What Is Toothy AI?
Toothy AI builds AI agents that automate dental revenue cycle management from end to end. The system connects to your practice management software (in under two minutes, according to the company) and takes over the workflows that currently eat up your back office team's entire day: verifying insurance eligibility and benefits, filing claims with proper attachments and clinical remarks, processing EOBs, posting payments, managing denials, generating appeals, and following up on aging accounts.
The most technically impressive piece is the voice AI that actually calls insurance companies. Anyone who has worked a dental front desk knows that insurance verification means sitting on hold for 20-45 minutes per call, navigating automated phone trees, and reading CDT codes to a human representative. Toothy's AI agents handle those calls autonomously, gather the eligibility and benefits information, and update the PMS automatically.
Founded by Tejas, Matthew Kerrigan, and CEO Johnny Chen, Toothy was part of Y Combinator's Winter 2025 batch -- which means it passed YC's rigorous selection process and has access to the network and funding that come with it. The company claims its AI agents save practices 160+ hours per month and increase revenue by 5-10%.
Who Is It For?
Practices struggling to hire back office staff: The dental industry has a well-documented staffing shortage that extends beyond clinical roles. If you cannot find or keep good billing staff, Toothy replaces the need rather than competing for scarce talent.
Offices drowning in insurance verification calls: If your front desk spends 2-4 hours per day on the phone with insurance companies, Toothy's voice AI directly targets that time sink. The AI makes the calls, gathers the data, and updates your PMS.
Practices with high claim denial rates: Toothy's claims filing includes optimized clinical remarks and proper attachment handling, which should reduce denials. When denials do happen, the AI generates appeals and follows up automatically.
DSOs looking to centralize RCM: AI-powered RCM scales across locations without hiring proportionally more billing staff. The economics improve with each additional practice.
Any practice that wants to reduce administrative overhead: Toothy's pitch is simple -- 160+ hours saved per month and 5-10% revenue increase through better verification, cleaner claims, and faster follow-up. If those numbers hold, the ROI is obvious.
Key Features
AI Insurance Verification: Voice AI agents call insurance companies, navigate phone trees, talk to representatives, gather eligibility and benefits information, and update the PMS automatically. This is not screen-scraping a portal -- it is making actual phone calls with conversational AI.
Automated Claims Filing: Files claims with proper CDT codes, required attachments, and optimized clinical remarks. The AI learns your practice's specific processes and adapts its outputs to match your preferences.
EOB Processing and Payment Posting: Processes Explanation of Benefits documents and posts payments directly into the PMS. Eliminates the manual data entry that creates errors and delays.
Denial Management and Appeals: Identifies denied claims, determines the reason, generates appeal letters, and follows up on aging accounts. Turns denial management from a reactive scramble into an automated workflow.
Two-Minute PMS Connection: Connects to your existing practice management software quickly with no complex interfaces or lengthy training. The system adapts to your PMS rather than requiring you to change workflows.
Learning and Adaptation: The AI learns your clinic's specific processes, preferences, and payer quirks over time, improving accuracy and efficiency with use.
Pros
- Automates the full RCM cycle including voice calls to insurance companies
- Saves practices an estimated 160+ hours per month
- Connects to PMS in under two minutes with minimal setup
- Y Combinator-backed with access to top-tier talent and funding
- Early customers report early customers report potential reductions of 50-75% in back office staffing needs, though this has not been independently verified needs
- AI learns and adapts to each practice's specific workflows and preferences
Cons
- Very early-stage company (founded 2024) with limited track record
- No public pricing -- hard to evaluate cost before talking to sales
- AI calling insurance companies is cutting-edge but unproven at scale
- Unclear how many PMS integrations are currently supported
- Dependent on continued funding and company survival as a startup
- May face resistance from staff worried about job displacement