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.
Luis Estrada spent nearly two decades in Texas Medicaid provider relations, working directly with the practices that deliver care across the state. A native Spanish speaker, he brings the provider-side fluency required to make assigned-member activation work at the practice level.
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.