Fewer surprise bills. Less under-collection. No more portal marathons.
Carelyze syncs your schedule from Dentrix or NexHealth, verifies every patient’s coverage on the carrier’s own portal, and prices the treatment plan — the real number, before the visit.
- Syncs with Dentrix & NexHealth
- Live portal data
- Traceable estimates
Watch it run
From treatment plan to the number
The whole flow, unedited: upload the PDF, watch the coverage pull, get the line-item estimate your team can trace.
How it works
Three steps to the patient’s real number
Connect once — tomorrow’s schedule is verified and priced before your team sits down.
- 01
Syncing the schedule
Connect your practice systems
Appointments and patient insurance sync from Dentrix, NexHealth, and more — or start from the treatment-plan PDF your system already exports, no integration needed.
Many ways in · one synced schedule - 02
Checking live coverage
Carelyze verifies every patient
For every appointment on the schedule, it signs in to the carrier portal, clears MFA, and pulls eligibility, benefits, deductible, annual max, and history.
The same screens your staff read - 03
Pricing the estimate
Get the line-item estimate
Carelyze applies the plan rules to your fees and returns insurance vs. patient responsibility, with a trace behind the number.
Line item · split · tracedemo data
With CarelyzeA number you can say out loud at check-in — ready overnight for tomorrow’s schedule, re-run in seconds when the plan changes at the chair.
Who it’s for
One estimate, three jobs it makes easier
The same number does different work at every desk in the practice.
Front desk
Skip the portal grind
- No more one-portal-at-a-time logins and MFA codes
- No hand math from benefits screens to the fee schedule
- Tomorrow’s estimates are ready before the patient is at the counter
Office managers
Cleaner estimates, fewer write-offs
- Every dollar traces to a rule and the carrier field behind it
- Low-confidence estimates land in a review queue — never in front of a patient
- Missed frequency limits stop turning into write-offs
Owner dentists
Collect at check-in, not in collections
- Fewer surprise bills, fewer billing disputes after the visit
- Under-collection surfaces before the appointment, not on the aging report
- A clear number up front makes it easier for patients to say yes to treatment
Why Carelyze
The estimate your EHR can’t give you
Your EHR prices from whatever benefits were last keyed in. Carelyze prices from what the carrier says today — and applies the rules nobody has time to check by hand.
Real coverage, pulled live
Carelyze logs in to the carrier’s own provider portal with your credentials, MFA handled, and reads the same eligibility, benefits, and history screens your staff reads. If it can’t confirm something from live coverage, it doesn’t state it — the AI organizes the rules; live carrier data drives the number.
Catches what the EHR skips
Two cleanings a year. One panoramic every five. One crown per tooth per five years. The clauses that quietly turn “covered” into a write-off — checked on every estimate, automatically.
The fee math, done in order
Billed fee, contracted fee, the carrier’s per-procedure cap — Carelyze applies the lowest, takes the deductible only where it applies, in order, and treats the annual max as the hard cap it is. Secondary coverage included.
The rules, in plain English
Frequency limits
How often the plan pays for a service. Carelyze checks history first, so a cleaning the patient already used never shows up as covered.
Waiting periods
New plans often don’t cover major work right away. Carelyze flags services that may not be covered yet.
Downgrade clauses
Some plans pay for the cheaper alternative — amalgam instead of composite. Carelyze prices what the plan actually pays, so the estimate isn’t inflated.
Carrier cap
The carrier’s allowed amount per procedure. Carelyze starts the math from that number, not just the office fee.
The platform
From today’s estimate to the whole insurance cycle
Carelyze ships the insurance team one member at a time — so here’s the honest map: what’s live today, what’s in development, and where this goes.
- Live today
Verified coverage, priced before the visit
The schedule comes in, the carrier gets checked, the plan gets priced — end to end, on tomorrow’s appointments.
Schedule & patient-insurance sync
Appointments and patient insurance import from Dentrix, NexHealth, and more.
Eligibility verification on live carrier portals
Carelyze signs in to the carrier’s own portal, clears MFA, and reads today’s coverage.
Line-item treatment-plan estimates
Insurance versus patient responsibility, with a per-dollar trace behind the number.
Treatment-plan PDF upload also works — the no-integration on-ramp for any other system.
- In development
The full claim, end to end
Built on the same live portal access and rules engine that prices estimates today — shipped one member of the team at a time.
Claims submission
Filed from the coverage Carelyze already verified.
Denial analysis
Reading the remittance back to the rule that caused it.
Appeals
Assembling the response, with the trace already on file.
- The mission
Beyond the insurance cycle
Every other job the front desk carries — and the same insurance work, beyond dental into the broader healthcare revenue cycle.
- Intake
- Scheduling
- Patient communication
- Patient billing
The autonomous front and back office for healthcare — so every provider gets paid in full, for less.
Carrier coverage
Build around the carriers your practice actually checks
On the demo, we map your practice’s top carriers and confirm what can be automated first.
Missing a carrier your team checks every day?
Ask about your carriersTrust & security
Fair questions
What every office manager asks first
Straight answers. Anything not covered here, ask on the demo.
Do we have to change our EHR or our workflow?
No. If you’re on Dentrix or NexHealth, Carelyze connects directly — appointments and patient insurance sync automatically, and setup is handled by our team. On anything else, start from the treatment-plan PDF your system already exports. Either way, no workflow change for your staff.
Where do the numbers actually come from?
From the carrier’s own provider portal. Carelyze signs in with your stored credentials, clears MFA, and reads the same eligibility, benefits, and history screens your staff reads today — then applies the plan’s rules to your fees. Nothing comes from a generic benefits database — the AI organizes the rules; live carrier data drives the number.
What does it cost?
Simple per-clinic pricing, shared on the demo — after you’ve watched Carelyze run on your own appointments, so you’re pricing something you’ve seen work.
Can it handle prior authorizations or chase claims?
Not yet. Claims submission, denial analysis, and appeals are in development now, built on the same live portal access and rules engine that prices estimates today; prior authorizations follow the same path. Pre-visit estimates stay the foundation the rest is built on.
Is the estimate a guarantee of payment?
No — no pre-visit estimate is, and you should be suspicious of anyone who says otherwise. The carrier decides at claim time. Carelyze gets you the closest defensible number before then: live coverage, the plan’s actual rules, a confidence score, and a per-dollar trace your staff can check. Anything low-confidence is flagged for review instead of shown to a patient.
See Carelyze run on your own schedule
Connect your schedule — or bring a day of appointments — and we’ll run live estimates side by side with your system’s numbers, so you judge the difference. Onboarding, security, pricing — ask us anything on the call.
Visit us
333 West San Carlos Street
San Jose, CA 95110
Email us
contact@carelyze.comOpens an email — tell us your practice name and EHR. A person replies, not a sequence.
you judge the difference