An agentic, human-in-the-loop system that runs the dental insurance and claims lifecycle end to end — working alongside the practice's Open Dental, not replacing it.
SanctifAI Dental automates the part of a dental practice that quietly leaks the most money: insurance. It mirrors how a trained billing coordinator works — verifying coverage before treatment, assembling and submitting clean claims afterward, and chasing every payment, denial, and ERA until the loop is closed.
It's built as part of SanctifAI's human-in-the-loop approach — autonomous where it's confident, and escalating to a person the moment a decision needs human judgment.
Three processes run continuously, triggered by real events in Open Dental. Together they form a closed insurance loop — coverage in, claim out, payment reconciled.
When an appointment is scheduled or confirmed in Open Dental, SanctifAI verifies insurance and pulls coverage — deductibles, annual maximums, benefit usage — so treatment planning and estimates run on current data. Missing or ambiguous data is flagged for human review rather than guessed.
Once treatment is finalized, it assembles the claim package — procedure codes, clinical notes, narratives, and supporting documentation — validates completeness, and submits through the clearinghouse. If something's missing it tells staff exactly what to fix, then resubmits automatically once resolved.
After submission it watches outcomes: ingesting claim responses and ERAs, determining paid / partial / denied / rejected, routing denials into corrective workflows, preparing resubmissions, and monitoring stalled claims so A/R never ages silently.
Subscribes to Open Dental webhooks and API for appointment and treatment events, and reacts in real time. Integration-first by design — it observes and augments the practice management system instead of replacing it.
Agents reason over practice events and act on them — built on the Vercel AI SDK with Claude — escalating to a human the moment a decision needs judgment, exactly like a trained billing coordinator would.
A Model Context Protocol server exposes Open Dental to the agents through a clean tool interface, including foreign-key traversal so an agent can follow relationships across practice records safely.
Real-time benefit checks flow through STEDI; claims and remittance move through the Vyne clearinghouse as 837D submissions and 835 ERA responses.
Automation logic is kept out of the PMS entirely. The integration layer scales independently as new workflows are added, with no business logic coupled into Open Dental.
A Node.js + Express (TypeScript) backend and a Vite + React console, run under PM2 in production with a single server serving the compiled app and all API routes.
SanctifAI runs alongside Open Dental rather than ripping it out — lower risk to adopt, and the practice keeps its system of record.
Every step supports human review, and the agents escalate whenever data is missing or a call needs judgment. Automation assists the team; it doesn't replace accountability.
Claims are tracked from eligibility through payment. Nothing stalls silently — denials are routed to correction and aging claims are surfaced.
Completeness is validated before submission and corrections are guided precisely, cutting the preventable rejections that drain a practice's revenue cycle.
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