Dental insurance is one of the main health insurance services. Once you have experienced a...
Dental problems treatment costs a fortune, so dental insurance is essential for all members of society. Most insurance companies do not bear the burden of dental treatment costs because most of the materials and equipment used for treatment are imported, and a lot of money has been spent to prepare them.
High costs and the dentist’s salary create a high payment and coverage price, creating a financial loss for insurance companies.
StrAIberry, as a dental health service application, has provided suitable solutions for dental insurance, which will be discussed further.
StrAIberry and dental insurance
StrAIberry is an application for continuous care and follow-up of personal oral health status. Users can perform regular monthly examinations of their mouths and teeth through the StrAIberry mobile application and quickly learn about the latest state of their oral health and its changes compared to the previous checkup.
For this, you can enter the checkup section in the StrAIberry app and perform the following types of checks:
• Regular checkups
• Teeth whitening
• Toothache and tooth sensitivity
• Problems with previous treatments
• X-rays
By choosing each checkup, you will be asked relevant questions that will help advance the diagnosis and treatment process.
This app is free to use, and users can create better and more appropriate care for their teeth by creating reminders for brushing and flossing. It is better to know that if you have daily and regular checkups, you can prevent more than 90% of problems related to oral hygiene.
Dental insurance services of StrAIberry
Another service provided by this application is dental insurance, which is provided according to the patient and insurance company’s conditions. If you use this application, you will realize that almost all aspects of the user’s dental problems are recorded. Users can enter their daily routine in this app, their oral and dental health checkups, and answer questions about their general health status to register the oral health care routine. As a result, important and valuable information is collected from each user that insurers can use and provide personalized products by carefully evaluating each one’s history.
Also, by continuously monitoring the user’s condition, they can encourage him to visit the dentist before his dental problem gets out of control. It also allows the doctor to check each patient’s dental history via the digital record of each patient’s file and the state of their teeth. Also, insurance companies use them to evaluate the invoices sent by the patient and pay based on the accuracy of the patient’s information and condition.
Insurance industry problems in dental and oral health
Iran’s insurance industry has experienced prolonged growth due to its traditional and non-competitive structure. However, competition between insurance companies has been created today due to new technologies and market saturation. Especially in the past year, each insurance company has considered a wide variety of products in the product portfolio to solve user treatment problems as much as possible. Technology advancement has brought about any company’s attention to the issues in the insurance field. Oral health problems include the following:
• Fraud
• Patient files
• Assessing the risk and cost of each person
Fraud in the insurance industry
One of the most common problems in the insurance industry is fraud. In global markets, on average, 20% of the cost of insurance requested by users is fraudulent. Due to the weaker insurance supervision in Iran, the percentage of fraud is definitely much higher than this. Even assuming a 20% share of fraud in the losses paid by insurance companies, nearly 7 thousand billion Toman of insurance income is spent annually on paying fraudulent claims.
Patient files in insurance industry
One of the most critical problems in Iran’s insurance industry is the non-integrated and digitalized files for each patient, and measures are currently being taken to minimize this problem. Due to the difficulty of transferring existing data to other systems, a large part of the patient’s information is out of the reach of insurance companies because few people take responsibility for moving information to online systems.
Assessing risk and cost in dental insurance industry
One of the most critical parameters in the insurance industry is a risk. The insurance company can estimate the required cost by evaluating each person’s risk. It can increase productivity and optimize the cost of services and insurance products for each person by managing its portfolio and expenses. Also, it can increase income and profit for them. All these cases are possible when the insurance can correctly assess the patient’s current condition and predict future needs.
StrAIberry’s solution for dental insurance
StrAIberry has been developed to improve the quality of oral and dental health in the community to provide good services for regular and continuous dental care. However, the primary value created in StrAIberry is in line with the goals of insurance companies. These measures help insurance companies quickly know about their users’ general health status and reduce the costs of insurance payments by better managing users. More than 95% of oral and dental problems can be prevented with direct and continuous monitoring, and StrAIberry has implemented monitoring strategies in its program.
StrAIberry solutions for insurance include the following:
• Providing personalized products for each user
• Urging the user to see a dentist before the problem gets out of control
• Eliminate the possibility of fraud
• Creating a digital and integrated file of the patient
• Assessing the risk and cost of each person
Providing personalized products for each user
Using artificial intelligence and machine learning, the StrAIberry app evaluates the user’s behavior when using and working with it. An analysis of the user’s behavior, the problems he has had in his mouth and teeth, and the routine he carries out daily to care for his mouth and teeth is done and creates valuable information. Insurance companies can use this information to create personalized products for each user.
Urging the user to see a dentist before the problem progresses
Since StrAIberry creates a field for registering oral and dental problems in its application, artificial intelligence can recognize the stage the patient is in and, if necessary, warn it to treat the trouble caused to the teeth. See a doctor. This possibility is profitable for the insurance company and the user. Both the user pays less for his treatment, and the insurance needs to return less money to the user.
Creating a digital and integrated file of the patient
Perhaps the most important solution provided by StrAIberry is the creation and maintenance of each person’s file. Note that each person’s file includes the general changes of their teeth over time. This means that the insurance specialist will easily find out what problems each tooth has had over time and what treatments have been done on it. This information is provided to the insurance specialist in an understandable form. Therefore, he can know about the person’s current and past situation without needing dentistry knowledge.
Eliminate the possibility of fraud
According to the same file available from the individual, the insurance specialist can easily find out about fraud in the user’s payment request. For example, when a person has had a root canal treatment for one of his teeth, he cannot claim a fee for a tooth filling because these two treatments are not performed for the same tooth. Also, by having the history of each individual’s teeth, the insurance specialist can easily evaluate each of the claims received from the individual.
Assessing the risk and cost of each person
One of the chief advantages that StrAIberry provides for insurance companies is the evaluation of insurance applicants’ oral and dental health. In this way, at the very beginning of the process of applying for insurance services, the insurer can make an accurate and quick assessment of the individual’s dental history and then, based on the risk of insuring him, offer an adjustable cost to the individual. As a result, the insurance company can create an accurate and intelligent management strategy for its portfolio.
