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ANN ARBOR, Mich.–(BUSINESS WIRE)–October 19, 2023–
NovoDynamics, Inc., the industry’s leading provider of artificial intelligence (AI) solutions for the Dental industry, today announced the commercial deployment of the latest version of NovoHealth Dental. While automatically performing real-time utilization review, NovoHealth Dental pre-screens insurance claim submissions to determine if all required documentation is attached — including x-ray images, charts and correspondence — based on specific payer guidelines for each dental procedure code. Now, the NovoHealth Dental Claim Quality Assurance module also verifies that the anatomy referenced by the claim is clearly visible in the attached images. If the request is incomplete, NovoHealth Dental immediately activates an alert to request the missing documentation from the dental office.
NovoHealth Dental has automatically analyzed claims data for dozens of major US dental insurers and found that up to 78% of claims paid were missing required documentation.
“NovoHealth Dental’s proactive approach to quality and claims verification saves both payers and providers significant time, effort and cost,” says NovoDynamics Dental Director Joseph Borg, DDS. “And, by adding intelligent automation early in the claims submission workflow, NovoHealth Dental Claims Quality Assurance also brings greater consistency and transparency to the system, making it easier for dentists and their patients to know when their claims qualify for payment.”
Historically, payer personnel have had to determine whether claim attachments include the images required for clinical review, and clinicians can typically review only 1 to 2% of a large submission volume. Many incomplete claims go through and are either paid or stall the review process. As a result, both payers and providers may incur excessive costs and delays, and from the provider’s perspective, payers appear to pay, suspend, or deny their claims inconsistently.
The NovoDynamics Dental AI solution reviews each incoming submission in real-time and appropriately routes claims through the payer workflow.
NovoHealth Dental Claim Quality Assurance automatically:
- Recognizes and classifies types of communication, distinguishing between radiographs (X-ray images), photographs, graphs and correspondence.
- Separates individual images from full-mouth series and specifies each image as bitewing, periapical, or panoramic.
- Identifies and labels quadrants and teeth and ascertains whether necessary anatomy is visible.
- Determines whether evidence required by the payer for the specific procedure is included.
- Notifies the submitted dental office of unfilled claim requests.
About NovoHealth Dental
In addition to determining whether each claim submission is complete, NovoHealth Dental automatically performs clinical analyzes that assess whether the evidence provided qualifies the claim for payment, based on the insurer’s criteria. Plus, NovoHealth Dental reliably detects potentially suspicious appearances. When a claim meets the payer’s standards, it can be sent for automatic adjudication. If NovoHealth Dental notes any concerns that may warrant denial, it flags, notes, prioritizes, and automatically routes the request for review by the clinician. Results include:
- Greater review productivity, consistency and cost savings for payers.
- Faster, more accurate and more predictable decisions for providers and their patients.
About NovoDynamics, Inc.
NovoDynamics provides artificial intelligence (AI) solutions that address critical healthcare challenges, save payers and providers time and money, and help improve the quality of patient care. NovoDynamics, an In-Q-Tel portfolio company, has been applying its proven AI expertise and advanced image processing technology to solve complex problems for governments, commercial enterprises and academic institutions since 2001. More information, follow NovoDynamics on LinkedIn and Twitter ( @NovoDynamics ), or visit NovoDynamics.com.
See source version at businesswire.com:https://www.businesswire.com/news/home/20231019727132/en/
CONTACT: MEDIA RELATIONS:
Catherine Irwin
cirwin@novodynamics.com
KEY WORD: UNITED STATES NORTH AMERICA MICHIGAN
INDUSTRY KEYWORDS: OTHER HEALTHCARE OTHER TECHNOLOGY INSURANCE ARTIFICIAL INTELLIGENCE SOFTWARE DATA MANAGEMENT PROFESSIONAL SERVICES PRACTICE TECHNOLOGY MANAGEMENT MOBILE/WIRELESS DENTAL FINAL HEALTH INSURANCE MENT
SOURCE: NovoDynamics, Inc.
Copyright Business Wire 2023.
PUB: 19.10.2023 02:00 PM/DISC: 19.10.2023 02:01 PM
http://www.businesswire.com/news/home/20231019727132/en
Copyright Business Wire 2023.
