Employer funds
Dental dollars are established for eligible employees.
Employer-funded dental care
Fund dental care.Not claims.
Employers fund the care. Employees choose it. Practices are paid at the chair—no claims, no denials, no PPO write-offs.
Any licensed dentistOne funded walletZero insurance claims
Toothsome PayReady to pay
Treatment plan$1,450
Today
W
Employer-funded walletPatient-selected amount
$1,200
+
HSA or personal cardAutomatic remainder
$250
Practice payment$1,450
One seamless transaction · No claim · No adjudication
Zero deductibleFunded dollars start with care
Zero copay mathThe patient chooses how much to apply
Zero claims burdenNo attachments, denials, or A/R chase
Clinical freedomThe treatment conversation stays in the operatory
Built for employer cash flow
Annual access for employees. Predictable funding for employers.
Employees can use their annual dental allocation when care is needed. Employers fund it through predictable monthly contributions, with automatic top-ups when spending runs ahead of schedule.
Employee experienceA clear annual allocation—not twelve months of waiting.
Employer experienceBounded exposure, scheduled ACH, and real-time
visibility.
Employer funding account25-person example
Maximum annual obligation
$25,000
Scheduled funding base
$2,083/mo
Starter reserve target
$4,166
Monthly ACHFunds only what is needed
→
Employer reserveSettled funds only
Employee allocationAnnual dental dollars
→
Care paymentWallet + personal sources
Payment capacity$3,000 available
Automatic top-ups restore the reserve when spending runs
ahead of the monthly schedule.
Payment at the point of care
Plan presented. Plan paid.
The wallet, an HSA, and a personal card settle in one checkout while the patient is still in the chair. The practice closes the visit paid in full.
Practice checkoutFunded patient
Crown · Tooth #14$1,450
Toothsome wallet−$1,200
HSA or personal card−$250
Paid in full · Today✓
No claim was created.
Eligibility appears
The practice confirms Toothsome during its normal intake flow.
Dentist recommends
The treatment plan reflects clinical judgment—not payer rules.
Patient chooses
The patient applies the funded amount they want to use.
Practice gets paid
Wallet, HSA, and personal funds become one transaction.
For practices · Insurance takes more than the write-off
How much do you pay to get paid?
The hidden bill arrives after the patient leaves: staff time, attachments, vendors, denials, delayed cash, and a payer second-guessing the treatment plan.
The write-off
A discount taken before the first claim is even touched.
The work
Eligibility, coding, attachments, follow-up, resubmission, and reconciliation.
The wait
Care is delivered today. Payment becomes an uncertain future event.
Toothsome removes all three.
Known dollars. Patient choice. Payment connected directly to care.
For dentists
Deliver care. Not claims.
Toothsome takes the practice off the claims treadmill: a funded patient and a direct payment at the chair.
Apply to join Toothsome DirectNo insurance administration
No prior authorization packet, radiographs for a payer, denial follow-up, or claims-driven receivables chase.
Clinical autonomy
You diagnose and recommend. The patient decides. Toothsome does not rewrite the treatment plan.
Transparent economics
Participating practices see and accept their payment schedule before treating Toothsome patients.
Funded patients
Employees arrive with employer dental dollars ready to move into care.
You already did the dentistry. You should not have to keep working
to get paid.
Dentistry belongs in health
The dental visit becomes a front door to whole-person care.
The sickest 5% of a covered population drive half of its medical spend—and many of them avoid the doctor. They still show up when a tooth hurts.
That visit is the opening. Medical-dental intelligence builds on direct payment: oral findings meet medical risk, the right funded intervention is surfaced, and the member is connected back to their own medical home—so employers, health systems, and accountable-care organizations can measure what happened next.
The diabetic who hasn't seen a physician in two years still books
the appointment for tooth pain.
Spend concentration: AHRQ Medical Expenditure Panel Survey.
01
Risk identified
Medical and dental context meet
Medical and dental context meet
02
Care activated
The right dental intervention is surfaced
The right dental intervention is surfaced
03
Benefit applied
Employer dollars move into care
Employer dollars move into care
04
Impact measured
Oral health reconnects with total health
Oral health reconnects with total health
The difference
Dental benefits without the insurance machinery.
Keep the benefit.
Skip the claims.
Fund care · Preserve choice · Pay practices directly
Traditional PPO Illustrative crown
Practice fee$1,350
PPO write-off−$540
Allowed amount$810
RCM overhead−$170
Practice receives$640
With Toothsome Illustrative direct payment
Accepted direct price$1,150
Contractual write-off$0
Payment processing−$34
RCM overhead$0
Practice receives$1,116
Illustrative example only. Actual practice fees, accepted Toothsome prices, administrative costs, and payment-processing costs vary.
Traditional PPO
Toothsome
How the practice gets paid
Claim and adjudication
Direct checkout
Clinical review
Payer rules and documentation
Dentist + patient
Patient cost
Deductible, copay, exclusions
Funded wallet + chosen remainder
Practice economics
Write-off + RCM overhead
Known payment before care
Employer value
Premiums pay for machinery
Dollars follow delivered care
For advisors and consultants
A dental strategy worth bringing to renewal.
Give clients an alternative when traditional dental plans feel expensive, stagnant, and hard to use—without asking them to fund the entire annual maximum on day one.
Build a client pilot →A differentiated benefit story
Employer dollars become visible dental value instead of disappearing into premiums and adjudication.
A bounded way to begin
Define the population, annual allocation, funding cadence, reserve, and replenishment authority before launch.
Evidence buyers can use
See where dollars went, which care was delivered, and where oral health can influence total health.
Straight answers
What buyers and practices ask first.
Is Toothsome dental insurance?
No. Toothsome is an employer-funded dental care platform. Employers establish dental dollars for eligible employees; Toothsome connects eligibility, payment, and required benefit administration without introducing a traditional dental carrier or PPO claims workflow.
Can employees choose their dentist?
Yes—any licensed dentist. There is no network to stay inside. At a participating practice, the visit ends with direct checkout at the chair: the practice has already seen and accepted its Toothsome payment schedule, so there is nothing to adjudicate. At any other dentist, the employee pays the practice's usual fee from their funded wallet. Either way, the dentist—not a payer—decides what to recommend.
Does a practice have to sign up to treat Toothsome patients?
No. Any licensed dentist can be paid by a Toothsome patient without signing anything. Practices that want direct checkout at the chair, a known payment schedule, and visibility into funded patients enroll as participating practices—there is no fee to do so.
What does Toothsome cost the dentist?
Nothing. There is no dentist subscription, onboarding fee, or Toothsome platform fee. Toothsome earns its fee from the employer as care is delivered.
How does the employer fund it?
The employee receives an annual dental allowance. The employer uses scheduled funding and an employer-specific operating reserve, with automated monitoring and replenishment as care is delivered.
Where does medical-dental intelligence fit?
It turns dentistry into an activation point for whole-person health. Toothsome can connect evidence-supported dental interventions to medical risk and help employers, health systems, and ACOs measure what happens next.
Who is behind Toothsome?
Toothsome was founded by Dr. Samy—Shouvik Ponnusamy, DMD—a board-certified oral and maxillofacial surgeon who treats the most severe end of dental disease: head and neck space infections that lead to ICU admissions and hospital operating rooms. Read more about why Toothsome exists →
Start a conversation
Fund care. Free dentists.Connect oral health to whole health.
Employers — scope a bounded pilot: population, annual allocation, funding cadence.
Practices — see the payment schedule before you treat a single Toothsome patient.
Advisors — bring a differentiated dental story to renewal.
Health systems, ACOs, partners — connect dental visits to measurable medical outcomes.