Payers: Insurance Intelligence Platform

AI: The New Standard for Utilization Review

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Overjet’s Clinician-built Insurance Intelligence Platform™, trusted by leading dental insurers, uses industry leading AI to streamline utilization review, providing faster coverage decisions for over 120 million members. 

Overjet instantly recommends approval of claims that meet criteria for over 350+ CDT codes, and, for in-depth reviews, is the only dental AI company to power a marketplace for clinical review capacity.

 

 

Unleash the Power of AI and Partner with the Leading Dental Platform for Payers

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AI Recommendations

AI-powered claim approvals or pends based solely on your benefit guidelines. Improve quality and consistency of review by removing subjectivity and high volume manual review

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Augmented Workflow

Overjet’s workflow support platform is designed to manage complex aspects of review. Consolidate data and reviewers all in one secure platform to support efficient and accurate final benefit decisions 

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Marketplace for Accredited Reviewers

Extend your team’s capacity through our platform’s marketplace for licensed clinical review agents. This allows you to tap into additional, pre-vetted capacity of clinical reviewers that leverage the criteria that your plan outlines as a guide. This eliminates overhead costs and ensures claims are reviewed quickly, accurately based on your plans, and compliantly

Gain efficiency with comprehensive, modern & scalable claims administration

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No one needs to tell you that insurance companies are in a tough spot: You process a vast number of claims, and when you reject the few that don’t meet necessity criteria, you become the bad guy to patients and providers.

  • Millions of dollars spent by each payer for limited review
  • Inconsistent decisions lead to high appeals
  • 5% fraud, waste, abuse still makes it through

Overjet makes things easier for your team.

We use powerful AI tools to analyze radiographs — the primary means for detecting dental problems — and give you detailed, granular insights about any pathologies that exist to better inform your benefits decisions. The objective system reduces human error, ensures consistency and maximizes efficiency.

790%

Actual ROI achieved in 5 months for SRP and Crowns/CBU (Client with ~8M commercial membership)

$4MM

Net savings 6 months. (Client with ~8M commercial membership)

Unlock the Benefits of Overjet

With AI that Streamlines Utilization Review for Payers, Providers, and Members

Enhance the Quality of Your Claims Review

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With Overjet’s configurable AI, claims are reviewed objectively based solely on your clinical criteria. Overjet will recommend approval if a claim meets criteria and route more complicated cases for manual clinical review.

Improve Efficiencies and Modernize Your Claims Review in a Single Platform

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Make Overjet your single source of truth for making final benefit decisions. Equip your dental consultants with an end-to-end claim review platform to manage complex aspect of claim review, keep all your data and reviewers in one place and help enable faster, more consistent benefit decisions 

 

Cost-Effective, Efficient Claims Review with Dental Consulting Services

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Alongside our AI-powered approval recommendations, Overjet is the only dental AI company that offers URAC-accredited utilization review services* to handle the claims review process from end-to-end in compliance with all applicable laws and regulations  and minimize operational costs by leveraging a network of dentists with decades of experience.

Strengthen the Payer-Provider Relationship

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Overjet’s AI-powered platform automates approvals in minutes, increasing administrative and clinical efficiency while strengthening the provider relationship. Providers will benefit from faster dental benefit payments through efficient claims processing and standardized, consistent reviews that minimize appeals. Overjet’s AI flags missing data and prompts providers for additional information, improving communication and minimizing delays in decisions to provide a stronger member and provider experience.

Discover Why Top Dental Insurers Choose Overjet

Highly configurable industry leading AI

Overjet is the only AI company with a configurable rules engine that learns your benefit guidelines to make objective recommendations on medical necessity with unmatched accuracy and precision.

First-of-its-kind augmented workflow support

Overjet offers a workflow support tool for administrative and clinical reviewers. It increases efficiency and consistency by consolidating data in one place and surfacing insights to streamline manual reviews.

Our Platform: Powerful AI + Marketplace for Review Capacity

Our AI automatically reviews claims based on your plans’ criteria and routes claims for approval. As part of our platform, we also power a marketplace for licensed clinical review agents. This allows you to tap into additional, pre-vetted capacity of clinical reviewers that leverage the criteria that your plan outlines as a guide.

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Guardian Life Insurance Company

Guardian Life continues to be committed to facilitating the best oral health care possible for our members. By partnering with Overjet, we are able to leverage AI technology to improve the consistency of our dental claim review process while ensuring that we are able to make decisions based on the most precise clinical data.

Dr. Randi S. Tillman

Former Chief Dental Officer

Would You Like See Overjet in Action?

See for yourself why Overjet is #1 and trusted by some of the largest insurance companies..

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