22 min
Front desk staff spent 4+ hours daily on hold with insurance companies verifying oral appliance therapy (OAT) coverage. Each call averaged 22 minutes of hold time, and information was often incomplete.
Eliminating 20 Hours/Week of Manual Insurance Verification for a Sleep Dentistry Practice
Front desk staff spent 4+ hours daily on hold with insurance companies. We built a real-time eligibility engine that verifies coverage in 12 seconds — saving 20 hours per week and eliminating post-treatment denials.
Get StartedAbout the Project
A Florida solo practitioner had a full-time staff member on hold with payers for 22 minutes a call, pushing treatment starts out 2+ weeks. The real-time eligibility engine verifies coverage in seconds at registration — eligibility denials fell from 30% to 4% and that staffer moved to care coordination.
Industry
Healthcare / Dental Sleep Medicine
Oral appliance therapy for sleep apnea, billed across both medical and dental plans.
Business Type
Solo Practice
A Florida solo practitioner with one staff member dedicated to insurance calls.
Core Offering
Insurance Eligibility Verification
Real-time coverage checks in 12 seconds, down from 35 minutes per patient.
Coverage Intelligence
What the engine reads off a plan
OAT-specific benefits surface upfront instead of being discovered after treatment.
Integrations
Wired Into the Front Desk
Eligibility badges on the patient dashboard and case view, with alerts before appointments.
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Talk to our experts
Scope your own real-time eligibility engine with our healthcare billing team.
The Challenge: Hours on Hold, Claims Denied
Hours on hold caused denials and treatment delays.
2+ weeks
Verification delays pushed treatment start dates out by 2+ weeks. Patients ready to begin therapy were stuck waiting, and many lost motivation or sought care elsewhere.
$95K
30% of claims were denied due to eligibility issues discovered after treatment had already begun, with annual losses from post-treatment denials exceeding $95K.
Verify eligibility in seconds.
Eliminate surprise denials.
Start treatment on day one.
Talk to Our Team
Our Solution
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Automated Intake & Card Scanning
Automated Intake & Card Scanning
- OCR scanning of insurance cards to auto-populate plan details
- Real-time electronic eligibility verification at patient intake
- Coverage breakdown: deductibles, copays, OAT-specific benefits
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Smart Coverage Analysis
Smart Coverage Analysis
- Payer suggestion engine recommending optimal billing pathways
- Auto-flagging of patients with no OAT coverage before treatment planning
- Insurance plan comparison for patients with dual coverage
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Workflow Integration
Workflow Integration
- Eligibility status badge visible on patient dashboard and case view
- Prior authorization requirements surfaced upfront
- Batch eligibility checks for entire daily schedule
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Proactive Denial Prevention
Proactive Denial Prevention
- Pre-treatment eligibility confirmation prevents post-service denials
- Coverage expiration alerts before appointments
- Automated re-verification for long-running treatment plans
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Reporting & Payer Insights
Reporting & Payer Insights
- Verification volume and failure reasons tracked per payer
- Coverage-denial patterns surfaced before treatment planning
- Staff time saved measured against the manual baseline
Why They Chose Us
The practice needed more than a simple eligibility check — they needed a system that understood the nuances of dental sleep medicine billing, including OAT-specific benefits, cross-coding requirements, and prior authorization rules.
OAT-Specific Coverage Intelligence
The eligibility engine understands oral appliance therapy coverage — not just generic dental or medical benefits — surfacing the exact information the practice needs.
OCR Card Scanning
Insurance cards are scanned and parsed instantly, eliminating manual data entry errors that led to rejected claims downstream.
Batch Verification
The entire daily schedule can be batch-verified in one click, ensuring no patient arrives without confirmed eligibility.
Payer Optimization
For dual-coverage patients, the system recommends the optimal billing pathway to maximize reimbursement.
The Results
Every number below was measured in production after launch — not projected in a pitch deck.
20hrs→<1hr
Weekly Insurance Call Time — Staff reassigned to patient care
12sec
Verification Time Per Patient — Down from 35 minutes
4%
Eligibility-Based Denials — Down from 30%
$87K
Annual Savings from Prevented Denials — $95K→$8K in losses
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