Issue link: https://beckershealthcare.uberflip.com/i/1212192
8 BECKER'S DENTAL + DSO REVIEW - VOL. 1 FEB 2020 How AI is being used to stop dental insurance fraud By Mackenzie Garrity W est Hollywood, Calif.-based startup Pearl has devel- oped artificial intelligence to help combat dental in- surance fraud, according to The Wall Street Journal. The software is based on a dataset of tens of millions of dental images, such as X-rays, 3D images and intraoral photography. When insurance providers receive claims, Pearl's machine learning tool compares images to detect duplicates and near duplicates. Then AI technology is used to determine if the im- age matches the procedure described in the claim. Pearl claims that its AI solution has identified thousands of cases in which dentists are using repeat X-rays or other med- ical images to bill insurers. Liberty Dental Plan Corp. is one of the insurers that has teamed up with Pearl. The insurer says that annually between 17 percent and 20 percent of their claims are fraudulent. "Our primary goal is to shed light and to provide analysis and real-time information so that the appropriate action can be taken," said Ophir Tanz, CEO and founder of Pearl, to WSJ. n SmileDirectClub competitor raises $10M By Mackenzie Garrity U niform Teeth has raised another $10 million, bringing its total funding to $14 million, according to TechCrunch. With the funding, Uniform Teeth plans to open two locations in Seattle and Chicago in early 2020. Throughout 2020, Uniform Teeth hopes to expand throughout the U.S. Uniform Teeth requires patients to have in-person visits. Pri- or to the visit with an orthodontist, patients use the compa- ny's app to upload photos of their teeth and bite. During the in-patient visits, orthodontists scan patients' teeth and use 3D imaging to determine treatment plans. "There really is a need that is not being addressed in the mar- ket," said Uniform Teeth CEO Meghan Jewitt to TechCrunch. "We see so much of the activity in the space targeting sim- ple vanity cases, but that's just a small fraction of the market. We're focused on the moderate to full-spectrum cases, which is like 75 percent of the market." Among the competition for Uniform Teeth is SmileDirectClub, which went public in 2019. n SmileDirectClub can now sell aligners to dentists after agreement with Align Technology ends By Mackenzie Garrity N ashville, Tenn.-based SmileDirectClub plans to sell its clear aligners directly to dentists and orthodontists through a wholesale channel. The company announced Jan. 14 that it will offer dentists and orthodontists the opportunity to enroll in an in-office option this year. SmileDirectClub will support the distribu- tion through its manufacturing operation in Antioch, Tenn. Additionally, the company is building a second manufactur- ing facility in Texas to support its increasing demand. SmileDirectClub is now able to sell its products directly to providers since its exclusive supply agreement with Align Technology ended Dec. 31, 2019. "We have seen increasing demand from the dentists and or- thodontists in our network who wish to provide SmileDirect- Club clear aligners to their in-office patients, and with our agreement with Align Technology now expired, we are no longer obligated to stay in the direct-to-consumer channel," said SmileDirectClub Co-founder Alex Fenkell. n North Carolina proposal would let dental hygienists practice without supervision By Gabrielle Masson O n Dec. 13, 2019, the North Carolina Board of Dental Examiners approved a proposal that would allow den- tal hygienists to provide care for patients who haven't met the prior exam requirement, NBC affiliate WECT reported. The prior exam rule requires a previous dental examina- tion within 120 days for patients receiving care from pub- lic health programs. The North Carolina Division of Public Health recommends individuals visit the dentist twice a year, yet local groups providing care to dental shortage areas say the prior exam rule inhibits that possibility. William Donigan, DDS, dental director for Gastonia, N.C.- based Gaston Family Health Services, told WECT the pro- posed rule changes are "vital" to North Carolina commu- nities. The revision would allow dentists to provide dental hygienists with written orders so they could serve the com- munity in mobile dental units, Dr. Donigan said. n CLINICAL CARE