Accurate insurance verification and customized benefit breakdowns - so your team can focus on patients, not phone calls or paperwork.
Book a Consultation →Annual
Maximum
Remaining
Maximum
Individual
Deductible
Ded Remaining
| Procedure | Coverage | Frequency | History | Status |
|---|---|---|---|---|
| D0120 · Periodic Exam | 100% | 2 / year | Used 1 | Eligible |
| D0274 · Bitewing X-rays | 100% | 1 / year | — | Eligible |
| D1120 · Prophylaxis | 80% | 2 / year | Used 1 | Eligible |
| D1206 · Fluoride | 80% | 2 / year | — | Eligible |
| D2391 · Composite FillingDowngrade to D2140 | 80% | Every 24 months | — | Eligible |
| D2740 · Porcelain Crown | 50% | Every 5 years | — | Eligible |
| D9310 · ConsultationDeductible applies | 80% | 2 / year; lifetime per provider | — | Not Eligible |
Automated tools can retrieve insurance information quickly, but important coverage details often require additional review. Payla combines automated verification with experienced specialists to review benefit limitations, document coverage details, and deliver accurate, ready-to-use information directly into your practice management system.
We provide a complete, organized breakdown of your patient’s dental benefits — ready for treatment planning and patient communication.
Procedure-level benefits
Waiting periods, downgrades, exclusions
Clear, organized information
Sample Patient · MetLife · Effective 01/01/2023 · No waiting period
| Procedure | Coverage | Frequency | History | Eligible |
|---|---|---|---|---|
| D0120 · Periodic Exam | 100% | 2 per calendar year | 03/23/2026 07/31/2026 |
✓ Yes |
| D1120 · Child Prophylaxis | 100% | 2 per calendar year Age up to 14 |
03/23/2026 07/31/2026 |
✓ Yes |
| D1351 · Sealant Permanent molars only · Excl. wisdom teeth | 100% | 1 per 60 months Age up to 19 |
— | ✓ Yes |
| D2393 · Composite, 3-Surface Posterior Downgraded | 80% Deductible applies | 1 per 60 months | — | ✓ Yes |
| D2930 · Stainless Steel Crown | 80% Deductible applies | 1 per 5 calendar years | — | ✓ Yes |
| D9230 · Nitrous Oxide | Not covered | — | — | No |
Payla actively manages each step so the benefits are ready before the scheduled appointment.
Upcoming appointments are identified early.
Carrier sources are checked for benefit details.
Coverage, history, and limitations are examined.
The completed breakdown is entered and organized.
Usable information before the visit.
Verified benefit information helps your team prepare reliable treatment estimates and reduces unexpected patient balances.
Based on verified benefits
Waiting periods and downgrades
Clearer financial conversations
Complete benefit details help reduce estimate errors.
Fewer repeated phone calls, manual entry, and last-minute verification.
Helps your team explain estimated patient portions early.
Reduces outstanding balances caused by incomplete benefit information.
Flexible options based on your monthly verification volume.
Up to 100 verifications
Regular monthly rate
Ideal for smaller practices
101 - 200 verifications
Regular monthly rate
Great for growing practices
Over 200 verifications
Contact us for a personalized plan, tailored to your practice needs.
Let us handle the verification, so you can focus on what matters most — your patients.
