Dental clinics in the United States spend a lot of time on insurance tasks. These include checking patient insurance, submitting claims, handling denials, and posting payments. Studies show that dental offices spend more than 160 hours each month on these tasks. This takes away time that could be used for patient care or other office work.
A 2024 study reported that dental offices waste about 800 million hours and $13.2 billion every year because these jobs are done manually. These tasks often need phone calls to insurance companies, navigating several online websites, and typing in lots of information. There are also staff shortages. Around 90% of dental offices find it very hard to hire workers for these roles. This causes delays and makes staff feel tired and stressed.
The process of managing insurance claims and payments takes the most time and is often done with mistakes. This includes checking insurance, submitting claims, fixing denials, and posting payments. Eighty percent of dentists say that their money problems come from these slow and faulty tasks. This shows a strong need to reduce administrative work and improve billing accuracy.
Automation and artificial intelligence (AI) are being used to cut down the time and money spent on insurance tasks. AI tools made for dental offices automate many steps, from checking insurance to handling claims.
One example is Toothy AI, started in 2024. This system, which follows privacy laws, automates insurance checks, claim preparation, submission, denial handling, and payment posting. By doing this, Toothy AI lowers the workload for staff and cuts costs.
Insurance verification used to be done by staff who collected information, called or faxed insurance companies, and checked coverage details like limits and deductibles. AI systems now do many of these jobs automatically. They call insurance providers and access their websites without human help. They can read insurance documents using Optical Character Recognition (OCR) and understand coverage using Natural Language Processing (NLP).
This automation helps dental offices check insurance faster and more accurately. This leads to fewer claim denials because of wrong information. Those who started using AI verification noticed big time savings and improvements in how their offices work.
Automation helps dental practices save money in two main ways: by lowering staff costs and by bringing in more money faster.
First, dental offices using AI automation need fewer back-office workers. Customers of Toothy AI reduced their administrative staff by 50 to 75 percent soon after they began using the system. This cut in staff does not lower service quality because the AI can handle many repetitive tasks well. Hiring fewer staff lowers salaries and benefits costs and also reduces hiring, training, and turnover expenses, which are big issues with staff shortages.
Second, automating claims makes billing faster. Faster payments help cash flow, which is important to pay daily bills. AI tools also check claims for mistakes before sending them in, which lowers denials. Fewer denials mean less work fixing them and following up, saving time and money.
AI also helps handle denials better. It studies why claims were denied, fixes the errors, and resubmits claims automatically. Some AI systems even write appeal letters for denied claims. These steps cut delays and help get paid more often. Some practices say they earn 5 to 10 percent more money thanks to better billing and faster payments.
Lastly, AI handles over 50 insurance codes when entering claim data. This supports accurate billing and follows payer rules. Fewer mistakes from manual coding also mean fewer problems with patients.
Besides saving money, automating insurance tasks makes dental offices run more smoothly.
Staff who used to spend time on verification, data entry, and follow-ups can now help patients more. This lowers staff stress and makes them feel better about their jobs. Patients also get better service because staff can answer questions, schedule appointments, and support treatment plans more easily.
Automation also helps avoid treatment delays. Insurance checks, which often slow down scheduling and care approvals, happen faster and with fewer mistakes. This means patients wait less and cancel less often.
AI can fit well with existing office systems. For example, Overjet Dental AI can pull insurance data, check it with treatment plans, and warn staff if pre-approvals or coverage are missing. This helps workflows run better without big changes to how offices work.
Dental teams using AI have fewer claim denials and faster billing. This leads to smoother operations. With fewer mistakes, dental offices have better communication with insurance and fewer payment problems.
More healthcare facilities, including dental offices, use AI and automation for managing billing and payments.
Nearly half of hospitals use AI in revenue cycle management (RCM), and 74% have some type of billing automation. This shows many places find it useful.
AI helps in several billing areas:
These changes cut down manual work, improve financial planning, and lower risks of breaking rules. AI helps finance teams plan and budget better by testing different billing and payment options.
Different healthcare groups and dental tech companies give examples of AI helping with insurance tasks.
These examples show that AI helps healthcare and dental offices improve work and make more money.
Dental office leaders and IT managers should think about these points when adding AI and automation for insurance tasks:
Plan carefully by reviewing current workflows, finding problem points, trying out automation tools, training staff, and checking progress often.
Using AI and automation to manage back-office insurance tasks offers important financial and operational benefits to dental practices in the United States. It helps lower labor costs, speeds up payments, reduces claim denials, and makes staff work better. Practices that use these tools handle complex insurance work better in times of staff shortages and rising administrative needs. This leads to better money flow and smoother daily operations, which helps both the practice and its patients.
Toothy AI is a company that builds AI agents specifically for dental practices to automate insurance verification, billing, and claims processing, aiming to reduce administrative workload and improve revenue cycle management efficiency.
Toothy AI addresses the issue of dental clinics spending over 160 hours monthly on repetitive insurance tasks like verifying policies, billing, and claims, tasks that are labor-intensive, error-prone, and exacerbated by labor shortages and frequent policy changes.
Dental practices waste approximately 800 million hours and $13.2 billion per year on time-consuming and repetitive back-office tasks related to insurance and revenue cycle management.
Toothy’s AI automates insurance verification, claim creation, claim submission, denial correction, claim resubmission, and payment posting, covering the entire revenue cycle management process for dental practices.
The AI agents make calls to insurance payers and use online portals to confirm patient coverage, ensuring accurate and up-to-date verification without manual intervention.
Early adopters have reported cutting back-office team sizes by 50-75% within weeks and an increase in revenue by 5-10%, reflecting significant labor savings and improved financial performance.
The AI understands denial reasons, updates the claim accordingly, resubmits it to payers, and can draft appeal letters, reducing delays and improving reimbursement rates.
Toothy AI uses voice AI for calls, integrates with practice management systems, accesses imaging software, and processes comprehensive coding with 50+ codes to automate complex insurance workflows.
Toothy AI is HIPAA-compliant, ensuring it meets the stringent regulatory requirements for handling sensitive patient health and insurance information securely and legally within dental practices.
Dental practices face unprecedented labor shortages and difficulty filling positions, with 90% reporting filling vacancies as extremely challenging; Toothy AI reduces reliance on manual labor by automating routine insurance tasks, easing staffing pressures.
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