OrthoFi Review

---

What Is OrthoFi?

OrthoFi is an orthodontic revenue cycle management (RCM) platform that handles the financial side of running an ortho practice. The company's pitch is straightforward: let OrthoFi handle insurance verification, contract creation, payment processing, billing, and collections so your team can focus on clinical care.

The platform operates on a fundamentally different model than traditional practice management software. Instead of selling you software and leaving you to figure out billing, OrthoFi combines technology with dedicated human teams who actively manage your revenue cycle. Every practice gets assigned account managers, insurance specialists, and patient billing representatives who work as an extension of your team.

The 2020 merger with OrthoBanc was transformative. OrthoBanc was the leading orthodontic patient financing platform, and combining it with OrthoFi's patient start and insurance management created a single platform that covers the entire financial journey from initial consultation through final payment. The combined entity, backed by private equity firm Accel-KKR, now serves as the largest integrated orthodontic financial management platform in the industry.

---

Who Is It For?

OrthoFi is built exclusively for orthodontic practices. The platform targets:

• Practices struggling with case acceptance rates who want to present more flexible payment options without taking on the financial risk
• Offices overwhelmed by insurance complexity who want specialists handling verification, claims, and appeals
• Growing practices and DSOs that need scalable financial operations without proportionally growing their administrative staff
• Orthodontists who want to offer affordable payment plans without becoming a bank

The platform is particularly strong for practices that have been managing billing and collections in-house and are hitting a ceiling. OrthoFi's model essentially outsources your financial back office while giving you better tools and data than you could build internally.

---

Key Features

Patient Start Optimization: OrthoFi's patient start workflow presents treatment options and payment plans on an iPad at the consultation. The system calculates what each patient can afford based on insurance benefits, financing options, and practice policies, then presents customized payment plans that maximize case acceptance. Practices using OrthoFi report acceptance rates above industry averages.

Insurance Management: Dedicated insurance specialists handle verification, claims submission, tracking, and appeals. This is not software-only -- actual people work your insurance on your behalf. The platform supports real-time eligibility verification and automates much of the claims workflow while human specialists handle exceptions and appeals.

Payment Processing and Collections: Integrated payment processing with automated recurring billing, payment reminders, and collections workflows. The OrthoBanc merger brought sophisticated patient financing capabilities including flexible payment plans with extended terms. OrthoFi handles the entire payment lifecycle from initial contract through final payment.

Revenue Cycle Analytics: Dashboards and reporting that track production, collections, accounts receivable aging, insurance claim status, payment plan performance, and practice financial health. The analytics help practices identify revenue leaks and optimize financial performance.

Treatment Coordinator Tools: Scripted presentation workflows, real-time insurance benefit display, and customizable payment plan options help treatment coordinators close cases more effectively. The iPad-based presentation creates a professional, transparent financial conversation with patients and families.

Multi-Location Support: Centralized financial management across multiple practice locations with standardized workflows and consolidated reporting. DSOs can maintain consistent financial policies while allowing location-level customization.

---

Pricing

OrthoFi uses a revenue-share model rather than a flat monthly subscription. The company typically takes a percentage of the collections it manages through the platform. Exact percentages are not publicly disclosed and likely vary based on practice volume, the scope of services used, and contract terms.

This pricing model aligns OrthoFi's incentives with the practice's success -- they make more money when you collect more money. But it also means that high-volume practices are paying significantly more than they would for a flat-fee software subscription. For a practice doing $2 million in annual collections, even a small percentage represents a meaningful dollar amount.

The counterargument is that OrthoFi's services replace multiple in-house positions (insurance coordinator, billing specialist, collections staff) and the revenue increase from improved case acceptance and collection rates more than offsets the revenue-share cost. OrthoFi claims their practices see measurable improvements in both metrics.

---

Pros

• End-to-end revenue cycle management built specifically for orthodontics
• Combines software with dedicated human specialists for insurance and billing
• Patient start workflow demonstrably improves case acceptance rates
• Merger with OrthoBanc creates the most comprehensive ortho financial platform
• Revenue-share model aligns vendor incentives with practice success
• Manages $7B+ in annual production across 700+ practices
• Scales well for multi-location groups and DSOs
• Takes insurance complexity off your team's plate

Cons

• Revenue-share pricing means high-volume practices pay a lot
• Less control over financial workflows compared to managing in-house
• Some practices report feeling locked in once they adopt the platform
• Transition period can be disruptive as workflows change
• Not a full PMS -- still need Dolphin, Ortho2, or Cloud 9 for clinical management
• Pricing is not transparent -- requires a sales conversation
• Dependency on OrthoFi's team means your financial operations are only as good as their staff

---

The Bottom Line

OrthoFi is the closest thing orthodontics has to a turnkey financial back office. The combination of purpose-built software and dedicated human specialists creates a revenue cycle management solution that no practice could replicate internally without hiring an entire team. The patient start workflow, insurance management, and integrated payment processing address the three biggest financial pain points in orthodontics.

The revenue-share model is the dealbreaker for some practices. If you are running a high-volume, high-efficiency operation with a strong internal billing team, paying OrthoFi a percentage of your collections may not pencil out. But for practices where insurance is a mess, case acceptance is below 70%, or the office manager is drowning in billing work, OrthoFi can transform your financial performance.

With 700+ practices, $7 billion in managed production, and Accel-KKR backing, OrthoFi has the scale and resources to be a long-term partner. This is not a startup that might disappear -- it is the market leader in orthodontic revenue cycle management, and the OrthoBanc merger cemented that position.