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Eliminate Dental
Claims Leakage.
Accelerate Every Decision.
Olive Pro is an AI-powered Dental Claims Intelligence Platform that enables insurers to detect fraud, validate clinical accuracy, and automate adjudication—all in real time.
Impact
Measurable outcomes from day one of deployment.
20–40%
Reduction in Claims Leakage
50–70%
Improvement in TAT
90%
Fraud Patterns Detected Early
60%+
Routine Claims Automated
Dental Claims Are Complex. Manual Reviews Make It Worse.
Inconsistent adjudication across reviewers
Difficulty validating clinical necessity
High incidence of over-treatment & upcoding
Delayed approvals impacting customer experience
Limited visibility into provider behaviour
Olive Pro solves this with clinical intelligence + automation at scale.
Built Specifically for Dental Claims Intelligence
Unlike generic claims engines, Olive Pro understands dental procedures, treatment pathways, and clinical evidence—ensuring precise, standardized decision-making.
Dental procedure intelligence
AI fraud, waste & abuse detection
Visual claim risk scoring
Clinical document & image validation
Smart adjudication engine
Provider behaviour analytics
Key Capabilities
01
Dental Procedure Intelligence
Understands dental codes, treatment pathways, and clinical protocols—ensuring accurate validation of dental procedures
01
AI-Powered Fraud, Waste & Abuse Detection
Upcoding / procedure inflation
Unnecessary treatments
Repeated or duplicate procedures
Suspicious provider behaviour
01
Claim Risk Score
Clinical appropriateness
Cost deviation
Fraud probability
01
Clinical Document & Image Validation
Dental X-rays (OPG, IOPA)
Dental X-rays (OTreatment notesPG, IOPA)
Before/after images
Validate medical necessity and treatment accuracy
01
Smart Adjudication Engine
Policy coverage (COB)
treatment
Claim history
01
Provider Behaviour Analytics
High-cost providers
Treatment pattern deviations
Procedure frequency anomalies
How It Works
1
Claim Submission
Invoices + treatment plan + X-rays
2
AI + Rule Engine Analysis
Clinical + financial + behavioural validation
3
Risk Scoring (Speedometer View)
Low | Medium | High risk classification
4
Decisioning Engine
Auto-approve | Flag | Investigate
Benefits for Insurers & TPAs
Reduce leakage from dental overutilization
Standardize adjudication across teams
Improve claims turnaround time
Enable individual risk profiling
Power dynamic pricing models
Optimize provider network performance
Use Cases
Pre-Authorization Validation
Provider Fraud Detection
Claims Audit & Quality Control
High-Value Claim Monitoring
Network Clinic Audits
Scalable across geographies and segments
Why Olive Pro Wins
Built exclusively for dental claims
Combines clinical + financial intelligence
Visual risk scoring (speedometer reports)
AI + configurable rule engine
Scalable Across Geographies
Continuous learning from claims data
Traditional vs SmartCheck
Traditional Approach
With SmartCheck
Flat-rate dental pricing
With SmartCheck
No baseline health data
Oral health score at onboarding
Reactive claims handling
Proactive risk management
Manual underwriting judgment
Standardized AI risk scores
High loss ratio variability
Predictable portfolio risk
From Risk Detection to Claims Perfection — One Unified Ecosystem
Combine Olive Pro with SmartCheck to unlock end-to-end insurance intelligence:
Enterprise-Grade Security
Secure PHI Handling
Audit-Ready Workflows
Role-Based Access
Compliance-Ready Architecture
Stop Guesswork. Start Intelligent Claims Processing.
Transform dental claims into a strategic advantage with Olive Pro.
