Sally is your practice’s supervised AI insurance and operations employee. She prepares the morning huddle, works pre-authorizations, protects revenue, and writes approved results back into the practice-management system your team already uses.

Does Sally write completed work back into the PMS?

Yes. Sally re-reads changing PMS facts before critical actions, runs a preflight check, gets human approval when required, writes the approved result into the PMS, confirms the write landed, and shows the team an auditable receipt with undo for reversible changes.

How does Sally handle uncertain insurance information?

Sally never turns stale coverage or an unconfirmed patient fact into a confident answer. When she needs a current source response, a confirmed card detail, or a human approval, she hands that boundary to your team instead of guessing.

Comparison · Oct 30, 2026

Portal verification vs the 271

A 271 answers one question well: is this coverage active? Dental treatment decisions need different answers — what this procedure pays for this tooth, given this patient's history, clauses and remaining maximum. Those facts live in the payer portal. They are mostly absent from the electronic response, which is why “verified” patients still produce denials and write-offs.

Fact	271 (EDI)	Payer portal
Coverage active / inactive	Yes — its core job	Yes
Annual maximum & deductible remaining	Often, varies by payer	Yes, from the payer's own record
Procedure-level (CDT) coverage %	Category-level at best	Yes, per scheduled code
Tooth-level benefits	No — the 271 has no tooth segment	Yes where the portal exposes it
Frequency limits vs procedure history	Stedi's own reliability table: dental “sometimes”	Yes, checked against history
Missing-tooth / replacement clauses	Not typically returned	Yes
Waiting periods	Not typically returned	Yes
Downgrades (e.g. composite → amalgam rate)	Not typically returned	Yes
Treatment history affecting this visit	No	Yes where the portal exposes it
Typical transaction cost	$0.08–$0.30 per check (Stedi published pricing)	Replaces a 12–20 minute staff task (CAQH manual cost $6.52/transaction)

What this means in dollars

EDI checks cost pennies ($0.08–$0.30 at Stedi's published tiers) because they replace a $2.53 electronic transaction (CAQH Index). A manual benefits breakdown — the work a portal verification replaces — takes staff roughly 12–20 minutes and is exactly the work busy front desks skip, downgrading verification to a seconds-long active check. Each denied claim that follows costs $25–$118 to rework (HFMA/MGMA), before the write-offs that never get worked at all. Sally prices the two answers separately: $1.25 for the electronic answer, $5.99 for the portal-verified visit — see the full price card.

Is a 271 response enough to quote a patient's out-of-pocket cost?

Usually not for planned treatment. The 271 confirms eligibility and some benefit amounts, but procedure-level detail — frequencies, clauses, downgrades, tooth-level rules — is typically absent, which is why offices still fall back to payer portals and phone calls before quoting treatment.

Why is portal verification priced higher than an EDI eligibility check?

They replace different work. An EDI check replaces a $2.53 electronic transaction (CAQH Index) and answers whether coverage is active. A portal verification replaces a 12–20 minute manual benefits breakdown and prevents the write-offs that follow clause and frequency surprises. Denied-claim rework alone runs $25–$118 per claim (HFMA/MGMA).

When is the cheap electronic check the right tool?

For active/inactive screening at volume — recall lists, schedule hygiene, coverage discovery. Sally sells that tier too ($1.25). Planned treatment with money attached deserves the portal answer.

Sources (retrieved Oct 2026): Stedi 271 reliability guide and published pricing; CAQH Index transaction costs; HFMA/MGMA denied-claim rework benchmarks; Zuub dental eligibility evaluator guide. Portal capabilities vary by payer; Sally returns what the portal exposes and labels the rest unresolved rather than guessing.