Know What Patients Owe Before the Visit
Carelyze reads the treatment plan, checks live carrier coverage, and returns a patient-ready estimate your team can trace.
- Live portal data
- Traceable patient estimates
- No EHR integration
Carrier coverage
Carrier rollout timeline
Delta Dental is live now. Guardian and Anthem are in progress. Future carriers are added around the portals each practice actually checks.
- 1Active now
Delta Dental
Live portal coverage checks for supported Delta Dental plans.
- 2In progress
Guardian
Portal workflow support is being added now.
- 3In progress
Anthem
Coverage checks are on the near-term rollout list.
- 4Future+Your next mix
More carriers
We prioritize the carrier mix each practice actually verifies.
Missing a carrier your team checks every day?
Ask about your carriersHow it works
Three steps to the patient’s real number
No integration project. It starts with the PDF your front desk already exports.
Reading the treatment plan
Upload the treatment plan
Drop in the PDF your EHR already exports, or type the procedures in. Carelyze reads CDT codes, teeth, and fees.
Checking live coverage
Carelyze checks the coverage
It signs in to the carrier portal, clears MFA, and pulls eligibility, benefits, deductible, annual max, and history.
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.
Estimates are ready overnight for tomorrow’s schedule — and re-run in seconds at the chair when the plan changes.
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. Not a stale database. Not a guess.
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.
Before & after
The manual workday, replaced
Insurance verification eats hours of every front-desk day. Carelyze does the same work, the same way — minus the portal grind and the missed rules.
- Pull tomorrow’s appointments from the EHR
- Log into each carrier portal, one patient at a time
- Transcribe deductible used, max remaining, coverage %, and history
- Cross-reference every code against the fee schedule
- Hand-compute the patient’s out-of-pocket
- Quote it at check-in — and hope nothing was missed
- Upload the treatment-plan PDF you already export
- Portal login, MFA, and the coverage pull happen on their own
- Estimates ready by morning, each with a confidence score and rule trace
- Re-run in seconds at the chair when the plan changes
- Every dollar traces to a rule and the carrier field behind it
- Low-confidence estimates go to a review queue, never to a patient
Trust & security
Numbers you can show a patient
These numbers get said out loud at check-in. So every estimate is built to be checked — by your staff, and by us.
Explainable
Every dollar traces to a specific plan rule and the exact carrier field behind it. No black box.
Confidence-scored
Every estimate carries a confidence score. Uncertain ones route to a staff review queue — never to a patient, never shown blind.
Cross-checked
Compared against your EHR’s own estimate, with the difference surfaced — not hidden.
Real coverage or nothing
If Carelyze can’t confirm it from live coverage, it doesn’t state it. The AI organizes the plan’s rules; it never invents a price.
Where it’s heading
Estimates first. Then the rest of the insurance grind.
We started with the highest-stakes number a front desk produces: what the patient owes before service. The same engine — live portal access plus the plan’s real rules — is built to take on more of the back office.
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. Carelyze works from the treatment-plan PDF your EHR already exports — Dentrix, Open Dental, Eaglesoft, or anything that can print a treatment plan. No integration project, no IT ticket.
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, and the AI never invents a price.
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.
Which carriers does it work with?
Carelyze works through carriers’ provider portals — the same places your team checks coverage today. On the demo we’ll confirm your practice’s specific carrier mix before you commit.
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, by design. We’re making the pre-visit estimate excellent first. Prior auth, claim follow-up, and denial responses are on the roadmap, built on the same portal access and rules engine.
See Carelyze run on your own schedule
Bring a day of upcoming appointments. We’ll run live estimates on them, side by side with your EHR’s numbers, and 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.