Claim Anomaly Detection
Because of the huge volume of dental insurance claims submitted, typically, fewer than 1% are reviewed by clinical analysts.
NovoHealth Dental Claim Anomaly Detection quickly and accurately assesses every claim submitted to the insurer’s system. It automatically flags and annotates anomalous claims that may have errors, omissions or a high probability of fraud, and serves up a daily queue of claims prioritized for clinician review, ensuring that the insurer's valuable human resources are used as efficiently and effectively as possible.
The Image Anomaly Detection (IAD) module is currently available. It detects similar images that appear in multiple claims — even if they've been modified — even if cloned images have been inserted into different radiograph sets in multiple claims.
What if your system could
automatically identify anomalous claims and prioritize them for analyst review?