DenQAI decision lab

Payer offer comparison

Compare allowed amounts code by code using actual volume, collection probability, direct cost, and chair time.

Use this ifYou need to test an assumption before spending money, signing a contract, or treating a composite score as an answer.

DecisionIdentify the viable path, the downside case, the assumption that breaks it, and the next diligence request.

Evidence neededUser-entered records, source dates, verification states, actual contract and schedule data, provider activity, procedure history, staffing, and cash timing.

Work productA transparent calculation with exposed formulas, limitations, stop-and-verify conditions, and a printable decision record.

Method, stop-and-verify condition, and required review

Method: Use ranges and scenario stress; keep illustrative defaults separate from user data; never let a composite score override a non-negotiable gate.

Stop and verify: Do not treat results as an appraisal, diagnosis, legal conclusion, coding source, lender approval, or substitute for primary records.

Human review: Buyer, dental CPA, lender, counsel, clinical reviewer, benefits specialist, and operator according to the calculator.

Last reviewed: July 24, 2026

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Calculator 04

Insurance fee-schedule comparator

Do not judge a network by a headline discount. Weight every offered code by the practice’s real utilization, collection, time, and direct cost—and read the contract that controls how claims are processed.

Admin cost per submitted claim$Expected collection of allowed amount%Target contribution per chair hour$

Import CSVDownload template

Use the template headers for the cleanest import.

Offer / office	Annual change	Contribution / chair hr.	Signal
—	$0	—	Enter data
—	$0	—	Enter data
—	$0	—	Enter data

Weighted offer / office fees—

Offer vs. current annual revenue$0

Modeled cash after collection$0

Contribution after direct + admin cost$0

Weighted contribution / chair hour—

Annual modeled units0

Fee schedule questions

Which codes drive the most total revenue and write-off?
Are preventive codes attractive while high-cost or high-time services are deeply discounted?
Does the offered schedule beat the current contract after real utilization?
What access, wait-time, location, or patient-volume leverage can be documented?

Contract questions

Bundling, downcoding, LEAT, alternate benefits, and non-billable policies
Network leasing, silent PPO access, most-favored-nation terms, and plan hierarchy
Unilateral amendments, notice, termination, appeals, audits, recoupments, and records
Noncovered-service limits, assignment, virtual-card fees, and credentialing after a sale

Use licensed data and code only what the record supports.

CDT content is copyrighted. This tool does not ship code descriptions; upload the fee schedule and utilization data your practice is authorized to use. AI can compare, rank, and identify questions. The dentist remains responsible for diagnosis, documentation, coding, and compliance.

ADA fee negotiation guide Read the benefits chapter

Method, not magic

Every output should create a diligence request.

01Reconcile

Use adjusted production, collections, units, provider days, patients, and source reports. One percentage cannot carry the conclusion.

02Segment

Separate provider, procedure family, payer, patient cohort, and month. A blended average can hide the exact thing the buyer will lose.

03Stress

Run buyer-fit, staff-loss, no-show, denial, wage-reset, and entrant cases. Record the case that breaks the deal.