Pearly Review: Automated Patient Billing for Dental Practices, Pricing on Request

Pearly is Pearly Technology, Inc.’s patient billing software for dental practices and DSOs that sends statements, text and email payment links, payment plans and pre-collection letters for patient balances, and syncs payments with your practice management software (PMS). It works on the patient’s share of the bill. The saved pages don’t describe insurance verification or claims, and pricing is on request after a free 30-day pilot.

Quick verdict

Pearly suits a practice or DSO whose problem is patient balances that sit unpaid after insurance pays. The vendor says it sends statements and text-to-pay links on its own, reads and writes your PMS ledger, and handles card, ACH and payment plan collection through Stripe. Capterra reviewers rate it 5 out of 5, but the sample is tiny and mostly incentivized.

Pearly’s pages don’t describe eligibility checks or claims, so plan on something else for that. Its results figures are the vendor’s own, taken from its own site and customer stories. Before you sign, ask what the pilot will measure, what you pay after it, and whether Pearly connects with your exact PMS version.

Pearly at a glance

Pearly is a patient billing and A/R automation platform from Pearly Technology, Inc., with pricing on request and a free 30-day pilot. It has no FDA listing under the vendor’s name, the vendor says it offers a BAA, and it holds a 5 out of 5 rating from 6 Capterra reviews, all checked October 21, 2026.

What is Pearly?

Pearly is a dental patient billing platform for the part of the bill insurance doesn’t cover. The vendor says it reads your PMS ledger, works out which patient balances qualify for billing, and sends statements and texts with a payment link, followed by more messages, payment plan offers and mailed letters. Two Capterra reviewers say statements or payment notices go out on their own once an insurance payment is posted.

The vendor calls this “rules-based workflows, automatic balance qualification, and omni-channel patient billing engagement.” In plain terms, you set rules for who gets billed and how, and Pearly sends the messages. Patients land on a Pay Portal that checks their identity against your PMS and shows what they owe and why. They can pay by card, Apple Pay, Google Pay, Microsoft Pay or eCheck/ACH, or choose a payment plan.

The connection to your PMS is what Pearly leans on most. Its integrations page says Pearly works at the ledger level, reading procedure codes, adjustments, write-offs, insurance payments and patient balances, and that “A payment posted in Pearly reflects in the PMS ledger, and vice versa.” The vendor says that keeps statements from going out for balances already paid. It also says setup typically takes under 15 minutes of active work, with no data migration.

Pearly sells two versions: one for private practices (“Patient billing & A/R management”) and one for DSOs and group practices (“Enterprise revenue cycle automation”). The home page says 200+ location DSOs and private practices use it and puts the total at 3K+ dental offices. Those figures are the vendor’s.

Key features

Pearly’s features, as its home, all-features, online payments, integrations and pricing pages list them, cover billing workflows, statements, payments, payment plans, mailed letters, reporting and the PMS connection. The vendor’s list:

• Billing and A/R automation: rules-based workflows that decide which balances to bill and send messages by text, email and mail on a schedule
• Digital statements: statements that show what the patient owes and why, with a link to the Pay Portal
• Online payments: pay from your website, a text or an email; cards, Apple Pay, Google Pay, Microsoft Pay and eCheck/ACH by bank login
• Saved cards and recovery: cards on file with automatic updates, retries at set times and failed payment notifications
• Payment plans: in-house plans patients set up themselves, plus membership subscription fees and one-time payments (custom payment plans are an add-on, per the pricing page)
• Letter automation: mailed statements and pre-collection letters triggered at set points (mailed statement automation is an add-on, per the pricing page)
• Reporting: an A/R reporting suite and a group dashboard of revenue cycle metrics
• Ledger-level PMS integration: two-way sync of payments, balances and adjustments; the vendor says Pearly is an Authorized Vendor for Dentrix Ascend
• Patient financing: the demo of the Pay Portal shows a financing option through Sunbit; the saved pages don’t describe it further

Pearly vs. what an insurance and billing tool should have

Pearly meets the PMS write-back and security must-haves, and lists reporting and multi-location support. It doesn’t list eligibility checks, benefit breakdowns, payer connections, estimates or claims, because its pages describe billing patients for what insurance didn’t pay. Our checklist was first written around insurance verification, so the Not listed rows below mark jobs Pearly doesn’t claim to do.

Must have

Should have

Nice to have

FDA status and privacy

Pearly has no FDA listing under the vendor’s name: we searched the FDA’s 510(k) and PMA databases on October 21, 2026 and found none. The saved Pearly pages don’t mention the FDA. On privacy, Pearly’s security page says it offers a Business Associate Agreement to its dental practice customers and that Stripe handles all card and bank data.

The FDA search used openFDA’s 510(k) and PMA device databases, with Pearly as the applicant name and, for 510(k), the device name.

Pearly’s security page calls the product “HIPAA & PCI Compliant Software”. Those are the vendor’s words; no audit report or certification for Pearly itself is in the pages we saved. What the page says, specifically:

• Patient data is stored on Google Cloud Platform and Confluent Cloud. Pearly says it has countersigned BAAs with both and verified their compliance with HIPAA, SOC2 and ISO 27001. Those certifications belong to the hosting providers, not to Pearly.
• Data is encrypted at rest (AES-256) and in transit (TLS), cloud networks are isolated, and non-production data is anonymized.
• Logins run on Google Identity Platform, with SHA-2 password handling and role-based, session-limited access.
• All card, debit, ACH and other payment data is collected, stored and processed by Stripe, which the page says is certified to PCI Service Provider Level 1.
• Pearly says it keeps an Internal Security Policy for protected health information.

Pearly reads your ledger, including procedure codes and balances, and texts and emails patients. Ask for the BAA itself, and ask who at Pearly can see your patient data.

Pricing

Pricing on request. Pearly’s pricing page publishes no prices; it asks a few questions about your practice and then designs a package (checked October 21, 2026). You can start with a free 30-day pilot at up to 5 offices, with no set-up costs and no subscription fees, the vendor says.

The pricing page splits the product into two parts. The core platform covers billing automation workflows, integrated payment processing, digital statements, A/R reporting, the branded payment portal, the PMS integration, HIPAA and PCI security, and training and support. Custom payment plans and mailed statement automation are add-ons. The page doesn’t give payment processing fees or what a plan costs after the pilot.

The vendor’s home page gives results figures: an average 33% increase in collection rate and 65% less staff time spent on billing. Pearly names no study behind either number. Its customer stories make similar claims for single DSOs, such as a 68-location DSO that cut aging A/R by 47% and a 55-office DSO that saved 72% of staff time. Treat them as marketing, and ask the vendor to measure your own A/R before and after the pilot.

Pros (from user reviews)

Capterra reviewers mostly praise Pearly for easy setup, helpful support, ease of use and text-to-pay. The sample has only 6 reviews, half of them clearly from dental offices, so each theme below rests on a handful of people.

• Setup or implementation was easy, a few reviewers say. A dental office manager liked how simply Pearly connected to their practice software.
• Support gets praise from a few reviewers, who mention quick answers and staff who check in. None of these reviewers is flagged as a dental office.
• Pearly is easy to use or user friendly, according to a few.
• Text-to-pay comes up in two reviews: patients can pay from a text or email link. A dentist in January 2024 likes texting patients their balances so they can pay through the link.
• Staff time saved is a theme for a few. One dentist says it cut the workload of some front office staff.
• Two say statements or payment notices go out on their own once an insurance payment is posted. One of them, a VP of operations writing in February 2026, says that also ended their postage costs.
• Two say patients pay faster or collections went up. One says their accounts more than 30 days late went down.
• One dental office manager who switched from Dental Intelligence says that tool wasn’t automated and that Pearly lets them block certain statements from going out.

Cons (from user reviews)

Capterra reviewers’ complaints about Pearly are few and mild: two want more settings, one dentist had to adjust to a different collections approach, and one notes that rivals bundle billing with other tools. Two reviewers say they have no complaints.

• Two reviewers want more customization. One would like a different delay before the first text for some procedures, such as crowns. The other wants more setting options for individual accounts.
• One dentist says Pearly’s strategy for collecting balances is different, and the office wasn’t used to sending invoices to only some accounts.
• One dentist says other software does similar things bundled with confirmations and phones, and wishes Pearly integrated with Weave.

Every review in the sample gives 5 stars, and Capterra marks most of them as incentivized. All but one were written in January 2024, within a week of each other, so they describe the product as it was then. The only review from 2026 is the only one not marked incentivized.

Who it’s for

Pearly fits a practice or DSO that already verifies insurance and files claims some other way and wants the patient side of the bill handled: statements, reminders, text-to-pay, payment plans and letters, synced with the PMS ledger. The DSO version, the group dashboard and the vendor’s multi-office customer stories point at groups, but the vendor also sells a private practice version.

Look elsewhere if you want one tool for eligibility, claims and patient billing, since Pearly’s pages describe only the last. If you already pay for a patient communication platform, check what it does for billing first: one reviewer points out that other software bundles similar features with confirmations and phones. And if your PMS isn’t Dentrix Ascend, Open Dental or Eaglesoft, the three named on the saved pages, ask Pearly to confirm the integration before the pilot.

FAQ

How this review was put together

We didn’t use Pearly ourselves. This review is built from six Pearly pages (home, pricing, all features, integrations, online payments and security), a search of the FDA’s 510(k) and PMA databases, and all 6 Pearly reviews on Capterra, written between January 18, 2024 and February 13, 2026. All sources were checked on October 21, 2026.

The review sample is very small, so review themes are described only as “one”, “two” or “a few”, and a theme was counted only when a review stated it. Figures on the vendor’s pages, including its customer stories, are reported as the vendor’s claims. The amounts in the Pay Portal demo are sample data and weren’t used. We didn’t search for published studies.

Sources

1. Pearly: home page, accessed October 21, 2026
2. Pearly: pricing page, accessed October 21, 2026
3. Pearly: all features, accessed October 21, 2026
4. Pearly: PMS integrations, accessed October 21, 2026
5. Pearly: online payments, accessed October 21, 2026
6. Pearly: security and compliance, accessed October 21, 2026
7. openFDA device databases (510(k) and PMA), accessed October 21, 2026
8. Capterra: Pearly reviews, accessed October 21, 2026