The NovoHealth Dental platform uses NovoDynamics AI to automatically analyze dental insurance claims in real time at enterprise scale. NovoHealth Dental rapidly assures claim quality; accurately supports clinical assessments; and reliably detects fraud, waste, and abuse.
NovoHealth Dental immediately analyzes each and every incoming claim before it is routed through the payer’s system. It automatically:
NovoHealth Dental found more than 76% of claims submitted to a major U.S. dental payer had insufficient documentation.
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NovoHealth Dental analyzes images and available data to assess medical necessity. It immediately routes clean, compliant claims to the payer’s system for approval and reimbursement. Claims with issues are prioritized for review and are only routed to professional resources when necessary.
NovoHealth Dental uncovered tens of millions of dollars in potential savings for a major U.S. payer — more than 25X the savings human reviewers had found in the set of claims.
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NovoHealth Dental compares each incoming radiograph to all available images to ascertain whether it may have been previously submitted. NovoHealth Dental:
NovoHealth Dental can help improve focused review processes for payers, as well as reduce risk for DSOs and group practices, by detecting if a provider’s behavior significantly deviates from their peer group or if a provider’s procedure patterns appear suspicious. NovoHealth Dental automatically:
NovoHealth Dental Image Similarity Detection tracked the same radiograph submitted to the same payer by 11 different providers in 6 different states for 10 different patients in 14 different claims over 4 years. Read the full story …
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