Your front desk is on hold with insurance. Ours isn’t.
An AI agent calls the carrier and asks for the seven fields the electronic check never returns — recording the representative’s own words as evidence. It verifies the employer plan once, not every patient, so one call answers everyone on that plan all year.
Press play. You will hear it authenticate, hold, and ask a carrier for four benefit fields.
It did not guess the fourth. That is the product.
Twenty minutes, read-only, nothing to install. If the concentration isn’t there we tell you on the call and there’s nothing to sell you.
Your team isn’t slow.
The transaction is short.
The X12 271 comes back in seconds and it’s genuinely useful. It just doesn’t return the seven fields that actually move the patient’s number — and six of those belong to the plan, not the person in the chair. Your front desk is on hold because there is no other channel. Not because nobody trained them.
What the 271 gives you Instant
- Coverage active
- Annual maximum, and what’s left
- Deductible, and whether it’s met
- Preventive / basic / major percentages
- Subscriber and group identifiers
What decides the bill Someone calls
- Waiting periods
- Frequency limits per procedure
- Downgrade provisions
- Missing-tooth clause
- Replacement clauses & age limits
- Which category this code falls in
| What a real estimate needs | Electronic check (271) | Calling the carrier | Plan Breakdown |
|---|---|---|---|
| Coverage active, subscriber & group ID | Instant | Instant | Instant |
| Annual maximum, remaining, deductible | Instant | Instant | Instant |
| Preventive / basic / major percentages | Instant | Instant | Instant |
| Network status & category assignment | Sometimes | Instant | Instant |
| Waiting periodsTier C | Never | 20 min hold | Instant · from library |
| Frequency limits per procedureTier C | Never | 20 min hold | Instant · from library |
| Downgrade provisionsTier C | Never | 20 min hold | Instant · from library |
| Missing-tooth clauseTier C | Never | 20 min hold | Instant · from library |
| Replacement clausesTier C | Never | 20 min hold | Instant · from library |
| Age limits | Sometimes | Instant | Instant · from library |
| Orthodontic lifetime maximumTier C | Never | 20 min hold | Instant · from library |
| Service history — what they have already usedTier C | Never | 20 min hold | Asked per patient |
What it’s worth to you
Every figure below comes from numbers you set. Drag them to your practice and the arithmetic follows — including the case where it doesn’t pay for itself.
These are starting points, not our estimate of your office. Move them to your real numbers — the arithmetic underneath is shown so you can check it.
| Calls your team places a year | 6,500 |
| Hours on the phone | 1,950 |
| That is roughly | 1.1 full-time |
| Verifications a location runs a month | 433 of 500 included |
| Proposals to accept, year one | 840 once per plan, not per patient |
| Your time accepting them | $196 a year |
| What it costs you today | $54,600 |
| Plan Breakdown, year one | $50,440 |
| Every year after | $32,940 |
| Year one difference | $3,964 |
We do the waiting. Your team makes the call. The agent navigates the menus, authenticates and sits on hold. Your desk reviews what it found — each value shown with the representative’s exact words — and accepts it. That time is counted above, not hidden. It happens once per plan, not per patient, and it shrinks as each carrier and field earns the right to write without review.
Read this the way an owner would. Those hours are salary you are already paying, so this is time returned to your team rather than a cheque you stop writing — unless you choose to run leaner. The cash line is the honest one.
Time only. It does not count a quote that was wrong, the write-off that followed, or the patient who did not come back — which is the expensive half and the one nobody can put a number on for you.
Those are our defaults. Twenty minutes and we run it on your actual database.
Get your free Insurance MapThe Map finds treatment nobody scheduled
Diagnosed, never completed, sitting in your own ledger. On the sample practice that was $28,335 in gross fees across 76 cases. We surface it and rank it by how long it has been sitting. What you recover from it is yours — we don’t take a share and we don’t count it as savings.
Price
Two line items. No per-seat pricing, no usage surprises, and nothing that scales with how busy your front desk gets.
- Every plan resolved and delivered as your library
- Every employer plan you carry, resolved and on file
- Carrier concentration and your top-five share
- Diagnosed-not-completed treatment, priced and ranked
- Read-only connection, set up and handed over
- All 23 benefit fields, not just what the 271 returns
- The plan library, kept current through the plan year
- Carrier calls placed for you, rationed by plan
- Unlimited users — we don’t charge per seat
- Every answer carries its source and its evidence
- Past 500? A flat $250 block adds 150 — no per-check meter
▸ Show me the technical proof
43 tests, all passing. npm test — no network access and no credentials required to run them.
Seven pass/fail criteria, committed before the harness first ran. Six stand exactly as declared. One was amended after the first run because it encoded a clinical error on our side — we’d assumed a hygiene visit never needs a Tier C field, which is wrong, because frequency limits govern cleanings. The file carries the original wording, the amendment, and the reasoning.
The benchmark runs on sample data today. Re-running it against live reads is step five of connecting a practice, not something already done.
Six IVR failure paths drilled — wrong department, extended hold, mid-call disconnect, blanket refusal, missing credentials, menu loop. Across every run the agent has never produced a value without a source.
One day, end to end
What happens between your schedule and an answer your front desk can quote from, in eight steps. It runs on its own — or step through it yourself.
Swipe the diagram →
It reads tomorrow's schedule
Straight from Open Dental, read-only. Ten appointments on this day. The codebase has one HTTP call site and it issues GET — there is no write function to disable, because none was written.
Our agent works the carrier line the way your team does — menu, NPI and TIN authentication, hold, then the named fields. It is drilled against six failure paths.
Nothing lands on confidence alone — but the person clearing that queue is ours. Your office never sees a review queue and never inherits our exceptions; it sees accepted values with a source attached. A refusal is recorded as unconfirmed, never as a guess.
The answer is filed against the employer’s plan. Every patient under that plan is answered from it instantly, for the rest of the plan year.
This is the software
Not a mockup. Your schedule, with a verdict on every appointment, and a plan sheet where every value carries the call it came from.
Robert and Maria are both on Acme Logistics. One plan resolved, both ready — that is the whole idea, on a real schedule.
We do the waiting. Your team makes the call.
Other tools promise to write benefit breakdowns straight into your chart while you sleep. We don’t — because carriers mumble and models fill silences.
What we will not do By design
- Write a benefit value into your chart on the agent’s confidence alone
- Record a number the representative did not actually say
- Fill a gap with a plausible default when the rep declines
- Let a payer’s refusal look the same as a question never asked
What you get instead Seconds, not minutes
- Every value beside the representative’s exact words
- A queue you clear once per plan — not per patient
- Roughly 840 proposals in year one for a 60-plan practice
- That number falls as each carrier and field proves accurate
Built to pass an IT review
One read-only credential you issue and can revoke. Nothing we run can alter a chart, a schedule or a ledger — not by policy, by construction.
Asked once. Answered for everyone on that plan.
These four never come back from the electronic check, so somebody phones the carrier for them. They belong to the employer’s contract, not the patient — so the answer goes into the library once and serves every patient who works there, until benefits reset in January.
The 23 fields, and who owns each one
Our taxonomy, not an industry census — nobody publishes a canonical list. It’s here in full, ungated, so you can count it yourself and disagree with it.
| Field | Tier | Belongs to | Electronic? |
|---|---|---|---|
| coverage_active | A | the patient | Yes |
| coverage_effective_date | A | the patient | Yes |
| coverage_termination_date | A | the patient | Yes |
| subscriber_id | A | the patient | Yes |
| group_number | A | the patient | Yes |
| annual_max_remaining | A | the patient | Yes |
| deductible_met | A | the patient | Yes |
| coordination_of_benefits | B | the patient | Sometimes |
| annual_maximum | A | the plan | Yes |
| deductible_individual | A | the plan | Yes |
| pct_preventive | A | the plan | Yes |
| pct_basic | A | the plan | Yes |
| pct_major | A | the plan | Yes |
| network_status | B | the plan | Sometimes |
| category_assignment | B | the plan | Sometimes |
| age_limits | B | the plan | Sometimes |
| waiting_periods | C | the plan | Effectively never |
| frequency_limits | C | the plan | Effectively never |
| downgrade_provisions | C | the plan | Effectively never |
| missing_tooth_clause | C | the plan | Effectively never |
| replacement_clauses | C | the plan | Effectively never |
| ortho_lifetime_max | C | the plan | Effectively never |
| service_history | C | the patient | Effectively never |
Your numbers.
Not our slides.
We connect to your Open Dental database, read-only, and report what you’re actually carrying: how many distinct employer plans, how patients distribute across carriers, what share your top five hold, and every procedure diagnosed and not yet completed — priced at your own fee schedule, ranked by how long it’s been sitting.
Every count comes out of your own database.
Check one against your ledger tonight.
Try to make it guess
A benefits answer that’s confidently wrong costs more than no answer, because you quote off it. So abstaining is cheaper to express than asserting. Empty the value. Delete the evidence. Tell it the source was a hunch. It refuses, and names the rule you broke.
Attacks attempted: 0 · Values invented: 0
The questions we get every time
Find out what your plans are actually costing you
Fifteen minutes, on a call, with your Open Dental connection open. We run the Insurance Map live and read you your own top plans, your carrier concentration, and your diagnosed-not-completed treatment in dollars. One read-only credential, revocable at any point.
If the concentration isn’t there, we’ll say so on that call and there’s nothing to sell you. You keep the report either way.