Zentist to Unlock $2.24 Billion in Real-Time Insurance Claim Payments
Zentist, the automated dental insurance claims processing platform, announced the launch of a financial pre-funding pilot program for the $156 billion U.S. dental services industry. The program applies machine learning models to dental insurance claims data so that multi-location dental service providers are paid on certain types of claim submissions in real-time. The anticipated outcomes include lower insurance reimbursement risk, improved liquidity and better near-term financial health which enables dental service organizations (DSOs) participating in the program to better fund their current operations and invest more in their future growth.
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Zentist’s proprietary revenue cycle management (RCM) platform will predict dental insurance payments with a high degree of confidence and then pre-fund the accounts receivable (A/R) of DSOs and their affiliated practices. The additional capital that is unlocked through Zentist by eliminating aging A/R is then monetized by the DSO or dental practice for meeting bank loan covenants and financing growth. DSOs and their affiliated practices can opt to use the immediate increase in revenue for such activities as:
- Issuing intercompany loans;
- Paying down existing debt;
- Purchasing dental supplies or equipment;
- Funding a dental office renovation or expansion;
- Obtaining new patients through advertising and marketing campaigns;
- Covering employee payroll and benefit expenses;
- Investing in employee recruitment, training, retention and rewards.
United Dental Corporation (UDC), a U.S. based DSO founded by Dr. Ray Khouri, who successfully started and exited the largest dental services platforms in Australia, New Zealand and Canada, will be the first participant in this financial pre-funding pilot program. Dr. Khouri founded Dental Corp. in Australia and New Zealand, which were later acquired for approximately $600 million. He replicated his international success in Canada via Dentalcorp Holdings Ltd., the country’s largest DSO, which raised $950 million in an initial public offering (IPO) earlier this year despite a global pandemic. The DSOs founded by Dr. Khouri have a 98% doctor retention rate, among the highest of any DSO.
“UDC intends to scale much faster with Zentist’s help because their leadership team has a global view of dentistry,” said Dr. Khouri, United Dental Corporation’s Founder & CEO.
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“Unlike in the United States, Canadian dental practices collect cash at the point of service. The insurance claim is submitted by the patient, who then receives reimbursement from the benefits provider. Although many Canadian practices offer to process the claim for the patient as a customer service, there is more limited exposure to payment delays, let alone frequent claim denials by payers. When I decided to build my fourth national DSO, I wanted to circumvent the RCM challenges that have plagued so many of my American counterparts.”
Sina S. Amiri, Vice President of Business Development and Partnerships at Zentist, said: “What has become the norm for RCM in the U.S. dental services industry isn’t acceptable to Dr. Khouri and I because during our respective careers, we’ve operated different DSOs in international jurisdictions that have had very limited insurance reimbursement risk. When I contrast my experience leading the national operations of a private equity backed DSO in Canada with the work I’m doing now at Zentist with U.S. based DSOs, it’s evident to me that receiving co-pays from patients at the point of service but then being required to submit claims directly to the insurance companies and waiting to get paid ultimately reduces practice profitability. Zentist is bridging the gap between production and collections using artificial intelligence so U.S. practices are just as profitable as their Canadian counterparts which today pay their dentists a higher percentage of collections due to lower adjusted production and less bad debt write-offs.”
Zentist is well-positioned to help more DSOs, having already grown to more than $200 million in annualized insurance collections. The company’s electronic health record (EHR) and dental practice management software agnostic RCM platform has minimized disruption to clinical as well as administrative workflows at a time when so many practices have been financially impacted by industry-wide labor shortages.
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