Retrace, the leader in oral health innovation and authority in dental quality metrics, today announced the launch of its real-time network for oral health providers, payers and patients to deliver instant value-based payments and care. A first for the $156.4 billion U.S. dental market, Retrace’s revolutionary network connects providers and payers to streamline the entire dental patient experience from start to finish, while providing the right incentives to get providers paid immediately.
The solution comes after a turbulent year with the COVID-19 pandemic where providers and practice owners saw as much as a 95% decrease in patient volume, forcing some payers to reimburse premiums. To compound issues, practice owners suffer from costly overhead while facing tremendous administrative inefficiencies, long claim processing times, uncertainty, and inconsistent collections. These challenges keep payers and providers from improving patient satisfaction and practice growth in an industry that is constantly stunted by patient fear and unease.
The Retrace platform leverages AI and infrastructure built specifically for oral health to deliver the following key benefits:
- Instant value-based payments: Retrace helps providers get paid instantly once a patient’s treatment is completed, as opposed to the average 14-180 days it historically takes. The network helps plans achieve up to 98% auto-adjudication rates backed-up by the company’s performance guarantee, regardless of the legacy systems, industry wide. Payers who leverage the Retrace solution are able to optimize payments integrity while simultaneously delivering a delightful member experience. This enables payers to deliver a better customer journey and cut down on administrative and customer service related issues, including call centers resources.
- Provider and Procedure Quality Ratings: Retrace enables the first and only evidence-based quality rating driven by quality metrics to help payers respond to increased emphasis on quality, ensure members have access to the highest quality of care, and payers are able to effectively reward quality outcomes. With a focus on delivering individualized care and precision treatment, rather than a care delivery model through utilization management, Retrace drives healthier oral health outcomes and more affordable care.
- Interoperability: The complex world of dental healthcare administration has traditionally been plagued by a lack of the proper connectivity to the right data sources, exacerbating dental practice overhead, while leaving patients and the employers who pay for care in the dark. Retrace quickly and seamlessly shepherds providers and payers through a complex system of traditionally disparate workflows to ensure the right treatment is delivered at the right time with the proper incentive structures to deliver optimal health outcomes that are rooted in evidence-based practices.
- Administrative efficiency: Retrace’s provider solution features intelligent automation capabilities that take the guesswork out of practice operations and purchasing by connecting the front office to the back office. This helps dental practices be more efficient, and decrease the administrative burden that is typically required to provide a positive patient experience. As a result, providers can more easily grow their business while keeping a strong focus on optimal patient care with the proper incentive structures.
- Transparency: Dental plans are challenged by the volume of incomplete claims that require significant resources from payers to review. This has led to a lack of transparency for patients, who have no easy path to confirm what insurance coverage they have, what proposed treatments from providers are covered and to what extent, and what their payment obligations are for different treatments. Retrace allows providers, payers and patients to quickly understand and align on what procedures are covered, the extent of the coverage, and aid in insurance and patient payments.
“While we are seeing innovation across the healthcare and insurance industries, today’s U.S. healthcare infrastructure isn’t equipped to handle real-time connectivity or support AI technologies to their full extent. We built our AI from the ground up with the right infrastructure to incentivize providers in a simple way to deliver high quality, evidence-based care to help patients,” said Dr. Ali Sadat, Retrace’s CEO and founder. “We are proud of our team and thankful to our partners, world class investors, industry leading advisors, mentors and academic partners at the University of California San Francisco, to have the opportunity to develop the best ways to measure quality standards that deliver the best outcomes for providers, payers and patients.”
The Retrace Network currently connects to over 200 external network connections and is accessible by invitation and referral only to all 200,000+ domestic oral health providers. Providers can request to join and upon referral granted access. Payers can sign up and access the network through the Retrace website at www.retrace.ai.
Founded in 2016, Retrace is the first and only quality based network enabling real-time connectivity between payers, providers and patients to enable instant value-based payments rooted in quality measures. Retrace’s network and Intelligent Automation solutions streamlines the complexity of dental administration for payers, providers and patients, with scalable end-to-end services powered by AI technologies to deliver high quality, simple and predictable healthcare. Retrace’s investors include Intel Capital and SoftBank Ventures Asia.
Retrace is privately held and headquartered in San Francisco, California. To learn more, visit www.retrace.ai.