For healthcare providers, insurance is a necessary business strategy. For patients, it’s stress inducing and often, unsupportive. In this episode, host Mike Huffaker sits down with Ben Baenen, Director of Healthcare and Life Sciences at West Monroe, to explore the evolving landscape of dental technology, real-time claims processing, and the impact of AI on the industry.

What You’ll Learn: 

• Why dental is becoming a more integral window into overall wellness and healthcare integration

• How the dental ecosystem is shifting from fragmentation to collaboration between payers and providers

• The roadmap to achieving real-time claims processing and why it's closer than you think

• Why data standardization and clean architecture are crucial for private equity investment in dental

• How AI is transforming dental operations, from fraud detection to patient experience

• The emerging trend of membership plans and their role in simplifying the dental benefits landscape

• Why vertical integration and ecosystem collaboration are driving industry transformation

• How technology modernization is creating new opportunities for practice growth and efficiency

Tune in for actionable insights on how to solve for trust erosion and friction in the world of dental insurance claims.
Episode Highlights:
09:25 - 12:36 The Integration of Dental Care into Overall Wellness Ben shares how dental care is becoming a critical window into overall wellness, representing 5-6% of US healthcare spending with expectations for growth. The integration allows dentists to conduct broader health screenings and coordinate care across the healthcare ecosystem, creating more value for patients - a shift driven by increasing patient interest in dental care and growing recognition of oral health's connection to overall wellness. This is further enabled by technology that provides better access to patient histories and health data at providers' fingertips, offering dental practices the opportunity to become central players in patients' complete healthcare journeys. 
16:47 -18:18 Building Trust Through Benefits Transparency Ben emphasizes how the historical "black box" approach to dental benefits has eroded trust throughout the ecosystem. The complexity of benefits verification creates friction between providers, payers, and patients, often leading to unexpected costs and damaged relationships. Modern technology solutions are emerging to help normalize and structure benefits data, making it more accessible and understandable. Payers are increasingly recognizing the need to help members better understand their coverage before treatment, representing a significant opportunity to rebuild trust and improve the patient experience.
21:06 - 25:17 Technology Readiness Assessment for Growth Ben discusses how private equity firms evaluate dental technology investments based on scalability, security, and data capabilities. The assessment looks at whether systems can handle doubling or tripling in size while maintaining performance and security standards. Technology debt is evaluated not in terms of if it exists, but rather how much exists and its impact on growth potential. Modern architecture and clean data become key value drivers for practices looking to scale or attract investment, creating opportunities for practices to strategically modernize their technology stack for future growth.
25:18 - 30:49 The Evolution of AI in Dental Ben reveals how AI has quietly been present in dentistry for years through fraud detection and radiographic imaging, though broader awareness is only now emerging. The dental industry shows increasing appetite for AI applications, particularly in areas like call centers and claims processing. Data standardization and cleanliness remain critical challenges for implementing AI solutions effectively. Healthcare organizations are approaching AI adoption cautiously but with growing interest, particularly in low-hanging fruit use cases. This measured approach to AI adoption allows practices to start small while preparing for bigger opportunities ahead.
Ready to rethink what’s possible? Listen now and subscribe for more dental business insights! 

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