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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
02
AI-Powered Fraud, Waste & Abuse Detection
Upcoding / procedure inflation
Unnecessary treatments
Repeated or duplicate procedures
Suspicious provider behaviour
03
Claim Risk Score
Clinical appropriateness
Cost deviation
Fraud probability
04
Clinical Document & Image Validation
Dental X-rays (OPG, IOPA)
Dental X-rays (OTreatment notesPG, IOPA)
Before/after images
Validate medical necessity and treatment accuracy
05
Smart Adjudication Engine
Policy coverage (COB)
treatment
Claim history
06
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
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
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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
Generic Engine vs OlivePro
Generic Claims Engine
Olive Pro
No dental-specific logic
Built for dental codes
Manual fraud review
AI fraud detection
No image validation
X-ray + doc analysis
Static rule sets
Continuous learning
Delayed TAT
Real-time decisions
From Risk Detection to Claims Perfection — One Unified Ecosystem
Combine Olive Pro with SmartCheck to unlock end-to-end insurance intelligence:
SmartCheck · Pre-Policy Stage
Risk Detection
AI dental scans for individual risk profiling & underwriting
Olive Pro · Post-Policy Stage
Claims Perfection
Intelligent claims adjudication & fraud detection
Better underwriting
Smarter pricing
Lower loss ratios
Closed-loop intelligence system
Enterprise-Grade Security
Secure PHI Handling
Audit-Ready Workflows
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Role-Based Access
Compliance-Ready Architecture
Stop Guesswork. Start Intelligent Claims Processing.
Transform dental claims into a strategic advantage with Olive Pro.
