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Abutment AIBook a demo

AI for regional dental carriers

Everyone in dental benefits is waiting on someone's inbox.

Dental benefit administration still runs on fragmented systems and manual work. Abutment is AI that does the first read in every queue, gathers the evidence, and hands a recommendation to the person who decides.

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  • The member

    On hold to ask what a crown will cost.

  • The dentist

    Faxing X-rays for a predetermination, again.

  • The employer

    Asking why the renewal went up.

  • Your team

    Four queues, each its own spreadsheet and inbox.

Four places the work piles up.

Each one is a queue today. Abutment does the first read in all four, and your people make the call.

  1. 01

    Provider support

    Credentialing, contracting, predeterminations and provider questions. Primary-source checks gathered and the file summarized before a person opens it.

  2. 02

    Member experience

    Plain answers on benefits, claims and finding a dentist, with the plan document the answer came from shown to the agent.

  3. 03

    Operational intelligence

    Billing that differs from peers in the same county is flagged, with the pattern that triggered it, for your SIU to decide.

  4. 04

    Predictive analytics

    Forecasts of claims cost, retention and network performance, built from your own history.

What changes, queue by queue.

Predetermination

Today

The office faxes X-rays and a narrative. The file waits for a consultant to find time.

With Abutment

Read on arrival. The consultant sees the narrative, the image and the clause together, and decides the same day.
Credentialing

Today

An application sits in a shared inbox while someone checks each source by hand.

With Abutment

Licence, exclusions and malpractice history are checked and summarized. Committee opens a ready file.
Member call

Today

The member holds while the agent searches the plan document.

With Abutment

The answer and the page it came from are on the agent's screen while the member is still on the line.
Claims review

Today

Outliers turn up in a quarterly spreadsheet, after the claims were paid.

With Abutment

The pattern is flagged as the claim arrives, with the reason, for your SIU to decide.

17¢

Massachusetts · minimum dental loss ratio 83%

Eighty-three cents of every premium dollar must go to care. All of the above has to fit in the other seventeen.

Abutment takes the manual work out of those seventeen cents, so administrative cost falls without cutting service.

Why now

Models can now read a narrative, a radiograph and a plan clause together, and the X12 messages your systems already send carry all three. Work that only the largest payers could staff for fits inside a regional carrier's seventeen cents.

Where we start

Predetermination. It is the one queue where the member, the dentist and your consultant all wait on the same file, so it is where a day saved is felt first.

The software recommends. A person decides.

The AI never denies a claim. A licensed dental consultant decides every adverse outcome, and the decision carries their name. Each time a member record is opened, the log says who, and when.

One predetermination, invented

  1. 09:38

    Abutment

    Recommends approve, with evidence: the narrative, the image and the clause it checked.

  2. 09:40

    Dr. R. Ilves

    Opens the record. The view is logged with her name and the time.

  3. 09:41

    Dr. R. Ilves

    Approves. The decision carries her name, and the office is told the same day.

Nothing to replace.

Abutment works beside your core system, on the X12 files you already send. Your claims system stays the system of record.

  • 837D
  • 835
  • 270
  • 271
  • 276
  • 277
  • 278

Bring one queue. Ninety days.

  1. Week 0

    Connect

    One queue through the standard files. We agree the measures before we start.

  2. Weeks 1 to 12

    Run

    Your team works with recommendations on. We compare time per item and reversals with the baseline.

  3. Week 12

    Decide

    Review the results together. Expand, change, or stop.

Fixed fee for the pilot, set before you sign. You keep the data either way.

What it's for.

Everyone in the first strip was waiting on someone's inbox. This is what each of them gets instead.

  • The member

    Hears what the crown will cost while still on the phone, and is in the chair this week.

  • The dentist

    Sends the predetermination once, and hears back the same day.

  • The employer

    Renews a plan whose administrative cost went down, and can read why.

  • Your team

    Opens one queue with the evidence already gathered, and decides.

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