Can AI fix dental billing? Overjet’s new network hopes to make pricing clear
Getting an idea of how much a dental visit is going to cost can be difficult, even if it’s staring you straight in the mouth. One company hopes to change that, using artificial intelligence to give patients and dentists real-time cost estimates—all while the drills are still buzzing and fluoride is flowing.
Overjet, a dental AI platform, just launched the Dental Clarity Network, a collaboration of dentists and health insurance providers that aims to give more clarity into dental billing. The first initiative of the Network is the deployment of ReviewPass, a program that helps deliver real-time cost estimates and insurance coverage information related to tons of dental procedures—effectively, helping dental patients avoid “surprise” bills that they weren’t expecting.
Put another way, if you’ve ever found yourself at the dentist, and an issue is discovered that needs to be remedied—be it a filling, or something else—you may not have any idea if your insurance will cover it, or how much you’ll be on the hook for, out of pocket. Yet, the work needs to be done, so you may tell the dentist to go ahead and do it, and then wait weeks for a bill to arrive—or not.
That’s what ReviewPass is hoping to clear up. The idea ropes in dentists (care providers), patients, and insurers, leveraging AI to quickly figure out if a procedure is covered under a patient’s insurance plan, and get an idea of how much everything will cost. This, as opposed to the dentist and insurer going back and forth for weeks, all while the patient waits in the dark with a sore jaw.
The Dental Clarity Network is launching with some big partners on board, too. Including insurers like MetLife and Humana, and the Dental Care Alliance, which comprises more than 400 dental practices in 24 states. Overall, Overjet estimates that ReviewPASS should be able to reach more than 100 million dental patients in the U.S.
“What we’re introducing is a group of major dental payers and provider groups coming together to work on reducing costs and providing more clarity to patients,” says Wardah Inam, Overjet’s CEO. “What we’ve done is help payers build out the infrastructure for real-time claims to happen. While the patient is in the chair, they’ll know whether a treatment must be covered,” she says.
The root of the issue is that most dentists don’t know, off the top of their heads, the intricacies of each dental insurance plan. And, as such, can’t tell a patient with certainty whether a specific treatment or procedure is covered by their plan. So, many times, they simply do the procedure, and then go back and forth with the insurer to determine whether it was covered by the plan, or if they need to bill the patient and have them pay out of pocket.
“People don’t realize how much time payers and providers waste talking to each other,” says Inam. It eats up a lot of time and money, inflating costs. As a result, Inam thinks that Overjet will help “significantly reduce costs” for insurers and providers, which might trickle down to patients.
But a big question: Why the sudden urge to increase transparency into pricing, particularly from insurers, who tend to benefit from opaque billing practices? Inam says it’s because, over the long run, the potential cost-savings are too much to ignore. Everybody should win: Dentists and insurers reduce administrative and overhead costs, and patients get more clarity on what procedures may be covered or not covered, and how much they’re ultimately staring at in terms of dental bills.
And once dentists and patients get a taste of it, Inam thinks it’ll be a game-changer. “It’s the first step,” she says. “When individuals have frictionless experiences, they don’t go back. Once they start getting real-time information about their bills, they’re not going back.”