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Published on March 14, 2023

The Journey to AI: Insights from AI trailblazer, Dr. Ron Inge

Dr. Ron Inge is the recently retired CDO and COO of Delta Dental Missouri. Overjet had an illuminating discussion with Dr. Inge at this years Delta Dental Biztech conference, where he shared key insights from his journey to implementing artificial intelligence

AI has become more than just a buzzword in the dental industry today; it has become a transformative technology actively embraced by payers and providers to enhance various aspects of operations. From chairside assistance to utilization review and payment, AI is revolutionizing the way the dental industry is operating. Overjet had the privilege of having a discussion at Delta Dental BizTech with Dr. Ron Inge, former COO and CDO at Delta Dental Missouri, who shared his remarkable journey of being one of the first to implement AI in dental utilization review. With 15 years of experience in general dentistry and two decades of work within the Delta system, Dr. Inge focused on network management, utilization management, and supporting his entire organization through technology. Read more to hear Dr. Inge’s insight on his successful integration of AI and how it has the power to significantly reduce costs while improving the quality of care provided.

Implementing Artificial Intelligence to Improve Utilization Review Processes

Utilization management in dentistry faces significant challenges today. The manual and repetitive nature of administrative and clinical reviews leads to high operational costs, inconsistencies in decision, and long turnaround times for patients. Dentistry’s subjective nature impacts the quality of care and member experience. Additionally, issues such as fraud, waste, and abuse result in unnecessary claim payouts. To address these issues, there is a growing need to accelerate automation and enhance transparency. The adoption of AI is no longer a question of “if” but rather “when,” as both payer and provider communities recognize its potential to streamline processes and improve decision-making in utilization review.

Dr. Inge’s Success in Implementing AI and Driving Improvements Across the Organization

Driven by the desire to transform utilization review into an objective, evidence-based approach, Dr. Inge turned to Overjet AI. By leveraging AI technology to evaluate radiographic bone loss for scaling and root planing (SRP), Overjet AI provided quantifiable visualizations that enabled claim reviewers to see precisely what met medical necessity criteria. This success led Dr. Inge to identify additional ways AI could drive a streamlined process, including increasing efficiency, ensuring consultant consistency, and using AI-powered insights to focus on the reasons claims did not meet criteria, thereby providing valuable information to providers instead of outright denial. Ultimately, this partnership with Overjet facilitated the development of a stronger relationship with their provider network, solidifying their commitment to exceptional care.

Within just three months, Overjet’s AI was tested and deployed successfully and drove significant improvements across the organization. Dr. Inge’s organization expanded from just SRP to molar extractions, where AI helped determine the amount of tooth covered by bone, facilitating evidence-based discussions with surgeons. The AI system also enabled peer-to-peer education between the dental insurer and surgeons, as well as quantifying the extent of tooth removal in complex procedures like crowns and build-ups, which are typically assessed with 2D radiographs. By quantifying the tooth structures affected, the insurer ensured accurate policy adherence.

Within six months, the dental insurer was fully operational across various procedures, experiencing remarkable results. They could review every claim in their designated categories, promptly paying those meeting the criteria. This streamlined process prevented consultants from wasting time on claims that met clinical requirements. The consistent application of AI also led to increased savings as more claims were reviewed. Dr. Inge emphasized that his organization achieved its desired outcomes and performed well in actuarial reports. Additionally, the IT team developed a system for daily claims transfer and rapid analysis, ensuring efficient integration into their existing workflow.

The Future of AI in Dentistry

Dr. Inge, an advocate for the future of AI in dentistry, sees it as a key player in achieving the holy grail of dentistry: a streamlined, patient centric process from provider to insurer to member. He envisions AI assisting dentists practicing chairside, streamlining payment processes and improving relations with payers. Dr. Inge believes AI can establish standards of practice and reimbursement protocols, bringing dentistry closer to the medical field. By leveraging AI, large DSOs can collaborate with payers and create efficiency throughout the supply chain. AI also has the potential to enhance public health programs by enabling preliminary assessments of oral health using smartphone pictures. Dr. Inge’s vision embraces the transformative power of AI in dentistry.

Overjet envisions AI redefining dentistry by making the healthcare journey intuitive, intelligent, and interoperable. Overjet’s Claim Intelligence Platform is currently making this vision a reality by driving improvements in utilization review, claims management, and providing valuable insights for providers and members. Overjet’s commitment to creating the future of dentistry with AI includes solutions to address fraud, waste, and abuse by catching duplicative submissions and downcoding. Overjet envisions a world where AI lends a hand to creating innovative plan designs, lower premiums, and supports clinical and administrative teams. Overjet’s Claim Intelligence Platform is currently creating a future where payer-provider integrations enable point-of-care adjudication for streamlined processes and improved healthcare outcomes.

Choosing the Right Partner and Lessons Learned

When selecting a partner for an AI system, Dr. Inge highlighted the importance of defining your business and clinical objectives and evaluating multiple companies. Beyond technology, successful partnerships are built on the people behind it. The team should take the time to understand your company’s operations and listen to your needs, as you assess their expertise. For payers, it is essential to consider the partner’s ability to quantify results, experience in the domain, and whether they possess the right people and funding. Overjet hit the mark for Dr. Inge.

Dr. Inge’s lesson learned in implementing AI is the importance of having a clear vision and starting point to progress effectively. He emphasizes the value of choosing a partner who actively listens, offers relevant solutions, and collaborates to enhance outcomes for all stakeholders.

When asked if he would do anything differently, Dr. Inge states that he wouldn’t change a thing. He appreciates the learning experience along the way and the discipline maintained throughout the process to achieve their ultimate goal.

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