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 a 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.
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