The specialty paradox
Risk-bearing dental, vision, and hearing plans live a paradox the health-tech industry ignores. You carry the same obligations as a full medical carrier:
But you carry them with a fraction of the headcount, on tools built for medical plans or built decades ago. Every demo you’ve sat through was designed for someone else.
You carry a full carrier’s obligations — on a fraction of the staff, with tools built for someone else.
Proven in specialty first
CareInsight’s flagship deployment runs at one of the nation’s leading dental plans, so the platform speaks your operational language natively: high-volume, lower-dollar claims; specialty networks; government-program compliance at dental scale; and correspondence volumes that overwhelm manual processes.
Where it helps
The Intake, A&G Decision, and Omni-Channel Notification agents run the case lifecycle end to end: intake in 2 minutes, evidence assembled, determination and resolution letters delivered on time, every action timestamped.
The Claims Pend Resolution agent assembles evidence across systems and cuts resolution to under 5 minutes at 80% lower cost, clearing pend inventories before they become prompt-pay penalties.
The Inbound Agent answers eligibility, benefits, and claim-status calls 24/7, while the Outreach Agent drives preventive utilization that proves value to state and employer clients.
LetterIQ replaces aging report tooling with governed templates, approval workflows, multilingual output, and automated PDF generation at scale.
Why specialty plans choose CareInsight
Because we’ve already done this — in production, at scale, in dental. You get a partner that doesn’t need your world explained, pricing built for specialty economics, and automation that lets a lean team operate with the compliance rigor of a carrier ten times its size.