Who uses this tool
Billing managers, front office staff, and RCM directors use PayorMap's claim routing tool to quickly answer the most common billing question: which network will this claim route through?
🦷 Solo & Group Practices
Identify silent PPO exposure before you see a lower-than-expected EOB. Know which umbrella network is paying your claims before you sign anything.
🏢 DSOs & Multi-Location Groups
Standardize routing knowledge across your billing team. Stop relying on institutional memory when a biller leaves — the answer is here in seconds.
📋 RCM & Billing Companies
Train new billers faster. Answer payor routing questions for clients without calling the payor. Catch silent PPO situations before they become denial patterns.
Frequently Asked Questions
What is dental claim routing?
Dental claim routing refers to the network path a claim takes from your practice to the paying entity. When a patient has MetLife insurance, for example, their claim might route through MetLife's direct network, a leased umbrella network like Conexis or MultiPlan, or (in silent PPO situations) a network the provider never contracted with directly. Routing determines your effective reimbursement rate.
What is a silent PPO?
A silent PPO occurs when a third-party claims repricing company accesses your contracted rate through a network leasing arrangement you may not have been aware of. You signed a contract with Network A, but Network B licensed access to your discounted rate without your explicit knowledge. This results in lower reimbursement than you expected.
How accurate are the routing probabilities?
Routing probability estimates are based on PayorMap's independent analysis of publicly available network filings, state insurance regulatory disclosures, and umbrella network leasing data. They represent probabilities, not guarantees — actual routing depends on the specific plan, employer group, and state. Always verify critical routing decisions with your contracted payors.
Is this tool really free?
Yes. Claim routing is free, no account required, forever. PayorMap's paid products — Pro ($79/mo) and Intel ($179/mo) — add rate benchmarking, provider-level data, and CSV exports. But the routing tool will always be free.
What's the routing complexity score?
The complexity score (1–10) reflects how difficult it is to predict claim routing for a given payor with certainty. High scores indicate multiple possible routing paths, leased network involvement, or plan-type dependency. A score of 8–10 means you should verify directly with the payor before assuming a specific routing path.