving into the self-employment space. And that's kind of where it all began. Like the entrepreneurial itch started around that time.
SPEAKER_00And it started around dental billing and it still lives today. I love that. And you've started multiple businesses, and I'm gonna brag on you because I know you won't, but I just want to list off some of your credentials that maybe our listeners don't even know about you. That you have over 25 years specializing in dental billing and revenue cycle management. You've taught dental billing in 31 states, serving practices across the entire nation and Mexico. You've analyzed hundreds of billing departments. I know I've helped you with some, but you've done hundreds, maybe even thousands at this point. I guess in the thousands, yeah. Yeah. And you you were actually an owner also in dental practices, correct? Two.
SPEAKER_01I was a partner in two practices. And that was one was a complete startup, like build out, ground up. And the other was an existing practice that was about to go under. And we turned that one around.
SPEAKER_00I love that story because we see so many of those things, and you have a real heart for practices that are struggling. And I think that's why also you're you're so great at pursuing the billing because you see the business side of it behind everything.
SPEAKER_01Yeah.
SPEAKER_00And then you're also the founder of the Dental Career College. So talk to us a little bit about that and how that played into your billing
Building Dental Career College From Scratch
SPEAKER_00journey.
SPEAKER_01Dental Career College was born out of complete frustration. I worked for a doctor who moved to Dubai and left me with four offices. And we grew that to eight. And I did the next four as acting owner, acquiring new practices. I kind of had experience as an owner, being that I had power of attorney and I was him, basically. And I remember when I signed it and he handed it to me. He goes, My life is in your hands. And you know, it's humbling when somebody trusts you that much. So, in all of that, managing and running as acting owner, eight practices in total, it was hard. It was hard to find front office. Dental assistants were always available. You could, I could hire them, you know, within the week. But front office was very hard. And I felt like, yes, you can have you can find someone with 20 years of experience, but they don't have the right attitude, or they don't have enough experience and they have the right attitude. And I always had more success with people that were more of a culture fit than anything else. And I found that how I trained them made them highly productive, right? So I found that if I find someone with no experience and I train them myself, we get a better outcome. Through that frustration, I just remember having a drink with my friend Barthy, who is in real estate. She has no idea what I'm talking about. And I'm like, I'm gonna start my own front office school and you know, cheers. And I got to work. I started working on the curriculum. That journey was very interesting. It took me 18 months to make the curriculum. I had first reached out to the Department of Education and thought, well, let's see if there's anything in the country related to dental front office training because medical has it. Medical has a medical administration program. Why doesn't dental? So I went down the path of creating the curriculum. It took me 18 months and I spoke to anybody and everybody that would listen to me. I did a survey of over 300 dental practices. Me myself calling dental offices all over the country and specifically asking to speak to the doctor. Because if you're gonna make a curriculum, you got to make sure that you have in it what they want. Like I'm gonna produce students that, and if I'm I miss the mark, they're not gonna hire my students. So the predominant two top reasons that I got out of that survey was verbal skills. I wish that my front office knew how to handle a new patient call. And then across the board, billing. Filling kept coming up just over and over. So I knew I needed to make that like a really big emphasis in the curriculum. And I did. Everybody that would speak to me gave input to that curriculum. And I started dental career college, launched my first class, and did that for six years. And it just, I think we ran through about 7,000 students over that six-year period. And these were people with predominantly no background in dentistry. So taught them from the ground up in the five months that we spent in the classroom together. And then they did their externship in an actual office, and they were trained so well that our hire rate was at 92% right out of their externship. And my students were replacing existing employees. Like we heard over and over again, you know more about billing than my biller that's been with me for 15 years. And this person is like fresh, it knew in dentistry, has never worked in an office before, but knew exactly how to navigate. I taught on Dentrix because Henry Shine had donated Dentrix to my college. So they were very well trained with Dentrix and knew how to navigate. I would have Dentrix trainers come in and show them the ropes. So yeah, it was a fun, fun journey with that college. I taught from 9 a.m. to 4 p.m., had a break, and then my evening class was 6 p.m. to 10.30 p.m. And I did that Monday through Saturday for six years. And the average class size was 20, about 24 students per class. So you had, you said 7,000 people over 7,000 students. Yeah, because it was a different class. Every day class met once a week, and then the rest of the course was self-study. Once a week we would meet. So every day was a different class. And I had Monday through Thursday, we had day and evening.
SPEAKER_00That is a lot. So you still had 7,000 within that career college, and you've spoken all over the country too. How many, if you had to guess, how many people do you think you've taught?
SPEAKER_01I just worked with Claude on this. I was trying to quantify like how many people I've taught, and it's no less than 24,000 people that I have taught dental billing.
unknownYeah.
SPEAKER_00And you've reached so many more through your social media and through webinars and other things too, that I'm sure the numbers probably double that even with the podcast and whatnot.
SPEAKER_01I'm probably forgetting some, but you know, I've I've hosted 240 of my own dental coding and billing workshops over the past 12 years.
SPEAKER_00So in those workshops, what is the same thing that keeps coming up? Like, what is your signature speech that
Denial Management As The Money Leak
SPEAKER_00you want people to really like hone in on?
SPEAKER_01Denial management. It's a problem. There's no system, there's no standardization with dental billing. So we all kind of think that just because my claim got paid, I must have billed it correctly. There's that term, clawback. You know, they can claw back that money if they want to because you didn't bill it correctly and they just they paid it by accident on the first pass. The denial management has no process, no standardized process. So offices are losing a ridiculous amount of money because the billers don't know what they don't know. And you and I have these conversations like for breakfast. It's like, and then again at lunch. So we're always talking about denial management and appeals and taking things to the insurance commissioner, overturning that denial from 2024 that you recently did.
SPEAKER_00Mm-hmm. Yeah. That's what comes up. Yeah. And that's such a big topic that people need to know about how to do those things. And it's different in every state, right? As far as like certain
Standard Of Care Versus Coverage Rules
SPEAKER_00billing procedures. We were just talking about this before this too. But the difference between standard of care and protocol and how, you know, I'm a hygienist, so I think of standard of care. And I know a lot of front desk think about protocol. So, what do you think is the difference when it comes to denial management? How we could differentiate between those two?
SPEAKER_01Well, I think a lot of people use the terms incorrectly. Somebody will ask me, can I bill for D0274, right? Every six months. And I always say, well, if you did it, you should bill it. Now, I think what you're really asking me is, will the insurance pay if I bill it every six months? So I think that we're constantly having the wrong type of conversation because if you did the bite wings and you code for them, that is good. But if you're asking, we did bite wings, but can I bill them? Will the insurance pay for it? That's a different conversation. So I think we need to get clear on that topic. And there's so much misinformation out there, you know, especially right now with social media, TikTok blowing up, you've got these self-proclaimed gurus, you know, that are on there talking about misinformation. We just talked about it right before we pressed record, how she's talking about no longer having to submit PAs for a certain, you know, and you're like, wait a minute, standard of care and what insurance will pay for, those are two different things. And I think too many times we allow when we start getting into the weeds of that conversation, we're allowing insurance companies to dictate standard of care way too often. Yes, yes.
SPEAKER_00And determining between standard of care and protocol as far as clinical necessity for those things. And
Staying Relevant With CDT And CE
SPEAKER_00that's something that you and I, man, we just hammer into every day. I feel like we talk about this subject.
SPEAKER_01It's a lot of things about billing have evolved. And there's a lot of people that are gonna find themselves out of a job because they have not kept up with the CDT codes. It's more common, Jen, that people have not bought up-to-date CDT book, which is scary to me because you could miscode something, you could use an old deleted code. That to me screams unprofessional, you know, and and I don't mean to offend anybody, but you you want to be paid as a professional, you want to be treated as a professional. Well, then you got to act like a professional and invest in your career. One of the questions that I often ask individuals, especially for individuals that are looking to work at the billing company, when was the last CE billing related workshop that you either threw a webinar, attended? Because I've never seen you in one of my classes and I host them all over the place. When was the last time you attended? And it's like either never or years ago. You know, I think as an industry, we need to really do better.
SPEAKER_00Yeah. So that brings up a great point with billers. What are like your top three things that we need to be doing to stay relevant? Obviously, buy the CDT book every year, the updated one. What else do we need to be doing? And in within our offices and within our practices that you see are crucial for billers since there is no
Diagnosis Codes And AI Are Here
SPEAKER_00standardized structure.
SPEAKER_01Well, I think you know what I'm gonna say. I do. Diagnosis codes. I mean, it's here. And I think I've been talking about diagnosis codes since 2012. That was in my early speaking years. The ADA had updated the claim form to include four sections where you can add diagnosis codes. Well, when the ADA updates the claim form, something's come coming down the pike, you know, like something's happening. And my crystal ball was correct when I was preaching to all my attendees, learn diagnosis codes because it's coming, you know, and now it's here. And that I think is where the relevancy is going to sit in addition to understanding AI and how it is affecting our world. And if you're not savvy with diagnosis codes and artificial intelligence, then you are going to find yourself struggling. Yeah. Because they're gonna be left in the dust. Totally left in the dust. I mean, they we are evolving so hard in dentistry right now, especially in the billing landscape. I focus on everything billing. It's evolving so hard right now that if you're not keeping up with it, then you're gonna struggle. Yeah. I've been doing dental billing since 1998. When I started, I was filling out claim forms. And look at how many times we've evolved since then. When I started, we didn't have practice management softwares. There was nothing. We worked off of pegboard. I don't even think half of my audience understands what that is. Probably not. We worked off of pegboard and we had these huge appointment books, and you only filled them out with pencil because if the patient needed to reschedule, you had to erase the existing appointment and then go over and find a new appointment for them. I knew I had to stay with the times. And now with everything being so techie, and I struggle with tech, but I still try my best to stay relevant because I love the field that I'm in and it's getting very techie.
SPEAKER_00Yeah. And that's a good point to bring up is that as billers, we need to stay relevant. There's a lot of billers I know that are probably listening as well that maybe we're not reaching out because we are so overwhelmed. We're so overworked sometimes. And maybe it's just overwhelming to think about changing anything. But I would encourage our listeners to reach out for help to Erica or myself. Come to our webinars that we host often, free webinars. We have one coming up on September 1st. We'll put that in the show notes too. And those things are there to help guide and teach you. And we are live in those. Like we set a time, set aside our time to be able to be live and answer your questions and deep dive into those. So I love that you have stayed relevant this whole time and you change with the types. Like you learn, you grow. And I would encourage our encourage our listeners to do the same.
The Book And The Big Next Move
SPEAKER_01Yeah.
SPEAKER_00Yeah. It it's, man, times are changing. They are. They are. And I want to bring up you also wrote a book. Tell me a little bit about that.
SPEAKER_01Did it's done. Need to just put it into editing. The reason I haven't launched it is because there is something very big happening in my career right now that I cannot talk about. And kind of want that to be the finale. The book is all about my journey in dentistry. My mom is a book writing coach. So she writes novels and she does ghostwriting. And so she's been my coach in all of this. So she calls it a business memoir, where you will learn along the journey, but you're also going to hear about all the experiences. And I've had a very unique career in dentistry. I just wanted to share my experience. The name of the book is I'm Just the Biller. And the tagline is When I Grow Up, I Wanna Be a Dental Biller. Said no one ever. It kind of just morphs into that. You just kind of end up here. It's a great career to have. It's taking care of my kids, it's taking care of my my family. And yeah, so that's why I wrote the book. And once it's released, I will definitely let everyone know. And we'll definitely have to do like a book launch party or something. Yeah, I love that.
SPEAKER_00That'll be really fun. I'll be there at the party. So yeah.
The Hill To Die On In Billing
SPEAKER_00Um, so any last thoughts as far as billing? Like, is there one piece of advice to billers that you want to leave them with that comes from your vast experience and the people that you've interacted with? You've you worked alongside some really big names in dentistry. And, you know, if you want to name drop those, you can. But what do you want to leave the listeners with as far as what hill will you die on as a biller and what do you want them to know about you?
SPEAKER_01I don't know everything. I've been doing this a long time, but I still learn from the people that I mentor and just be a constant learner. Like, don't stop learning. And I don't know it all. And I have been around the block a few times and I'm still learning.
SPEAKER_00Yeah. I think that's great advice. I think we always need to be learning. So I would encourage you guys to seek that out as you go throughout your career. Always be learning, always be willing to grow, always be questioning and not just questioning to figure out who's wrong and why, but why do you believe the things that you believe and then have things to back it up, right? And that's something you teach as well.
SPEAKER_01There's too much of that out there. I think there's there's too much finger pointing going on in these Facebook groups and bullying and that's just not the essence of what I want to be a part of.
SPEAKER_00Yes.
SPEAKER_01You won't find me going into any Facebook group or on TikTok or bashing anybody. And it's really unfortunate that what you just mentioned is very prevalent. So I would also say, lastly, like come to a conversation with curiosity and be willing to be wrong in a conversation sometimes.
SPEAKER_00And take accountability for that. That's huge. I love that. Yeah.
Where To Find Help And Follow Along
SPEAKER_00So where can people find you? I know this is obviously your podcast, but what podcast now? But what can where can people find you? Find helpful hints. I know you share a lot of great wisdom and information on your social media platforms and things like that. So if we have any new listeners, where can they find you?
SPEAKER_01TikTok has grown on me. And uh Instagram used to be my go-to. I don't spend a lot of time on LinkedIn, though I actually have a LinkedIn group that has almost a thousand members in it. It's just lives on its own. But if you want to connect with me, go over to TikTok. If you don't have TikTok, I also have Instagram. I'm dental billing coach on both. And I would love to hear from you there.
SPEAKER_00That's great. Yeah, and I love that we got to interview you because you interview everyone else. And maybe some people don't know your story and where you came from and kind of the journey that you came from, being, you know, an assistant to a biller, to a practice owner, to consultant, to business owner, to now an author and speaker. So your credentials back up themselves. And I'm so grateful to know you as a friend. And I'm so grateful to have you as a mentor in my life and my career
Webinar Invite And Closing
SPEAKER_00as well. So thank you. Thank you.
SPEAKER_01This was a great idea.
SPEAKER_00All right. Well, thank you again, Erica, for coming on. I want to encourage our listeners to go follow both of us on social media. I'm at the Hygiene Unlocked and Erica is at the digital billing coach. And that way you can stay up to date with everything. Also make sure to click on our webinar link down below so that you can be present for that webinar. Bring your denials, bring your questions, and we're happy to talk about it since Erica is the queen of denial management. So stay tuned and we'll talk to you guys soon.
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