BOCA / Overview

What is BOCA?

BOCA is Cadmus Labs’ flagship project for developing a new approach to dental benefits.

FROM DIRECT TO PRIME

BOCA Direct has a practical commercial purpose: helping independent dental practices operate their own membership programs. Successful operation could also establish capabilities, evidence, and relationships that make the larger coverage project better informed and better connected to practices and patients.

BOCA Prime is the larger proposal: a machine-coordinated dental coverage system. Its protocol would use verified information and predefined rules to establish eligibility, determine coverage contributions, and carry those obligations through to payment—with human oversight and review built in.

01 / The problem

Dental care has changed. Dental benefits have struggled to keep pace.

For Patients

For many patients, the relationship between what they pay and what they receive has become increasingly difficult to understand. The cost of care continues to rise, benefits often remain limited, and more of the financial responsibility falls directly on the patient.

For Practices

Dental practices experience the same system from the other side: navigating complex benefit rules, verifying coverage, managing claims, and resolving payment issues. At the same time, insurance reimbursement has not kept pace with the rising cost of providing care. Coverage decisions can also complicate treatment conversations: what a plan will pay for is not the same question as what care a patient needs.

If we were designing dental benefits today, what would we intentionally build differently?

What BOCA would build differently

BOCA starts by breaking dental coverage down into the functions the system actually has to perform. Eligibility has to be established. Clinical information has to be verified. Coverage and financial responsibility have to be determined. Payments have to be made. Those functions are necessary. The layers of interpretation, handoffs, reconciliation, and institutional machinery that have accumulated around performing them can be reconsidered.

Designing the system today also means we can build with capabilities that were unavailable or impractical when much of the existing system took shape. Rather than modernizing individual pieces of an inherited structure one at a time, BOCA proposes rebuilding these functions together as a coordinated, interoperable architecture.

Think of the difference between renovating a century-old building and designing a new one from the ground up. An old building can be upgraded with modern electrical systems, plumbing, climate control, networking, and automation, but every improvement has to work within a structure designed for another era. A new building can be designed around today’s materials, technologies, and capabilities from the beginning. Its structure and systems can be planned together—changing what needs to be built, how the pieces connect, and what complexity can be eliminated altogether.

BOCA has that same opportunity with dental coverage. Artificial intelligence, digital identity, privacy-enhancing technologies, cryptographic verification, programmable systems, blockchain, and modern financial rails are all advancing rapidly. Cadmus is developing proprietary capabilities within that environment as well, including Rootprint and DentAI. BOCA can be designed around what these technologies make possible from the beginning, with each capability developed in relation to the others and to the specific job the system needs it to perform.

That matters because an advance in one part of the system can change what another part needs to do. If information has already been reliably verified, the next participant may not need to verify it again. If a required fact can be proven without revealing the sensitive information behind it, less private information needs to move through the system. If predefined conditions have been satisfied, programmable rules can determine what happens next. Selected rules, actions, and financial activity can be made independently verifiable, giving participants a way to confirm what the system did and why. Each completed step can leave the next step with less work to do.

The same redesign can extend to the economics of coverage. When unnecessary work, duplication, and administrative friction are removed, the resources they consumed become available for other purposes. BOCA is being designed to create a clearer path for that value to strengthen the coverage relationship itself—through more useful benefits, stronger financial reserves, more reliable payment, sustainable provider economics, and ultimately more resources available for care.

And the architecture can address a problem that becomes increasingly important as institutions grow: who controls the system, who can change its rules, and how those changes can be trusted. Important rules and changes can be made more visible and verifiable. Governance can define who has authority to change them, how that authority is exercised, and where participants should have a meaningful voice. Accountability can therefore be designed into the machinery of the system from its beginning, rather than depending solely on the future behavior of whoever happens to operate it.

02 / BOCA DIRECT — THE FIRST BUSINESS

Start with useful membership software.

BOCA Direct is being developed to help independent dental practices create, operate, and grow their own membership programs.

A practice can create a membership program on its own. Keeping it running means collecting payments, tracking benefits, managing renewals, and staying in touch with members. As participation grows, that recurring work grows with it. BOCA Direct is being developed to bring those responsibilities into one system, making the program easier to operate and more practical to grow.

A practical option for patients.

A membership creates a direct relationship around defined care and benefits. The practice sets its offering; Direct helps manage the recurring work.

Explore BOCA Direct

03 / Why the sequence matters

Direct creates the foundation for what comes next.

FIRST PRODUCT · IN DEVELOPMENT

BOCA Direct

Commercial software for membership operations.

A PRACTICAL FOUNDATION

Operating capability and experience

Working systems for enrollment, billing, benefit administration, renewals, communication, and other recurring membership operations.

Evidence from real operations

Appropriately permissioned information about pricing, benefit use, retention, payments, and how membership programs perform in practice.

Relationships with practices and members

Direct relationships that can provide feedback, expose real operating needs, and create opportunities for voluntary participation in future research and development.

PROPOSED COVERAGE MODEL

BOCA Prime

A better-informed starting point for developing and testing a different approach to dental coverage.

WHY THIS FOUNDATION MATTERS

BOCA Direct does not have to prove BOCA Prime for this strategy to create value. A successful standalone business can establish operating capabilities, real-world evidence, and relationships that are difficult to create through research and modeling alone. Those assets can challenge assumptions, reduce uncertainty, and give the larger coverage project a stronger foundation from which to develop.

Using BOCA Direct would not enroll a practice or patient in BOCA Prime. Any research participation would require separate permission. Evidence and experience from Direct may inform Prime’s development, while Prime’s coverage economics, legal structure, safeguards, and other core assumptions would require their own assessment and validation.

04 / The wider ambition

Reconsider the structure of coverage.

BOCA Prime

BOCA Prime is Cadmus Labs' effort to give patients and dental practices a financial answer they can understand and rely on before care begins, then carry that determination into payment with less unnecessary friction and overhead cost.

Its larger aim is to keep more of what people already pay available for care and help make dental care more accessible and affordable.

Explore BOCA Prime

Architecture

Rootprint™, DentAI, Rootline, authorized agents, financial infrastructure and governance explore the capabilities that could support BOCA and potentially create value beyond it.

Each capability grew from a problem the larger BOCA architecture needed to solve. Together, they extend the project beyond coverage alone.

Explore Architecture

How can participants remain represented?

As a system grows, new rules, exceptions, and approval steps can accumulate. Financial pressures, leadership changes, and competing interests can add layers of administration without removing the old ones.

Over time, the needs of the institution itself can begin to compete with the needs of the people it was created to serve.

BOCA is being designed with that risk in mind. When coverage rules are clear and established in advance, fewer decisions have to depend on an administrator interpreting those rules after the fact. Where those rules can be executed reliably by the system itself, routine determinations can happen faster and with fewer opportunities for delay, repeated review, or unnecessary back-and-forth between the patient, practice, and coverage system.

Verifiable records can allow patients and practices to see that the relevant rules were actually followed. Privacy-enhancing technologies can give people greater control over what information they share and who can access it. Governance can establish how important rules are changed, who has the authority to change them, and where patients and dental practices should have a meaningful voice in decisions that affect them.

The goal is to give patients and dentists more control over their relationship with each other and reduce how often an intermediary needs to stand between them. The coverage system still has real responsibilities: protecting shared resources, verifying legitimate requirements, applying coverage rules, preventing abuse, and meeting its financial obligations. BOCA is being designed to perform those responsibilities with less friction, less repeated negotiation, and fewer opportunities for the system itself to become an obstacle to care.

The coverage system should be a responsible steward of the resources entrusted to it while making it easier for patients and dentists to understand what support is available and move forward with care. Its rules and safeguards should protect the system without creating unnecessary delay, uncertainty, or conflict between the people seeking care and the people providing it.

See how the work advances

Roadmap Research