AI Insurance Coordinator Support

Transcript performed by A.I. Please excuse the typos.

Discover how Toothy AI acts as an insurance coordinator for dental practices—handling verification, claims, and follow-ups. Jeff Williams shares how AI boosts ROI, reduces busy work, and supports teams so they can focus on patients, not paperwork.

00:00
tell people for every dollar you put in what do you get out how can I implement AI to streamline what we’re doing to become more productive it doesn’t call in sick doesn’t take vacations it works Fridays when the handpiece was invented it didn’t replace the dentist yeah it just allowed the dentist to be much more profitable

00:23
This is Dental All-Stars, where we bring you the best in dentistry on marketing, management and training.

00:33
Welcome to Dental All-Stars. I’m Eric Vickery, president of coaching at All-Star Dental Academy, and I’m super excited today to interview our guest, Jeff Williams. Jeff is the vice president of revenue at Toothy AI. That’s right, we’re talking AI today. I cannot wait. Bringing over 12 years of leadership in the dental technology. We’re just talking about his experience in dentistry and how many people he knows just in this profession, and he just brings such insight in this world to us.

01:03
He personally excels at driving go-to marketing strategy, building high performing sales teams, and scaling startups at the edge of innovation. A trusted expert in practice optimization, Jeff is passionate about solving complex problems and helping dental professionals unlock their full potential through the use of technology. So let’s get into this AI world today with Jeff. Jay, thanks so much for being here. I really appreciate it. Good to be here. Yeah, oh my gosh.

01:34
I just, know that everyone in my world from a coaching perspective just keeps asking me about all these new AI things that are coming out and I’m rattling off these things that are happening and going on and our team is demoing stuff and here we are, we fell in love with Toothy. What an incredible instrument to help practices but I know what people are thinking all the time. Why? Why do we need this? Is it gonna replace our people?

02:04
and I just want to get into a really healthy conversation about this real frank and real, let me be transparent on this. So let’s just talk about, I guess ROI. You when someone is using AI for their revenue cycle and creating ROI on it, is AI a good use for that? Is there value in it? Is there good RCM? Does it create something for us? Where’s the value in AI right now in the dental world?

02:33
Well, I think it’s important because like you said, it’s a real buzzword right now. Everybody’s talking about it. But if you rewind back about five, six, seven years ago, automation was kind of the buzzword at the time too. And so I think if you approach it with like a real business sense of, what are we trying to accomplish? Can we get more done with

03:02
lower labor costs, you know, that ROI, I think is important. I always tell people, for every dollar you put in, what do you get out? And that really will dictate at least the start of that conversation is, you know, what are good use cases for AI? How can I implement AI to streamline what we’re doing to become more productive to

03:28
generate a better customer experience, fill in the blank with whatever an office is trying to do. And I think that’s where that conversation starts is, you know, what AI does, it’s great is it allows us to, in a sense, automate certain processes without having to, I guess, command it or to

03:58
click and tell it what to do, it tends to, if it’s done right, it should take your lead. And when I do this, it then steps in and fills in these gaps. And so for me, where I’m looking at it, where the biggest use or benefit to an office is how do we eliminate busy work? How do we streamline our just workflow in the office? And how do we get it to compliment what we’re trying to do so that we can

04:27
help the office improve their overall revenue, customer experience. know, labor costs have gotten through the roof and I hate to be Mr. Anti-Insurance, but I mean, they’re spending millions of dollars making it, making the RCM process inconsistent and discouraging and

04:57
uh… very labor some very manual and so that to me is why i think what to do is doing is such a benefit is it actually allows uh… a i to step in and take a lot of that busy work often offices plate so that those staff members a lot of those are very highly skilled in your pain to them for a skill set that they’ve developed over years and yet a lot of times are spending hours and hours

05:25
on hold and jumping through hoops when they could be improving case acceptance, delivering a better patient experience.

05:38
Sorry, I just muted it. So that’s where we kind of started off as like, how do we really benefit that process for an office? Yeah. And I think everybody’s listening, okay, you mentioned toothy, you’re mentioning AI, and you’re talking about CRM. We’re seeing AI in a clinical note-taking process. We’re seeing AI in imaging overlay. We’re seeing AI in

06:07
voice receptionist. We’re seeing AI and insurance verification and support there. So where does Toothy fall into this? I think we need to clarify what your company does, what you guys do in this world, because there’s a lot of different AI coming at us right now. So what’s Toothy do? So we, in a sense, created an AI insurance coordination assistant. A lot of people have concerns, oh man, is this going to replace my job?

06:36
No, this is going to take a lot of the busy work off of both pre and post appointment insurance processing. So collecting all the insurance breakdown information, codes, downgrades, missing tooth clauses, all the information that an office really needs to know before that patient is in the chair, we’re helping collect that rather than having staff.

07:04
make phone calls, hit portals, do all those steps before the appointment. And then once the appointment is seen, the claim is created, we then step in and, you know, correcting errors, attaching narratives and attachments, submitting those claims. If they come back rejected, taking all the information we gathered on the insurance verification side of things,

07:33
and disputing it and then posting those payments. All the busy work that frees the staff up to then, like I always, I look at things as a patient. And so to me, patient experience is everything. There’s a big trust and a relationship there. And the better experience I have, I tend to accept cases at a higher tick. I tend to,

08:01
come to my appointments and visit frequently like I should. I tend to do all those things when there’s that relationship there. So we want to kind of help take the busy work off the office’s plate so that the staff is freed up to be able to do that. Yeah. You’re saying it does a lot of things and yet you’re being modest. I listened to the demo recording of Toothy calling the insurance company, waiting on hold for the 15 minutes, finally breaking through.

08:29
and watching live, well, pre-recorded live demonstration, while it’s hearing, I think in this case, was the Aetna rep telling it, and on your side, it was Open Dental, and the toothy AI representative was asking the Aetna rep for breakdown of benefits for this patient, this ID number, it’s reading Open Dental, giving the information. The Aetna rep didn’t even know it was talking to a bot, just answering the questions, like it was talking to a person, and watching Open Dental be filled out live as it’s going with all the notes and everything it does.

08:57
And my mind was like, I can’t believe it. And the editor rep was like, well, is there anything else I can help you with? No. Thank you. Bye. Thank you. Have a good day. know, nobody tells a bot to have a good day. So you knew it was like flying under the radar with this. It blew me away out of, this is awesome. Yeah, no. that’s, you know, that’s, that’s how we are able to automate and take a, what most would consider like a robotic process, but

09:27
really customize it to the practice because we are, you know, it’s able to read the codes, the downgrade, all those different things and then write those back in. And then what I love about it is oftentimes you’ll call and wait on hold for an hour and then maybe an hour, but you know, times an hour and then they’ll give you one patient’s information or even 10 codes and then they kick you off.

09:57
And that’s discouraging. That’s frustrating to, you know, an insurance coordinator or a staff member. AI, AI doesn’t show up sick. AI doesn’t get frustrated. If AI gets hung up on, they just call right back and go through the process. So that’s why I feel like it’s a perfect use case for AI because it’s able to collect all that. You’re able to customize the information you want it to collect, but really save a lot of money, not only in labor costs, but then

10:27
You know, we’re seeing a big uptick in just the amount they’re able to collect because we’re pulling all this information on each and every patient on every appointment. So they’re not only collecting more from the insurance companies, but I think it’s, I think there’s value in the fact that they’re helping patients maximize their insurance benefits. Yeah.

10:52
And talk about the frustration of just trying to get insurance companies to pay. Earlier you mentioned they’re gonna chase down the payment on this claim that’s been rejected or act like they lost. And so again, you’re not wasting your time having to call and figure out why it wasn’t paid. Am I summarizing correctly? Correct, yeah. And right out of the gate with most of our offices, the very first thing we do is turn it loose on their aging reports.

11:20
Offices are so busy that if something is denied, if it’s rejected, if there’s something missing, oftentimes they don’t have the luxury to just pause everything else going on in the office and try and identify that. So those claims tend to back up and that’s missed revenue. A lot of times offices are writing those off or at least that’s sitting in a backlog where this can start.

11:51
going through that from 90 days plus up to current. So it allows the office to, in my opinion, their RCM process becomes much more healthy. Yeah. So it will identify a claim that’s been sent and go, hey, there was no period charting attached to this. I just need to attach this and send it again. It does that? Yep. What it’ll do is once an office batches their claims, because every office has their own process and they create the claims,

12:21
uh, you know, at their own cadence and their own style. Once it’s batched, then our AI will go through and we do have, we, we partner the AI up. We assign every office, a us based insurance coordinator, uh, because there are a lot of nuances. There’s a lot of specifics. It’s pretty complex. So they will attach. Yep. And, and the AI can, you know, the longer they’re with us, it picks up.

12:50
patterns, it learns how they do things and so it becomes more and more AI dependent. But anytime there’s something that’s missing or something that is flagged, then we have an insurance coordinator step in because typically an office insurance coordinator, office manager, sometimes they’re both, they’re wearing multiple hats, they have to stop what they’re doing and address that or wait till they have time and that’s just

13:18
slowing down the process. it’s, it’s attaching those, it’s submitting them. Sometimes things come back denied or incomplete and nobody seems to know why. So AI can pick that up, scan through it. If everything looks great, it resubmits it. If it’s missing anything or if there’s information that needs to be gathered, it pings the office. So the office doesn’t have to monitor this. They don’t have to oversee it. If there’s anything missing,

13:47
they’ll be notified. Otherwise, they can just handle everything else that’s on their plate while our good friend AI takes care of the rest. So good. I imagine some insurance coordinator somewhere in the country is listening to this right now or a doctor’s listening to this going, okay, is this now replacing my job? Is this completely replacing the job of insurance coordinator practice? And so what do you say to that? Yeah, we hear that.

14:14
a lot. It’s a new technology. People are always a little bit leery of anything new, especially AI kind of has that connotation of like, Oh, they’re taking our jobs. I don’t know if this is the very best analogy, but I always looked at it and kind of tell them, Hey, when the handpiece was invented, it didn’t replace the dentist. Yeah, it just allowed the dentist to be much more profitable, much more productive and do their job at a higher rate. So this is meant to

14:44
really assist and kind of take the busy work off of the insurance coordinator and handle those kind of busy steps. you talk about the RCM process, you’re focusing on insurance. Do you guys touch at all the patient copay, the patient portion, the patient billing side, or is that left to the office and the AR manager there?

15:13
You know, we’ve talked about it and we’ve gotten feedback from some of our offices that that’s a potential option down the road. Our thoughts right out of the gate are, let’s leave the patient facing tasks to the office and let us handle everything between the insurance company and the office. I’m one that I think, you know, maybe that would be a next step in our product down the road.

15:41
But as of now, we’re just kind of handling the insurance interfacing. Makes sense, makes sense. So, you know, I know there’s a lot of nuances to this and the processes are very complex. I can’t imagine the technology of what you guys have done. But do you think AI is at the point where it’s a blanket solution for all of our needs right now? Do you think it’s at that place where it’s solving all the things we have an insurance coordinator doing? So when it comes to the RCM process,

16:12
No, I don’t think it is a blanket solution. think the use of AI combined with automation and then the options are we involve the staff when AI has hit a roadblock or what we did is just bring in highly qualified. I mean, they’re all

16:40
10 plus years of office experience, but on our side, somebody that can oversee that, handle those nuances and those loopholes, all the kind of complexities to the RCM process. Do I think it could get there potentially? It’s unbelievable. mean, even just being on this side of things, seeing what we’re able to do, I mean, it feels like every…

17:08
every week when we have our leadership meetings, I’m finding out about a new capability or function that AI can do. But I think a combination, at least that’s been our secret sauce, is combining the AI, let that take care of all of the data collection, all of the data entry, all the scanning and ensuring accuracy. All of that is very ideal for AI.

17:37
But then when we do run into little things, how can we step in and keep that moving forward without everything coming to a halt? it. All right. Someone out there right now, I know they’re thinking, but they’re thinking you’re putting my information out there, whether it’s a patient, a practice or whatever this whole AI. I mean, you go back to the Terminator, pick a movie. Right. And AI is ending the world and now we’re giving it our personal information and

18:08
So I’m sure someone out there is thinking, hey, how dangerous is this? How safe is the information? What sort of protections have you gone to to make sure that this works? And this thought just popped in my head as someone’s probably listed this wondering, but how safe is it? What sort of answers do you give people who are thinking that way? So the AI actually lives within their software system, their CRM, so like open dental. So we’re not actually pulling and storing information.

18:36
We’re working out of their open dental. are reaching out, we’re collecting information and writing it back into open dental. We’re a white-commodator company. And for those that don’t know what that is, it is an unbelievable access to resources. usually pick thousands of companies, pitch their product to white-commodator. They typically select the top.

19:06
percent. And then what they do is, and that’s based on the product, but then they take the founders, everybody that is involved in the company, and they kind of put them through a boot camp. They surround them with resources. Y Commodator happens to be the same company that selected OpenAI. So the very people that created ChatGPT are, in a sense, resources and advisors to what we’re doing.

19:35
We have gone to the highest level of security to make sure that there is never any type of breach or any kind of information that is, I guess, I’m trying to think of the best way to word it, but- It’s like vulnerable. Vulnerable. Yeah, exactly. So we’ve got BAs with different companies like OpenAI to where-

20:04
when we are collecting the information, that collection and right back into the software is very highly secured, but by not storing, collecting it and storing it off site, it really… It’s really closed AI. It’s HIPAA compliant because it’s not pulling out into the open network of the internet. It’s just keeping it on site basically and not putting…

20:32
So as long as your hardware, your firewall, your protectors are in place, then the data is just as safe as it’s ever been, correct? Correct, yep. I’ve got so many more questions, like how does it get on the phone? I mean, I’ve got so many things that I’m just wondering in my mind. It’s on the phone, it’s in your computer, and it’s operating like multitasking out at the same time. It doesn’t call in sick, it doesn’t take vacations. It works Fridays. It doesn’t have kids that are sick. exactly. Amazing.

21:02
So I’m an insurance coordinator, I’m out today, but I know that Toothy’s going to work with me, you know, for me as my assistant getting some things done so I don’t come back the next day with just an overwhelming level of insurance verification or whatever it might be. Is that a fair statement? Absolutely, yep. In fact, right now is the time where most offices have different people taking vacations and you know.

21:29
finally getting that little break or that recharge that they need. And the feedback we’ve gotten from our offices to know that the machine is still running and that the gears are turning and things are still happening even without those staff members is invaluable. Amazing. What an insurance policy, to use the word insurance again, an insurance policy for your practice. I’m super impressed with Toothy. I love what I’m seeing so far.

21:58
I can’t wait for our clients to really get their hands on it and really get in there and play with this and see what it can do for just the ROI on utilizing it. So how do people get in touch with you guys if they want to like do a demo? Do they reach out to? So we’ve got a website. We are a small kind of startup. So we have up until now kind of relied on word of mouth.

22:21
We’ve tried to go hit a lot of the dental events just to get our name out there and start having conversations, get good feedback on where the product is and where it can go. But as of right now, the easiest way is go to toothy.ai. There’s some information on there because it is a very custom approach to each office.

22:47
I’ve heard that it’s a little vague on the website, but there’s a button where they can click to request information. Myself or one of my teammates, we would reach out. And we right now feel like education is the first step to something like this being really implemented into the industry. So you’re not gonna get a real hard sales call. You’ll get someone just reaching out with some information, asking questions, answering those.

23:17
You know, if it’s something they have interest in, we can really walk them through that process and what it would look like to implement. Perfect. Love it. Love it. This is so good. Jeff, thank you so much for joining me today and appreciate your time. And I know you guys are passionate about this product and we are too. We’re very excited about it. AI is just becoming an incredible tool. So for those that are listening, thank you so much for spending this time with us. If you know of someone

23:46
who would want to listen to this, please forward it to them. Remember to like and share and follow, do all those things. We’d love your review if you like what we’re doing on the podcast, Dental All-Stars. And if you want more information about how our team can support you with case acceptance, with practice management, coaching, like what Toothy’s doing, just shoot us an email. Heather at All-Star Dental Academy. She will just be so grateful that you reached out and had questions. She’d love to help you.

24:16
and you can check out allstardentalacademy.com for all of our upcoming events or if you’re interested in coaching or just our online training platform. So thank you, Jeff. Thank you, Toothy. We appreciate you so much. And for those that are listening, until next time, go out there and be an All-Star.

24:34
We hope you enjoyed this episode of Dental All-Stars. Visit us online at AllStarDentalAcademy.com.