A.I. Will Change Insurance Billing, Too

Regular readers will note that we like to talk about dental AI on this blog. This is because — and we know that we’re really going out on a limb here — we foresee the evolution of AI technology leading to big changes for the dental industry as a whole, including new approaches to patient care and the potential for doctor rankings.

But one area we haven’t yet mentioned is insurance. There, too, AI is poised to shift how dentists do business.

Experts like Sina Amiri, a VP at Zentist who recently joined us on Dental Marketing Theory, predict that within the next few years, AI will start playing a major role in helping insurance companies determine whether they are willing to cover treatments. 

Traditionally, insurance reviews have always been performed by people — experts trained to do things like review x-rays and decide whether a patient’s claim is justified. Now, this system obviously has problems of its own — as anyone who has ever struggled to get necessary treatment covered by their insurance can attest to — but it’s been our go-to since health insurance first appeared on the scene.

Today, though, we’re fast approaching a new model of doing business where those judgment calls will be made by AI instead of humans. An AI would be able to review a patient’s medical records and spit out a decision in a fraction of a second, potentially saving insurance companies considerable time and money.

Presumably, there will still be an appeals process that does involve doctors speaking to doctors. But the overall trend points towards a future where everything moves faster than ever, while also allowing insurance companies to lower their overhead.

Is this a good thing for dental as a whole? Frankly, that depends.

Will insurance carriers use their cost savings to benefit dental patients? And will dentists be able to advocate effectively for those under their care in this brave new world?

While we freely admit a certain skepticism, we’ll also hold out hope that the answer to both of those questions is yes.