Auto-assignment gives you the panel, but the introduction never follows at scale. Claro bridges the gap — cleaning your data and turning passive assignments into the revenue your practice has already earned.
Turning assigned rosters into active appointments.
When a Medicaid member does not choose a dentist within 30 days of enrollment, the DMO uses a system-generated auto-assignment algorithm to designate a dental home. The assignment happens. The personal introduction rarely follows.
This is not a recall problem. Your front desk cannot reach these patients because most of them have never generated a chart. They are invisible to your system because they were never in it.
Because members can update their dental home assignment at any time by calling their DMO, the roster you receive on the first of the month reflects assignments that may already have changed. Claro solves both problems — stale data and the missing introduction.
"Members who receive dental services through a Medicaid managed care dental plan are required to select a primary dentist who serves as the client's dental home and is responsible for providing routine care, maintaining continuity of patient care, and initiating referrals for specialty care."
In plain terms — most of these patients were placed on your panel through a system-generated process. The assignment happened. The introduction did not. They are not avoiding you. They simply do not know you exist as their dental home. Claro makes that introduction.
Source: Texas Managed Care Quality Strategy, Texas Health and Human Services Commission, September 2024
That is not a patient behavior problem. It is a connection problem. Your medical patients trust you. They show up. They have an active Medicaid benefit that includes dental. The introduction was simply never made.
Claro contacts your established medical patients, identifies open care gaps — dental, well-child visits, THSteps checkups, preventive screenings — and schedules as many as possible from a single call. One family trip to your site. Multiple providers. Multiple PPS encounters billed at your confirmed HHSC rate. Every gap we close in that call is revenue your organization was already entitled to capture.
Your HRSA UDS dental utilization ratio improves in the process. The EQRO Annual Technical Report for SFY 2024 identifies improving dental access as an active quality improvement priority across all Texas DMOs — which means your UDS improvement shows up in grant scoring and site reviews.
Program economics calculated using your confirmed HHSC PPS rate — specific to your organization. We calculate your actual revenue opportunity before any engagement begins.
All financial projections are illustrative. Revenue calculated using each client's confirmed HHSC PPS rate at time of engagement.
Fixed program management fee invoiced monthly against completed encounters confirmed in your own system. Not a percentage of Medicaid reimbursement. Not tied to claim submission or claim payment.
We built Claro to put payer-side intelligence to work for providers — because we know exactly where the Invisible Patients are and why standard outreach never reaches them.
Michelle spent 25 years on the plan side of Texas Medicaid — including as CEO of a statewide Texas Medicaid dental plan. She tracked assigned panels, measured utilization gaps, and worked with dental providers across all 254 Texas counties to understand why members who had a benefit and a dental home were not showing up. She knows exactly what your Invisible Patient problem looks like from the other side of the table. She built Claro to ensure providers finally capture the full value of the panels they have worked so hard to earn.
Former Associate Director of Provider Strategy & Network Performance for Texas Medicaid. Spent his career as the central point of contact for dental and medical practices across Texas — negotiating APM contracts, tracking encounter data, and seeing firsthand where the gap between assigned panels and actual utilization lives. Has seen the Invisible Patient problem from both sides of the table. Native Spanish speaker, San Antonio-based, with deep community relationships across Bexar County and the Rio Grande Valley.
We start with a free Panel Opportunity Report — no commitment, no pitch. Just a clear picture of how many assigned Medicaid and CHIP members have never heard from you, and what bridging that gap is worth to your organization.
No upfront cost. No commitment. No technology to install.