Active status & plan type
Patient eligibility confirmed via payer portal or clearinghouse EDI 270/271; plan type (PPO, HMO, Indemnity) and network status verified.
The most rigorous benefit breakdown a dental practice can receive.
The Engine assembles a documentation-complete benefit breakdown pack — every eligibility field, every plan limitation, every frequency rule, every waiting period, and the full annual-max/deductible picture — checked against payer portals, plan documents, and AI voice calls before a specialist releases it.
Every payer portal & IVR checkedFull benefit schema: max, deductible, frequencies, downgrades, waiting periods, missing-tooth clausesAI voice calls for fields portals don't exposeSpecialist release on every pack48-hour pre-appointment SLA
Why verifications fail
A single missing field can deny a claim and surprise a patient.
A dental practice's revenue cycle is only as strong as the verification behind it. Miss a frequency limit, overlook a waiting period, or fail to catch a downgrade clause — and the claim is denied, the patient gets an unexpected bill, and the practice writes off time and money.
Most practices run this by hand, from memory, between phone calls. The front desk juggles payer hold times, portal logins, and plan-document PDFs. That is exactly where completeness gaps hide.
The Engine exists to close that gap with a single, exhaustive standard applied identically to every patient.
1 of 3
verification errors is enough to trigger a claim denial
The benchmark
Measured against the full benefit schema — field by field.
We do not summarize the plan and hope. Every pack is scored against a versioned rule pack tied to the exact benefit structure of the patient's plan. These are the fields each pack is held to.
Remaining benefits & deductible status
Annual maximum, amount used, remaining; deductible met or remaining; individual/family breakdown — all reconciled to the penny.
Frequency limits & last service dates
Frequencies for cleanings, X-rays, fluoride, SRP, etc.; last service date verified to prevent early-claim denials.
Plan limitations on benefits
Downgrade rules (e.g., to amalgam), missing-tooth clauses, and alternative benefit provisions extracted from plan documents.
Applicable waiting periods
Waiting periods for major, minor, or orthodontic services; effective date and remaining wait time calculated.
COB rules & secondary coverage
Coordination-of-benefits rules, primary/secondary determination, and any dependent coverage details.
How a pack is built
Intake to specialist release, with deterministic gates the AI cannot overrule.
AI extracts and drafts. Deterministic rules — running as code, outside the model — decide what is complete. A human specialist signs every release. That order is never reversed.
01
Verification Audit
Upload your schedule and payer list. We return a free completeness read: which fields and plans are already verified, and which are missing.
02
Payer portal & clearinghouse pulls
As your authorized clerical agent, we log into payer portals and clearinghouses to pull eligibility and benefit data via EDI 270/271 and web interfaces.
03
AI voice calls & document extraction
AI voice calls navigate payer IVR lines for fields portals don't expose; plan documents and EOBs are parsed for limitations, frequencies, and clauses.
04
Canonical benefit schema assembly
All data is extracted into a standardized benefit breakdown schema: annual max, deductible, frequencies, downgrades, waiting periods, missing-tooth clauses, COB.
05
Deterministic completeness gates
Every required field is checked against the schema; confidence scores below threshold trigger exception queue; any missing field blocks release.
06
Specialist release
A verification specialist reviews the exception queue and signs the release. High-value or complex plans route to senior review first.
07
Delivery
You receive the pack: full benefit breakdown, evidence log, payer contact summary, and a 48-hour pre-appointment calendar reminder — ready for your PMS.
The bar we hold
Rigor you can measure.
100%
Specialist-released
No pack ships without a human signature.
48 hours
Pre-appointment SLA
From complete intake to released pack.
<2%
Field-error target
Tracked against a gold-standard benefit schema library.
3+
Data sources per field
Portal, IVR, plan document — every field corroborated.
Why The Engine
Built to be the most thorough option a practice has.
Documentation-complete, by design
The deliverable is completeness itself — every benefit field accounted for or explicitly exception-coded. Nothing is left implicit.
Deterministic, not vibes
The gates that decide completeness are code, not a model's opinion. A drafting error cannot slip past a required field.
In its lane, on purpose
We prepare documentation and run searches as your clerical agent. We never contact the patient, give treatment advice, or guarantee claim payment.
Engagement
Flat fee, per released pack. No hourly billing, ever.
Simple, predictable, and aligned with a documentation standard — not a cut of any claim.
- A free Verification Audit before you commit — see exactly what is missing.
- One flat fee per released Benefit Breakdown Pack; disclosed pass-through portal fees.
- Optional fixed-fee senior review for complex plans or high-value procedures.
- Optional Same-Day Add-on for add-on appointments booked within 48 hours.
FAQ
Questions, answered precisely.
Is The Engine a law firm?
No. The Engine, a service of Your Deputy, Obuke LLC, provides documentation-completeness services. It is not a law firm, does not provide legal advice, and does not represent you in any legal matter. Senior review is available and recommended for complex plans.
Do you contact the patient or guarantee claim payment?
Never. The Engine is not a claims processor and does not contact patients or guarantee claim payment. The practice remains responsible for all patient communications and claim submissions.
What makes a pack 'complete'?
Completeness is defined by the benefit schema: all required fields (eligibility, annual max, deductible, frequencies, downgrades, waiting periods, missing-tooth clauses, COB) present, corroborated across sources, and confidence-scored. Deterministic gates enforce each one before release.
How fast is it?
The standard SLA is 48 hours before the appointment from complete intake to a specialist-released pack. The free Verification Audit is returned much sooner and tells you exactly what is still needed.
How are you priced?
A flat fee per released pack, plus disclosed pass-through portal costs. No hourly billing and no percentage of any claim amount.
See what's missing before it costs you a claim.
Start with a free Verification Audit. Send your schedule and payer list and we'll return a completeness read against every field of the benefit schema.
Documentation-completeness service · not legal advice · the practice submits every claim.