The Promise of Real-Time Adjudication: Can AI deliver?

The Promise of Real-Time Adjudication: Can AI deliver?

Wednesday, October 6
12:00 PM - 1:15 PM (CT)

As Artificial Intelligence (AI) systems, capable of accurate radiographic diagnosis, begin to penetrate the dental industry, carriers have emerged among the earliest adopters of the technology. The benefits of computer vision-powered utilization management and review – efficiency, automation, comprehensive claim examination, fraud detection and, of course, real-time adjudication – have been extolled by every dental AI startup bringing utilization management/utilization review (UM/UR) solutions.  Though real-world application of the technology too limited and nascent to have produced clear evidence of those benefits, most insurers – even those who have yet to see the technology in action – seem willing to grant that, at least in principle, AI holds considerable promise for the future of claim adjudication. The question is: Could that promising future actually include real-time claims adjudication? The Dental AI Council (DAIC) would like to try to answer that question with the help of members of the DAIC leadership committee, who will bring their dental care, insurance carrier, and AI experience to bear. They will address:  

  • Benefits of real-time adjudication for providers, patients and carriers  
  • Why AI holds promise for real-time adjudication  
  • Logistical impediments to real-time adjudication  
  • Regulatory impediments to real-time adjudication  
  • How to overcome impediments  
  • Steps that can be taken to facilitate a real-time reality 

    Dr. Kyle Stanley
    Chief Clinical Officer

    Dr. Kyle Stanley, DDS, is an award-winning dentist and the chief clinical officer at Pearl, an AI company specializing in diagnostic and business analytics solutions for the dental industry. A graduate and former faculty member of USC’s Herman Ostrow School of Dentistry, Dr. Stanley’s esthetics, dental implant, and smile design research has been published in the top international dental journals. He has been honored with the American Academy of Esthetic Dentistry’s(AAED) Charles L. Pincus Award for outstanding achievement in esthetic dentistry, and named to the American Academy of Cosmetic Dentistry®’s (AACD) "The Next Generation of Cosmetic Dentistry" and Seattle Study Club’s "Top 10 Young Educators in Dentistry" lists. As a key opinion leader and public speaker, Dr. Stanley has become the dental industry’s leading advocate for mental health awareness. His private practice is located in Beverly Hills, CA.

    Vidone_pinkbg_500w.jpgDr. Linda Vidone
    Chief Clinical Officer and Vice President of Clinical Management
    Delta Dental of Massachusetts

    Linda Vidone, D.M.D., is the chief clinical officer/V.P. Clinical Management at Delta Dental of Massachusetts (DDMA). She has 20 years of dental experience in clinical private practice, dental school faculty, and in the dental benefits industry. She is responsible for all clinical programs at DDMA, which include dental/medical integration, utilization review and management, oral health analytics, benefit criteria, clinical and contractual appeal review, and sets standards for quality care confirming DDMA maintains a quality network of providers.  She continuously stays abreast of innovations in oral health ensuring that DDMA continues to enhance and provide the best dental benefits to its customers. Dr. Vidone is a liaison to the National Scientific Committee and Policy Committee for Delta Dental Plans Association.

    Dr. Vidone is a hands-on leader in the dental insurance industry. Beyond her work with DDMA she currently serves as immediate past president and chair of the Certification Committee for the American Association of Dental Consultants. She is chairperson on National Association of Dental Terminology workgroup, is a voting member of the American Dental Association’s Code Maintenance Committee, where she represents American Health Insurance and a voting member for the Dental Quality Alliance as well as serving on their educational committee.  She holds membership with the American Dental Association and American Academy of Periodontology, National Healthcare Fraud Association, and New England Dental Society. She lectures nationally on Dental insurance, Claim coding, Opioid Epidemic in Dentistry and Quality in Oral Health, most recently at the American Academy of Periodontology and Tufts School of Dental Medicine.

    She received her DMD and advanced certificates in Prosthetics and Periodontology at Boston University and a bachelor’s degree in biology from Providence College. She maintains a private practice in Periodontology in Brookline, Massachusetts.

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