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Artificial intelligence has quietly revolutionized how dental insurance claims are processed, and most dental offices don't even realize it. Today we pull back the curtain on Novo Dynamics and their Novo Health Dental AI system that's scrutinizing your x-rays, documentation, and billing patterns before a human reviewer ever sees your claim.

The game has changed dramatically. Insurance companies have trained AI systems to review claims using very specific criteria determined by their own dental consultants—not treating clinicians. These systems don't just look at individual claims but cross-check x-rays across multiple insurance carriers, analyze your practice's billing patterns, and compare you to other providers in your area. If your practice performs more crowns, SRPs, or implants than what AI considers "average," all your claims face increased scrutiny regardless of their legitimacy.

This technological shift demands we evolve from merely submitting "clean claims" to creating "AI-proof claims." High-quality, clear x-rays that perfectly demonstrate necessity, concise standardized narratives, and meticulous documentation are no longer optional—they're essential. When AI improperly denies claims, request human review promptly. Document patterns of improper denials and report systematic issues to your insurance commissioner. The days of assuming a person will review your claim are over, but by understanding how these systems work, you can adapt your strategies to overcome these new barriers to reimbursement.

Ready to level up your billing skills and connect with fellow dental billers? Join us for our upcoming live workshop in Dallas! Send "Dallas" in a direct message to @dental_billing_coach on Instagram for your chance to win an all-expenses-paid trip to the event. Looking forward to diving deeper into AI and dental billing in our next episode where we'll share real-world denial stories and more strategies to beat the algorithms at their own game.

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Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.

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Perio performance formula:

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Delta Dental Locum Tenens Form:

https://www1.deltadentalins.com/content/dam/ddins/en/pdf/dentists/locum-tenens-form.pdf