OAKBROOK TERRACE, IL — September 4, 2026 — I-Med Dental Solutions, a national dental billing and revenue cycle management company, today issued guidance for dental practices preparing for the year-end benefit reset, pointing to industry data showing that the overwhelming majority of insured patients never come close to exhausting the coverage they pay for.

According to the National Association of Dental Plans, fewer than 5% of enrollees reached their annual benefit maximum in an average year between 2014 and 2023. At the same time, annual maximums have been climbing: 57% of commercially insured consumers were enrolled in plans with maximums of $1,500 or more in 2024, up from 48% the year before.

The gap between what patients are entitled to and what they actually use is substantial. NADP figures put average utilization at 3.28 services per enrollee in 2024, at an average undiscounted fee of $188 per service — roughly $617 in total billed charges per patient, per year. Measured against a $1,500 maximum, that leaves approximately $880 of coverage unclaimed, and the real figure is higher still, because plans typically pay only a portion of billed charges.

For most plans, that unused balance does not carry forward. It expires on December 31.

"The money is already allocated. The patient has paid premiums for it all year, and the treatment has usually already been diagnosed and presented," said Chris Johnson, Senior Manager of Clients & Operations at I-Med Dental Solutions. "What's missing is the operational step of identifying those patients and reaching them while the benefit is still live. That's a revenue cycle function, and in most practices it's the first thing to fall off the list when the front desk gets busy."

What practices should be doing now

I-Med Dental Solutions recommends four steps between now and mid-December:

1. Run a remaining-benefits report across the active patient base and rank patients by unused balance.

2. Cross-reference against unscheduled treatment plans to identify patients with both diagnosed treatment and available coverage.

3. Re-verify eligibility before scheduling, since mid-year plan changes and employer switches routinely invalidate benefit data captured in January.

4. Phase larger cases across the reset where clinically appropriate, allowing patients to draw on two separate annual maximums.

The company noted one caveat practices should not overlook: roughly 42% of PPO enrollees are now in plans offering some form of maximum rollover, meaning a portion of unused benefit does carry into the following year for those members. Practices should confirm rollover provisions during verification rather than applying a blanket "use it or lose it" message to every patient.

"Verification is where this either works or falls apart," Johnson added. "Acting on benefit data captured eleven months ago is how practices end up scheduling treatment against coverage the patient no longer has."

I-Med Dental Solutions provides dental revenue cycle management services to practices across all 50 states, covering eligibility verification, coding, claim submission, denial management and accounts receivable recovery.

About I-Med Dental Solutions

I-Med Dental Solutions is a US-based dental billing and revenue cycle management company serving general practices, specialty providers and dental service organizations nationwide. Services include end-to-end revenue cycle management, insurance billing, billing audits, credentialing and payer enrollment, breakdown of benefits and dental virtual assistant support. The company operates HIPAA-compliant billing processes from multiple US service centers. Learn more at I-Med Dental Solutions.