Insurance verification and prior-auth before the visit
A front-office system designed to check eligibility, benefits, and prior-authorization before a patient is seated — reading payer portals and your PMS so coverage is confirmed and documented ahead of the visit. Purely administrative: it never touches anything clinical or diagnostic.
An illustrative example of a system we can build — not a client engagement, and with no measured results.
The challenge
Eligibility gets checked by phone one patient at a time, and prior-auths are started too late to clear before the appointment. Coverage surprises turn into reschedules, write-offs, and awkward front-desk conversations — all administrative leakage that has nothing to do with the dentistry.
How we'd build it
- We'd build automation that reads each upcoming appointment and pulls eligibility and benefits from the payer portals before the day
- We'd flag prior-auth requirements early and prep the request so it can clear before the patient is scheduled to be seated
- We'd document verified coverage straight into the patient record in your PMS, so the front desk sees it without a phone call
- We'd keep a hard line at the front office — no images, no diagnosis, no clinical calls; everything clinical stays with your team
What it's designed to deliver
- Designed to confirm and document coverage before the visit instead of discovering a problem at the chair
- Built to start prior-auths early enough to clear, cutting the reschedules and write-offs that come from late checks
- Intended to stay strictly non-diagnostic — front-office, insurance, and revenue-cycle work only, never the operatory
- Handed over as code running on your PMS and infrastructure — owned by you, with no per-verification platform fee
And like everything we build, you'd own it
What to expect
No. This is an illustrative example of a system Plenaura can build — not a delivered client engagement, and it carries no measured client results. We're a pre-launch studio building our first projects, and we won't present invented case studies as real.
Yes. Like everything we build, you own 100% of the code, models, and infrastructure, deployed under your control — no vendor lock-in and no platform fees.
It's scoped per project on a timeline agreed in writing before any work starts. A single focused capability ships faster than a fully connected system; we lock scope and timeline up front so there's no open-ended drift.
Want a system like this? Let's scope it.
Tell us the problem. We'll map the system and scope it with you — or give an honest no.