Stop Verifying the Same Insurance Plans 47 Times Across Your Organization
Your DSO is wasting thousands of hours re-verifying insurance plans that other locations have already checked. Kaylie learns once, serves everywhere—automatically capturing verification data, policy provisions, and out-of-network allowed amounts across all your offices.
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The Verification Problem Costing DSOs Millions
Redundant Work at Scale
Your 12 locations each verify the same Cigna PPO plan independently. That's 12× the work for identical information.
The Out-of-Network Blind Spot
You quote 50% coverage on a $1,800 crown. Insurance MAC is actually $1,000. Patient gets a $1,300 surprise bill. Trust destroyed.
Knowledge Dies in Silos
Location A learns about Delta's missing tooth clause the hard way. Location B makes the same mistake next week. Your organization never gets smarter.
Industry data shows 85% of dental insurance verification work is redundant. For a 10-location DSO seeing 250 patients daily, that's 170 unnecessary verifications per day—over 44,000 wasted hours annually.
One Verification. Organization-Wide Intelligence.
Step 1: Aggregate Every Data Source
Kaylie pulls verification data from EDI sources, web portals, clearinghouses, and EOBs—creating a complete picture of every insurance plan your organization encounters.
Step 2: Capture the Details That Matter
Not just coverage percentages. Kaylie captures:
- Policy provisions (missing tooth clauses, downgrades, frequency limitations)
- Treatment history (what procedures were done, when, where)
- Out-of-network allowed amounts (revealed through EOB data)
- Plan-specific rules that cause denials
Step 3: Surface Intelligence Everywhere
When any staff member at any location looks up a patient, Kaylie instantly shows them everything your organization has ever learned about that insurance plan.
Finally Know What Out-of-Network Plans Actually Pay
The Problem You Know Too Well
- •Your fee: $1,800 for a crown
- •Insurance says: "50% coverage"
- •You estimate: $900 patient responsibility
- •Reality: MAC is $1,000 → Insurance pays $500 → Patient owes $1,300
- •Result: Angry patient, bad review, or $400 write-off
The Kaylie Solution
Every time an EOB processes, Kaylie captures the maximum allowable charge (MAC) for each procedure code and insurance plan. This data builds into searchable MAC tables.
- Look up procedure codes (D2740, D4341, etc.)
- See actual allowed amounts from your EOB history
- Give accurate estimates before treatment
- Make informed in-network vs. out-of-network decisions
Real Example: You're considering a Cigna contract. They offer '80% of their fee schedule.' But what's their fee schedule? With Kaylie, you already know from out-of-network claims that Cigna's MAC for a crown is $1,000. Their offer is $800. Your current out-of-network collection is $1,300. Now you can make a data-driven decision.
What Kaylie Captures
EDI Verification Data
Real-time eligibility checks from clearinghouses and EDI sources—annual maximums, coverage percentages, deductibles, effective dates.
Web Portal Information
Automated portal scraping captures details that EDI sources miss—plan-specific limitations, authorization requirements, coverage notes.
EOB Intelligence
Every processed EOB reveals MAC amounts, actual payment patterns, and denial reasons—turned into searchable verification data.
Policy Provisions
Missing tooth clauses, downgrade policies, frequency limitations, age restrictions, and other plan-specific rules that cause claim denials.
Treatment History
Complete procedure history across your organization—when procedures were done, what was paid, helping you avoid frequency violations.
Out-of-Network MACs
Searchable database of actual allowed amounts by procedure code and insurance plan, built from your EOB data.
Choose Your Verification Model
Software + AI Agent
Perfect for: Organizations wanting maximum automation
Kaylie's AI Agent automatically:
- Checks all electronic sources (EDI, portals)
- Extracts and standardizes data
- Updates verification records in real-time
- Flags when manual follow-up is needed
What you get:
- Instant verification for electronically-accessible plans
- Continuous learning from all data sources
- Automated updates across all locations
- AI-powered data extraction
Software + Human Verification Team
Perfect for: Organizations needing 100% coverage
Everything in Option 1, PLUS:
- Dedicated verification specialists for non-electronic plans
- Phone verifications for plans without portal access
- Quality assurance on all verifications
- Escalation support for complex cases
What you get:
- Complete coverage of all insurance plans
- Human verification for edge cases
- Blended automation + expertise model
- Guaranteed response times
Know the Hidden Rules Before You Submit
Common Policy Provisions Kaylie Captures
Intelligence That Grows With Your Organization
Single-Office Problem
One location verifies a plan. The data stays in that office. Other locations start from zero.
The Kaylie Difference
- Cross-Location Learning: Location A verifies Cigna PPO. Locations B through L instantly have that data.
- Unified Knowledge Base: Every verification, every EOB, every policy provision becomes organizational intelligence—not individual knowledge.
- Faster Onboarding: New locations inherit all verification data from day one. New staff have instant access to your organization's complete insurance knowledge.
- Better Decisions: Make network participation decisions based on actual MAC data from across your entire organization.
- Consistent Estimates: Patients get the same accurate estimates regardless of which location they visit.
Stop Wasting Time on Redundant Verifications
See how Kaylie turns insurance verification from a time sink into an organizational intelligence system. Book a personalized demo for your DSO.
— DSO Operations Director