The new platform integrates insurance verification and claim preparation into daily workflows to reduce denials and delays.

Pearl has launched Pearl RCM, a revenue cycle management platform designed to embed insurance intelligence throughout the dental workflow. The platform connects eligibility verification, imaging quality assurance, clinical documentation, and claim preparation to help practices submit cleaner claims and improve revenue predictability.

Upstream Insurance Intelligence

Unlike traditional systems that operate after treatment is completed, Pearl RCM embeds insurance intelligence during scheduling, imaging, diagnosis, and treatment planning. This allows staff to identify and correct issues before they delay, downcode, or compromise a claim.

The platform is built on FDA-cleared radiologic AI, which provides real-time X-ray quality assessment at the point of capture, automated selection of AI-annotated images for claim attachments, and AI-generated narratives based on imaging findings.

“Dental practices lose enormous time and revenue navigating disconnected insurance workflows,” says Ophir Tanz, founder and chief executive officer of Pearl, in a release. “Pearl RCM addresses claim issues proactively, before they become denials. Moving insurance verification and claim readiness to the point of care gives practices clarity and predictability that they’ve never had, and patients get a billing experience that finally matches the quality of their clinical care.”

Platform Features and Capabilities

The platform includes several core features aimed at improving efficiency across the revenue cycle:

  • Precheck: Automatically confirms eligibility and code-level benefits from four clearinghouses and over 300 carrier portals. Coverage data, including remaining benefits and frequency limits, is surfaced directly in the appointment card and schedule view.
  • Claim Actions: Provides proactive, in-schedule alerts flagging missing X-rays, outdated imaging, quality issues, or coverage gaps ahead of a patient visit.
  • Imagecheck: Detects quality defects, such as cone cuts or poor exposure, at the point of capture to reduce avoidable denials due to non-diagnostic X-ray evidence.

The company also plans to release Clean Claim, an automation tool for selecting relevant images and generating tailored clinical narratives, and Claim Insights, which will offer retrospective analytics on claim outcomes to identify patterns by procedure, payer, provider, and location.

Early Deployment Results

In early deployments across select practices, Pearl RCM reportedly has saved teams up to 35 staff hours per week on eligibility verification and claim creation. Practices also reported up to 80% fewer downcodes and denials related to missing, incomplete, or non-compliant supporting documentation, alongside an up to 2X improvement in initial clean claim submission rates.

“Pearl saves our team hours daily by both auto-verifying insurance and making coverage details clear and easy to find,” says Christine Marcin of Ballard Dental Partners, in a release. “The new RCM toolset goes a big step further, ensuring we have the right evidence, codes, and documentation to clear claims without insurance back and forth.”

Pearl RCM is currently available to dental practices across the United States.

Photo: Pearl