Provider FAQ

No. Toothsome is additive to your practice. You can continue participating with all your existing insurance networks and payers. Think of Toothsome as another payment option for a growing segment of patients.

You need to be a licensed dental provider in good standing. We'll verify your credentials, NPI, and practice information. The onboarding process typically takes 5-10 minutes to complete.

No exclusive contracts. You can join or leave the network at any time. We believe in earning your participation through value, not locking you in with long-term agreements.

Our fee schedule is based on fair market rates at the 70th percentile for your geographic region — not discounted insurance schedules. Rates are transparent and published upfront. You'll always know what to expect before treating a Toothsome patient.

You're paid at the visit. The patient pays you directly, just like any other patient. There's no claim to submit and no waiting period. The patient handles the reimbursement on their end through the Toothsome app.

When you join the network, you agree to our fee schedule based on the 70th percentile for your region. You can charge less than the fee schedule rate, but not more, for Toothsome patients. Rates are transparent and published upfront so there are no surprises.

No platform fees during our launch phase. There are currently no per-transaction fees, no monthly fees, and no hidden costs for providers. Since patients pay you directly at the visit, there's no payment processing on our side either.

Patients can show you their Toothsome app or digital wallet card. You can also verify their coverage through our provider portal. Many patients will mention Toothsome when scheduling their appointment.

Never. There's no pre-authorization requirement for any procedure with Toothsome. Provide the care you recommend, collect payment from the patient, and give them an itemized receipt. No waiting for approvals, no surprise denials.

You don't submit anything. The patient pays you directly at the visit. You provide them with an itemized receipt (including CDT procedure codes and fees), and the patient submits it to Toothsome through their app for reimbursement. No claim forms, no narratives, no X-ray attachments from your side.

The patient's wallet pays what it can, and the patient pays you the difference directly. You can see the patient's available balance when you verify their coverage, so you'll know the split before treatment begins.

Patients can use their wallet for any dental care. Medically necessary procedures (IRS Section 213(d) eligible) are tax-advantaged through the HRA. Cosmetic procedures may also be covered depending on the employer's plan, but with different tax treatment. There are no waiting periods or frequency limits — the only limit is the patient's available wallet balance.

We're working on integrations with popular practice management systems. Currently, patients submit their own receipts through the Toothsome app. Your main interaction is through the provider portal for verifying patient wallets and managing your listing. If you have a specific integration request, let us know.

Our provider support team is available via email, phone, and chat. We aim to respond to all inquiries within one business day. You'll also have a dedicated onboarding contact to help you get started.

Since patients pay you directly, you track payments through your normal practice management workflow. Your Toothsome provider portal lets you see which patients are in the network, verify wallet balances, and view your listing in our provider directory.