Abstract: A method includes receiving, by one or more processors, a clinical image associated with a dental procedure; identifying, by the one or more processors, one or more dental procedure codes based on processing the clinical image using a plurality of AI models; receiving, by the one or more processors, a periodontal chart image; processing, by the one or more processors, the periodontal chart image using optical character recognition to obtain pocket measurements associated with a plurality of teeth along with positional coordinates of each of the pocket measurements; identifying, by the one or more processors, a submitted dental procedure code in a dental claim for the dental procedure; determining, by the one or more processors, whether the submitted dental procedure code corresponds to a visibly detectable procedure; determining, by the one or more processors, whether the submitted dental procedure code matches any of the one or more dental procedure codes based on processing the clinical image when the submi

Abstract: A method includes receiving, by one or more processors, a clinical image associated with a dental procedure; identifying, by the one or more processors, one or more dental procedure codes based on processing the clinical image using a plurality of AI models; receiving, by the one or more processors, a periodontal chart image; processing, by the one or more processors, the periodontal chart image using optical character recognition to obtain pocket measurements associated with a plurality of teeth along with positional coordinates of each of the pocket measurements; identifying, by the one or more processors, a submitted dental procedure code in a dental claim for the dental procedure; determining, by the one or more processors, whether the submitted dental procedure code corresponds to a visibly detectable procedure; determining, by the one or more processors, whether the submitted dental procedure code matches any of the one or more dental procedure codes based on processing the clinical image when the submi

Abstract: A method includes processing, by one or more processors, historical claim and claim remittance information to extract prior authorization data; performing, by the one or more processors, a probabilistic analysis on the prior authorization data for a procedure to generate a first metric and a second metric, the first metric comprising a percentage of claims including the procedure in which prior authorization is applied for and the second metric comprising a percentage of claims including the procedure in which prior authorization was not applied for and were denied payment for not applying for prior authorization; determining, by the one or more processors, whether the first metric satisfies a first authorization threshold and the second metric satisfies a second authorization threshold, the first and second thresholds being associated with a prior authorization rule corresponding to the procedure; and generating, by the one or more processors, a recommendation on whether to obtain prior authorization before