75%
Hours recovered per 100,000 claims processed
for payers
Replace Manual Review with Auditable AI
OrthoAI automates dental claim validation with AI-powered assessment, medical justification verification, and approval prediction — across every dental specialty.
Claims Leadership
Built for the people who own the claims operation
OrthoAI addresses the distinct pressures facing medical directors and claims operations leaders — clinical rigour and operational velocity, in one platform.
Medical Directors
Healthcare insurance · Dental department
Accountable for clinical accuracy and regulatory standing. OrthoAI gives you a defensible, evidence-backed decision record for every claim — auditable, explainable, and consistent.
Every decision traceable to source evidence
Defensible under regulatory review
Confidence scoring on every assessment
Heads of Claims
VP Claims Operations · Insurance Leadership
Running a claims desk that processes thousands of decisions per week. OrthoAI brings a single standard to every claim reviewed — consistent, fast, and built to scale without headcount.
25–35% error rate reduced to <3%
71% of claims auto-adjudicated
Review time: 6 days → 4 hours
operational performance
Move at the speed your operation demands
Processing that required 2,000–4,000 admin hours per 100,000 claims is compressed by seventy-five per cent. That is 1,500–3,000 hours recovered, every cycle.
3,000 h
Recovered per cycle · 1,500 minimum per run
~$60M
Potential annual savings per large insurance operation
1 cycle
To validate 100,000 claims — with full audit trail
Claims Operations
Designed around the way claims teams work
OrthoAI fits into the operational reality of a claims desk — not the other way around. The platform surfaces what your team needs, at the moment they need it, in the format they already work in.
Reviewer-ready output
Escalation built in
Fits existing systems
automatic claim validation
Apply one standard to every claim you receive
Every incoming claim assessed against standardised criteria. Output is a structured approval likelihood score with supporting evidence — auditable, explainable, consistent. The same standard at 1,000 claims and at 100,000.
Every output includes the evidence chain that produced it. Not a black box score — a documented decision your team, your auditors, and your regulators can follow from input to conclusion.
Regulatory Standard
What makes every report submission-ready
Output conforms to payer evaluation criteria. Medical justification included as standard. Appeals reduced by more than 50%.
Defensible decisions with a complete evidence chain
If a decision is questioned, the complete reasoning chain is retrievable: what was analysed, what the model concluded, and what evidence supported that conclusion.
Documented outcome across every deployment
The primary cause of appeals is missing or inconsistent documentation — OrthoAI eliminates both at the source. Reports are formatted to meet payer criteria before they leave the clinic.
Confidence scoring that tells you where to look
Every claim receives a calibrated confidence score — so high-confidence decisions move through automatically, and your reviewers spend time only where it matters.
Institutional Foundation
From the research lab to the examination room
OrthoAI's diagnostic models are developed through rigorous academic research and validated at the leading venues in medical AI — before they reach a single clinical deployment.
