Insurers8 May, 2023



Insurers8 May, 2023

Are you curious about how AI is revolutionizing oral health? Overjet is the leading dental AI platform that’s trusted by the top insurers in the industry.

In today’s world, AI is becoming increasingly necessary to stay competitive. So, it’s important to choose a partner that can help you modernize your operations, improve efficiencies, drive return on investment, and provide a simplified experience to your network.

Here are a few ways Overjet’s AI can make an immediate impact on your dental insurance UR processes.

Automate Your Dental Claims Utilization Review Process

How would you like to review claim submissions for over 350 dental procedure codes, and save time by automating approval for the ones that meet your specific medical necessity guidelines? With our technology, we’ve gained the trust of dental insurers covering 100 million members. 

AI automation can reduce the workload on your payer team. For example, Overjet can process low-quality images, including cropping and enhancing the brightness of images to make them easier to read. Our algorithms can intelligently extract narratives to leverage the information for clinical decision-making. Our AI can even determine if information is missing and automatically alert the provider to send the supporting material needed for adjudication.

By adding automation, dental payers can reduce the amount of time their team spends chasing information and reviewing claims that meet their guidelines, and instead focus on the claims that require a closer look to make a benefit determination.

Reduce Subjectivity and Create Clinical Consistency in Claim Reviews

When your claim reviewers need to make a decision on medical necessity, how can they determine what “most” really means when a guideline says “only approve if most of the tooth is decayed?”

Overjet’s AI reduces subjectivity and creates clinical consistency by uniformly applying your medical necessity guidelines. For example, Overjet’s claim intelligence platform can quantify the percentage of the tooth that is compromised to help determine whether it meets your criteria for a crown, and quantify the radiographic bone level measurements to help determine whether the patient meets your criteria for scaling and root planing. Plus, the AI findings can reduce the amount of time it takes human reviewers to analyze a claim by about 80%. 

By choosing an AI software that can detect and quantify clinical pathologies based on customized rule engines specifically designed for your needs, you can give your providers and members predictable decisions.

Streamline Operations with Augmented Workflow & Dental Consultants

Wouldn’t it be nice to have claims that require clinical review instantly routed to the appropriate person?

Overjet’s AI offers a one-of-a-kind augmented workflow solution that automatically streamlines operations for clinical and administrative claim reviewers. 

It optimizes reviewer queues, surfaces insights from the claim submissions, and routes claims based on the state licensure and specialty requirements. The result is a clinical review that is 3 to 5 times faster than the traditional manual process.

Overjet is also the only dental AI company licensed as a national utilization review agent to provide end-to-end capabilities. You have the option to pair automation with expert dental consultants that meet state licensure requirements. This powerful combination allows dental insurers to outsource either their entire UM process or just specific parts, reducing operational costs while removing the burden of managing compliance and scheduling. 

Discover how Overjet AI Benefits Patients, Providers, and Insurers

Private dentists and dental support organizations (DSOs) trust Overjet to help them accurately diagnose and provide optimal care for their patients, too. Overjet is uniquely situated to bridge the gap between payers, providers and members to streamline historically complex and inefficient processes and reduce friction to deliver better dental care for all. This unique partnership has positioned Overjet to collaborate on a pilot for point-of-care adjudication, fraud, waste and abuse detection, and advanced data and analytics to transform the dental industry through AI technology.