Toothy AI is a dental insurance operations platform that automates verifications and billing, helping practices reduce manual work across coverage checks, claims, payment posting, and follow-up.
Toothy AI is a dental insurance operations platform that combines automated verification and billing workflows with revenue cycle support. It is designed to help dental practices reduce manual front-desk and billing work across the path from appointment scheduling to payment posting.
The product verifies appointments from the practice management system, checks primary and secondary coverage, and writes benefits data back into the PMS. It also handles billing tasks such as clean claim submission, rejection correction, payment posting, appeals, and AR follow-up, while exposing progress in dashboards and daily reports.
Toothy pulls appointments from your PMS and verifies coverage against the schedule instead of relying on uploaded lists or manual patient entry. The site says it can handle primary and secondary coverage automatically.
Benefits and eligibility details are written back into the PMS, including co-insurance, deductibles, maximums, fee schedules, frequency limitations, and coverage exclusions. The product also says it can fill in notes and alerts in your existing format.
The billing workflow covers clean claim submission, attachment handling, rejection review, payment posting, appeals, and AR follow-up. The billing page describes follow-up starting at 30 days and extending through 60 and 90+ day aging.
Toothy surfaces verification and billing progress through dashboards, daily reports, and analytics. The dashboard page includes real-time status, collections, aging, outstanding claims, and items needing attention.
The site says Toothy cross-checks data from multiple sources, including clearinghouse EDI, carrier portals, and benefits breakdown calls. RCM experts review outputs to help catch errors before they reach the patient.
The product handles urgent and same-day verifications and can flag items for the team to review. The dashboard and verification pages also show audit trails and workflow status by patient, date, carrier, and plan.
Use Toothy to verify an upcoming schedule automatically, including primary and secondary coverage, so staff are not starting each day with a manual call list.
Use the billing workflow to submit claims with supporting attachments, correct rejections, post payments, and manage appeals without juggling separate tools for each step.
Use the dashboard and daily reports to see what has been verified, what billing work has been completed, and which exceptions need action before the patient arrives or the claim ages further.
Use the product when a case needs same-day attention, such as an urgent appointment or a benefit question that requires a breakdown call and documented follow-up.
Toothy verifies appointments by pulling the schedule from your PMS, checking primary and secondary coverage, and writing eligibility and benefits back into the system. The site also says it can prioritize same-day or urgent verifications when needed.
The site says Toothy uses a human-in-the-loop model for billing and verification. Specialists step in for tasks such as benefits breakdown calls, claim review, rejection correction, and other exceptions that need manual handling.
Toothy provides dashboards and daily reports that show verification status, billing activity, collections, and aging. It also highlights items that need attention, such as missing attachments or urgent coverage issues.
The site states that Toothy is built with HIPAA-first workflows, access controls, an audit trail, and structured documentation.
No. The site positions Toothy as reducing insurance and billing work for the front desk, but it still expects the practice to supply items like checks, EOBs, clinical notes, narratives, and supporting documentation when needed.
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