Forbes Senior Contributor David A. Teich writes, “Medical insurance is, as patients, providers, and payors all can agree, often convoluted and complex. There’s a business problem in making processes more efficient… More robust AI can help all three stakeholder groups address their needs in managing medical insurance.” Mr. Teich interviewed NovoDynamics CEO David Rock and Senior Scientist Sean McMillan to learn how the company’s dental insurance claims processing support platform, NovoHealth Dental, is using its advanced AI and image processing technologies to address some of the industry’s most pressing challenges.

According to Mr. Teich, the use of neural networks for radiological analysis can be very important in dental care. “Periodontitis assessment, for example, can be very subjective,” says NovoDynamics CEO David Rock. “In one of our NovoHealth Dental studies, sixteen percent of participating clinicians disagreed with their own original diagnosis. Using AI to support clinical decisions with consistent, statistically based radiograph analysis can help eliminate ambiguity and improve client outcomes.”

Mr. Teich goes on to explain that no individual AI tool is a solution, they are components of a larger system. “In NovoHealth Dental, we use different AI technologies to analyze different types of data — there’s no one-size-fits-all solution,” says Sean McMillan, Senior Scientist, NovoDynamics. “To perform accurate clinical assessments on radiographs submitted to payors without scale information, we use neural networks along with advanced probabilistic methods such as random forests and statistical regression. When searching for the nuanced behaviors that distinguish provider outliers, we move beyond known sources of bias such as zip codes, employing fuzzy logic and causal inference techniques to automatically cluster more sophisticated sets of similar providers for peer group comparison.”

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