ANN ARBOR, Mich.--(BUSINESS WIRE)--NovoDynamics, Inc., the leading provider of automated, AI-driven dental insurance claim review technology, today announced that clinicians examining claims for Delta Dental of Michigan, one of the nation’s largest dental insurers, consistently concurred with the selection of claim line items that NovoDynamics® NovoHealth® Dental flagged to be reviewed for potential denial.

密歇根州安阿伯市——（商业新闻短讯）——自动化、人工智能驱动的牙科保险索赔审查技术的领先提供商NovoDynamics，Inc.今天宣布，检查美国最大牙科保险公司之一密歇根州Delta dental索赔的临床医生一致同意选择NovoDynamics®NovoHealth®dental标记为可能被拒绝的索赔项目。

The rate at which human healthcare experts agree with machine-based findings is regularly used to determine the accuracy of AI in assessing medical conditions. During a 10-month pilot program, NovoHealth Dental automatically screened more than 120,000 claim line items submitted for certain types of periodontal procedures.

人类医疗保健专家同意基于机器的发现的比率通常用于确定人工智能在评估医疗状况方面的准确性。在为期10个月的试点计划中，NovoHealth Dental自动筛选了为某些类型的牙周手术提交的120000多个索赔项目。

The system flagged those it recognized as not providing sufficient clinical evidence for approval and routed them for further review by Delta Dental of Michigan clinicians, who agreed with the NovoHealth Dental denial recommendations more than 86% of the time. A separate dental industry baseline study showed that after a secondary review, dental clinicians agreed with their own prior diagnosis only 84% of the time..

。另一项牙科行业基线研究显示，经过二次审查后，牙科临床医生仅在84%的时间内同意自己的先前诊断。。

NovoHealth Dental accuracy addresses the burden of unnecessary claim reimbursements

NovoHealth牙科准确性解决了不必要的索赔报销负担

generating avoidable costs for the dental industry

为牙科行业产生可避免的成本

Dental insurance companies are required to have a credentialed clinician review a claim before it can be denied for not meeting their clinical guidelines. But because payer claim volume often far exceeds the capacity of review staff, insurers do not have the capacity to manually review every claim submitted, so they typically perform spot checks, instead.

牙科保险公司需要有一名经过认证的临床医生对索赔进行审查，然后才能因不符合其临床指南而被拒绝。但由于付款人的索赔数量往往远远超过审查人员的能力，保险公司没有能力手动审查提交的每一份索赔，因此他们通常会进行抽查。

This gives rise to two issues: 1) Some claims are approved despite not meeting clinical requirements for reimbursement, and 2) Since it’s challenging for insurers to determine which claims are most likely to fail to meet clinical guidelines, the ratio of time spent by clinicians on deniable versus admissible claims selected for review may be low.

这产生了两个问题：1）尽管不符合报销的临床要求，但仍有一些索赔被批准；2）由于保险公司很难确定哪些索赔最有可能不符合临床指南，因此临床医生花费的时间比例可能很低。选择审查的可否认索赔与可受理索赔。

Because NovoHealth Dental automatically screens every claim submitted and reliably routes for review those most likely to fail to meet clinical guidelines, insurers can be confident that their clinical reviewers’ time and efforts will be optimized, and their plan payment savings will be maximized. Providers also benefit because their clearly admissible claims aren’t delayed by inconsequential reviews..

。提供者也会受益，因为他们明确可接受的索赔不会因无关紧要的审查而延迟。。

Rigorous analysis validates the capabilities of NovoHealth Dental running in real time

严格的分析验证了NovoHealth Dental实时运行的能力

in a demanding, high-volume, enterprise environment

在要求苛刻、高容量的企业环境中

Deployed in the insurer’s real-time production environment in 2023, NovoHealth Dental has been automatically screening claims containing reimbursement requests for scaling and root planing (SRP) procedures that were submitted to Delta Dental of Michigan and its affiliates in two other states. SRP procedures are used by dental practitioners to treat periodontitis (gum disease).

NovoHealth Dental于2023年部署在保险公司的实时生产环境中，已自动筛选索赔，其中包含提交给密歇根州Delta Dental及其在另外两个州的附属公司的缩放和根部刨削（SRP）程序报销请求。牙科医生使用SRP程序治疗牙周炎（牙龈疾病）。

A claim may be denied when the procedure does not appear to meet payer clinical guidelines, such as when insufficient bone loss to warrant an SRP procedure is detected on the radiographic (x-ray) image. Even when radiographs are attached to insurance claims as low-quality screenshots (which is a standard practice for many dental offices), NovoHealth Dental excels at accurately determining whether sufficient bone loss is present..

当程序似乎不符合付款人的临床指南时，例如在射线照相（x射线）图像上检测到骨丢失不足以保证SRP程序时，索赔可能会被拒绝。即使将X光片作为低质量的屏幕截图附在保险索赔中（这是许多牙科诊所的标准做法），NovoHealth dental也擅长准确确定是否存在足够的骨质流失。。

“The high rate at which NovoHealth Dental accurately predicts which claims would be denied by clinicians makes a very compelling case for its use in helping to select which dental claims to review,” said Delta Dental of Michigan Senior Vice President and Chief Science Officer Dr. Jeffery Johnston. “We believe AI technology that screens, flags, and prioritizes the right claims for review as reliably as NovoHealth Dental does can substantively increase the productivity of our staff.”.

密歇根州Delta Dental高级副总裁兼首席科学官Jeffery Johnston博士说：“NovoHealth Dental准确预测哪些索赔将被临床医生拒绝的比率很高，因此它可以帮助选择哪些牙科索赔进行审查，这一点非常有说服力。”。“我们相信，与NovoHealth Dental一样可靠地筛选、标记和优先审查正确声明的人工智能技术可以大大提高我们员工的生产力。”。

In addition to assisting insurers with presorting claims for clinician review in real time, NovoHealth Dental pre-emptively identifies claims that are missing required documentation, as well as claims that have been submitted with critical errors, allowing dental offices to immediately make corrections.

除了协助保险公司实时对索赔进行预排序以供临床医生审查外，NovoHealth Dental还可以预先识别缺少所需文件的索赔以及提交时存在严重错误的索赔，从而使牙科诊所能够立即进行更正。

Finding claim issues as quickly as possible reduces administrative time and costs for the entire dental industry..

尽快发现索赔问题可减少整个牙科行业的管理时间和成本。。

“We are excited to be giving payers the real-world data and confidence they need to make informed decisions about integrating our dental AI into their claim review workflows,” said NovoDynamics CEO David Rock. “The recent Delta Dental of Michigan results provide solid evidence that NovoHealth Dental brings quantifiable benefits to the entire dental ecosystem: It helps payers evaluate claims more quickly and consistently while better controlling costs.

NovoDynamics首席执行官David Rock表示：“我们很高兴能为付款人提供他们所需的真实数据和信心，以便他们做出明智的决定，将我们的牙科AI整合到他们的索赔审查工作流程中。”。。

It makes it easier for providers to submit compliant claims and obtain faster reimbursement decisions and payments. And consequently, it can offer patients better information when faced with making dental treatment decisions.”.

它使供应商更容易提交合规索赔，并获得更快的报销决策和付款。因此，当面临牙科治疗决策时，它可以为患者提供更好的信息。”。

About Delta Dental of Michigan

关于密歇根州的Delta Dental

Delta Dental of Michigan and its affiliates in Arkansas, Indiana, Kentucky, New Mexico, North Carolina, Ohio, and Tennessee make up one of the largest dental plan administrators in the nation. The Delta Dental plans are members of the Delta Dental Plans Association, a nationwide system of independently operated dental health service plans.

密歇根州的Delta Dental及其在阿肯色州、印第安纳州、肯塔基州、新墨西哥州、北卡罗莱纳州、俄亥俄州和田纳西州的分支机构是美国最大的牙科计划管理机构之一。三角洲牙科计划是三角洲牙科计划协会（Delta Dental plans Association）的成员，三角洲牙科计划协会是一个由独立运营的牙科健康服务计划组成的全国性系统。

Together, the plans provide coverage to more than 78 million Americans and operate two of the nation’s largest networks of participating dentists..

这些计划共同覆盖了7800多万美国人，并运营着美国最大的两个参与牙医网络。。

About NovoDynamics

关于NovoDynamics

NovoDynamics provides artificial intelligence (AI) solutions that address critical healthcare challenges, save payers and providers time and money, and help improve quality of care for patients. The company’s NovoHealth Dental platform analyzes dental insurance claims in real time; delivers accurate clinical assessments; helps deter fraud, waste, and abuse; and supports more consistent plan payments.

NovoDynamics提供人工智能（AI）解决方案，解决关键的医疗保健挑战，节省付款人和提供者的时间和金钱，并帮助提高患者的护理质量。该公司的NovoHealth牙科平台实时分析牙科保险索赔；提供准确的临床评估；有助于阻止欺诈、浪费和滥用；并支持更一致的计划付款。

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. For more information, follow NovoDynamics on LinkedIn or visit NovoDynamics.com..

。有关更多信息，请关注LinkedIn上的NovoDynamics或访问NovoDynamics.com。。

Delta Dental is a trademark of the Delta Dental Plans Association. The Delta Dental Plans Association does not make any representations, warranties or endorsements with respect to NovoDynamics, Inc. or its products.

Delta Dental是Delta Dental Plans Association的商标。三角洲牙科计划协会不对NovoDynamics，Inc.或其产品做出任何陈述、保证或背书。