Route every inquiry, 24/7.
Email, calls and webforms produce disconnected intake trails.
Est. deploy 3–5 weeksSee the walkthrough
Intake & Scheduling · Dental
Check coverage before the patient arrives.
Coverage surprises create front-desk delays.
For: Insurance coordinators and the team responsible for intake & scheduling in dental.
01 · The outcome
What good looks like.
The team has an eligibility summary marked unverified until staff review, with source evidence and an explicit approval before any external action. Track visits with eligibility checked in advance against a baseline; do not assume automation improves it.
A connected workflow that uses member identifiers, scheduled procedure codes, and authorized eligibility response to compare the eligibility response with the visit checklist and flag missing or conflicting benefits. It produces an eligibility summary marked unverified until staff review.
Where AI helps, and where a person decides.
AI can compare the eligibility response with the visit checklist and flag missing or conflicting benefits. It drafts and organizes; it does not authorize spending, commitments, clinical decisions or customer communication. The insurance coordinator verifies the source facts and approves the final action.
Insurance coordinator is accountable. People approve customer-facing, sensitive, financial, and legally binding actions.
- Insurance coordinator: Capture the source and scope
- Insurance coordinator: Review the proposed outcome
- Insurance coordinator: Release only the approved version
- Insurance coordinator: Check the result and exceptions
A named person approves customer-facing messages, spending, record changes and binding commitments before release. Pre-approved scripts are versioned; exceptions stop for review.
02 · The handoffs
How the work moves.
Every handoff has an owner. Select a step to open or close its detail.
Start when: A visit enters the seven-day preparation window. Connect only member identifiers, scheduled procedure codes, and authorized eligibility response. The insurance coordinator confirms the request is authorized and in scope.
Ready when: The source reference, permissions and accountable owner are recorded.
Use the authorized records to compare the eligibility response with the visit checklist and flag missing or conflicting benefits. Preserve the original language alongside the draft and label uncertain fields.
Ready when: Each proposed fact links back to a source, and missing information is visible.
Check an eligibility summary marked unverified until staff review against the original records and current policy. Correct errors and escalate exceptions to the qualified specialist; do not auto-approve.
Ready when: Insurance coordinator has recorded approval or a reason to hold the item.
After explicit approval, save an eligibility summary marked unverified until staff review in the system of record. Send only approved messages to verified recipients. Record the version and prevent duplicate delivery.
Ready when: The approved record is saved; any delivery is confirmed or placed in the retry queue.
Review visits with eligibility checked in advance each week, sample completed records for quality, and resolve held items. Change the rules only after reviewing actual errors and staff feedback.
Ready when: Exceptions have owners, the metric has a baseline, and corrective actions are assigned.
Sample record.
$ david run --workflow=dental-eligibility-check
ILLUSTRATIVE RECORD / NOT LIVE CUSTOMER DATA
- Example
- Illustrative only — not a real client record
- Reference
- DENTAL-ELIGIBILITY-CHECK-DEMO-001
- Trigger
- A visit enters the seven-day preparation window.
- Owner
- Insurance coordinator
- Prepared output
- an eligibility summary marked unverified until staff review
- Review status
- Awaiting human approval — no external action taken
- Missing information
- Owner to verify source completeness
- Measure
- Visits with eligibility checked in advance
Start with your tools.
Connect Practice management system, Eligibility portal, Secure messaging through approved APIs or controlled exports. Map record identifiers first; test permissions and field updates in a sandbox. Vendor names describe possible connections, not a guarantee of an available integration or license.
When things go wrong.
- A named person approves customer-facing messages, spending, record changes and binding commitments before release. Pre-approved scripts are versioned; exceptions stop for review.
- Use only authorized sources and role-based access. Keep an audit trail of source records, drafts, approvals and delivery status; deduplicate retries.
- If an integration fails, a source is missing or confidence is low, pause the action and assign the original request to the accountable owner.
- For healthcare uses, validate HIPAA applicability, execute required BAAs, restrict PHI to the minimum necessary, and use approved secure systems. Clinicians handle symptoms, urgent care and clinical decisions.
Try this week / no DAVID required
A useful first step.
This week, have your insurance coordinator time five examples of this work. Use redacted copies of member identifiers, scheduled procedure codes, and authorized eligibility response to make an eligibility summary marked unverified until staff review manually, then list which fields required judgment.
What to measure.
- Visits with eligibility checked in advance
- Minutes of human handling per completed item
- Drafts needing substantive correction
- Exceptions unresolved beyond the agreed review window
Estimate your time back.
20.8
$11,232
03 · More workflows to consider
Related workflows.
Answer every call on the first ring.
Leads call after 5 PM and hit voicemail.
Est. deploy 2–3 weeksSee the walkthrough
Prepare every treatment start before arrival.
Missing forms delay the first treatment visit.
Est. deploy 4–6 weeksSee the walkthrough
Want this running in your business in 4–6 weeks?
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