Adjudix is running a free design-partner pilot with a small number of independent dental practices and small groups. We rebuild your denial history, show you what was recoverable, and test a human-approved denial workflow against the way your team works today.
Narrow by design: one payer, two denial categories, files in and documents out. Nothing leaves your practice without a person approving it.
A single denied scaling and root planing line is a few hundred dollars. The billing lead has fifteen other things to do. The appeal window closes. The write-off happens quietly. Multiply that across a year, across every payer with its own clinical criteria and its own EOB layout, and the number is real.
Sources: the group figures are from a 2026 interview with a regional practice manager at a multi-state dental service organization, used with the numbers anonymized. Electronic adoption rates are from the CAQH Index, 2024 edition.
The reason this stays unsolved is not that practices don't care. It is that the information needed to work a denial lives in four places: the practice management system, the clearinghouse, a PDF in the document manager, and the memory of whoever handled it last time. No one has the time to put those together for every line.
We start with history, not software. Using your own exported data, we reconstruct every denied line from the last 12 to 24 months and link each one to what was done about it and what the payer finally paid. That audit is yours to keep whether or not you continue.
If the audit shows money worth going after, we move to a silent comparison: the system reads your incoming remittances and drafts a recommendation and an evidence checklist for each denial, while your team keeps working exactly as they do now. Nobody sees the system's output until we have measured it against your team's decisions.
Only after that, and only if it clears the bar, does the tool go into daily use, with a person reviewing and sending every appeal.
Why so narrow: a tool that is right 90% of the time on a small scope is worth more to a billing lead than one that is right 70% of the time on everything.
These are the actual terms. There is no fee during the pilot. The commitment is time and data access, and we have written it down so you can decide before the first call.
In detail
A repeatable export of 12 to 24 months of claims and ledger data from your practice management system, at little or no cost. We help you get the vendor's written answer on scope, format, and price before anything starts. If the only option is a $5,000 full dump, that is a finding, not a bill.
Historical denial EOBs and any appeals you filed, exported from your document manager.
Enrollment for electronic remittances (835) with your primary payer through your clearinghouse, if you are not already enrolled.
The appeal templates and payer policy materials your team already uses. The tool drafts from these, not from a generic library.
A business associate agreement, a data use agreement, and written pilot authorization from the practice owner, before any data moves.
A billing lead at 4 to 6 hours a week for roughly the first eight weeks (working sessions, labeling, documenting how you handle denials today), then 2 to 3 hours a week through the live pilot. A named backup so the work does not stall if that person is out.
A dentist available to review clinical narratives in draft appeals.
In detail
Every denied line from the history window, categorized, with what was recovered, what was written off, and what looks recoverable. Delivered as a report you keep regardless of what happens next.
Your current denial workflow documented as written procedures and a labeled taxonomy of denial reasons. Most practices have never had this on paper.
A side-by-side comparison of the system's recommendations against your team's actual decisions, including where it was wrong, before anything goes live.
8 to 12 weeks of daily use with a person approving every outbound action. Weekly reporting of recovered dollars, time saved, and error counts. We publish the misses, not just the wins.
Design partners shape what gets built. Early partners are also offered terms on pricing and, where it fits, a formal advisory role, discussed on the call rather than advertised here.
Practices that outsource all billing and have no internal denial process. Practices that want a tool to submit claims or appeals on its own. Practices looking for coding suggestions. We will say so on the call rather than waste your time.
This is a validation program with gates, not a product launch. Each step has to pass before the next one starts, and we will tell you the numbers.
We will not suggest procedure codes. We will not interpret radiographs. We will not submit a claim or an appeal without a person sending it. We will not write back to your practice management system. These are design constraints, not roadmap items.
Aseem Pandey has spent about 25 years running healthcare operations, across health systems and managed care, including Providence, Kaiser Permanente of Washington, Ascension, and Aurora Health Care. Before that, a 20-year career in the U.S. Army in healthcare administration. He holds an MBA and is based in the Puget Sound area.
Adjudix started with a question from a dental practice owner who works his own denials by hand and wins most of them: why is this still manual? The answer turned out to be that the data to do it any other way does not exist as a dataset anywhere. Building it, one practice at a time, is the work.
Engineers who want to work on denial-to-outcome data, payer rule extraction, and document understanding in a tightly constrained, human-approved setting: write to Aseem directly.
We are taking a small number of practices. Fill this in and Aseem will reply within two business days to set up a 20-minute call.