Paul Kaiser on Technological Advancements in the Dental Industry

In this episode of The Dental Economist Show, host Mike Huffaker sits down with Paul Kaiser, CEO and board member of DentalXChange at the Ignite Revenue Team Summit. 

Join them as they discuss:

• The advancements made by DentalXChange in the dental industry
• How DentalXChange have scaled up their claim processing capabilities
• Cybersecurity
• Innovative projects for dental businesses
• Automation in revenue cycle management
• Insurance

Paul Kaiser is CEO and a board member of DentalXChange, a dental revenue cycle management platform. DentalXChange’s aim is to simplify the dental RCM ecosystem and to help providers, payers and partners grow their business. Before working at DentalXChange, Paul was President and Chief Commercial Officer of Transaction Data Systems, and Chief Executive Officer and Board Member at MedeAnalytics. He is currently a Board Member for the Alumni Foundation of University of Central Missouri. 

Episode Highlights

DentalXChange Cyber Attack: Paul discusses the cyberattack on Change Healthcare and its impact on DentalXChange. He explains how DentalXChange had to quickly scale up and make changes to their business to support their partners and clients. Paul credits their dedicated team for their commitment and hard work during that challenging time. He emphasizes the importance of cybersecurity in the dental industry and how DentalXChange is taking it seriously, having implemented measures to ensure the security of their systems and educate their employees about the risks of phishing emails.

Leveraging AI: Paul says that navigating payer portals is a major pain point for offices, with each portal differing in nomenclature and data elements. He adds that staff turnover exacerbates this issue as new hires must relearn these systems. However, the new Eligibility AI that DentalXChange are working on leverages automation and AI to “screen scrape” portals for comprehensive data, making it available on a user-friendly interface. This system integrates with Denticon’s schedule book, automating eligibility checks days in advance. Providers then work by exception, addressing only anomalies. This automation reduces the cost and time of manual calls for benefits information, enhancing user experience and allowing further integration with treatment planning, claim pricing, and patient financing options.

Credentialing: Discussing the credentialing functionality of DentalXChange, Paul explains that they have an all-payer credentialing platform and have recently pivoted to emphasize direct-to-provider credentialing. They aim to simplify and speed up the credentialing process, reducing the time it takes for providers to get paid. Providers can now use DentalXChange to quickly credential with all payers, benefiting from features like data reuse and a secure communication portal. Paul notes how the partnership with Planet DDS aims to integrate practice management data via an API, expediting credentialing and reducing the time required for new providers to become productive, thus improving cash flow for DSOs.

Real-Time Claim Adjudication: Discussing the potential for real-time claim adjudication, where patients pay the exact amount upfront without subsequent billing adjustments, Paul says that while this level of integration is unlikely in the next five to ten years, it is “in our radar”. By the end of the year, Paul aims to handle 70-80% of dental transactions by leveraging AI to create accurate fee schedules based on payer and plan. This capability will enable instant claim adjudication and collection from payers, although Paul stresses that it won’t be free. Despite existing technical challenges within payer systems, Paul says that innovators like DentalXChange are paving the way for this advancement.