Image + Data Controls for Dental Claims
Evidence-based claim reviews that bring clinical images to the center of decision-making.
The problem today
Most anti-fraud screening tools operate "blind" to clinical images. They look for statistical anomalies in spending or provider behavior, which is useful—but insufficient when claims hinge on what's visible on an X-ray or photo. Without images, reviews are slow, inconclusive, and burdensome for honest clinics and patients.
Our approach: see the real thing
HexaShield ingests images + invoices + treatment plans together. It uses AI to spotlight mismatches and route claims for targeted human review. The outcome is not just anomaly scores, but a clearer rationale linked to the clinical evidence.
How it works (4 steps)
Ingest relevant artifacts
Radiographs, photos, treatment plan, invoice/claim data.
Analyze with multi-modal AI
Detect visible elements, cross-check with coded acts, and assess internal consistency.
Triage to the right queue
Fast-track consistent claims; route ambiguous or high-risk ones to an auditor.
Review & document
Auditors see structured evidence, annotate decisions, and export findings for case handling.
Why it helps
Fairness
Honest providers pass faster; suspicious cases get attention.
Evidence-based
Outcomes reference what's actually on the image.
Efficiency
Fewer blanket audits; more targeted reviews.
Policy feedback
Identify design gaps (e.g., codes frequently paired without clinical evidence).
Integrations & operations
We integrate at the workflow level your team prefers: bulk ingestion, API connectors, or secure portals. We align with national coding systems and privacy rules and can run pilots in a sandbox with de-identified samples before scaling. We do not delete original images—they remain legal evidence.
Public payers
For national systems, HexaShield can support targeted audits, quality oversight, and prevention initiatives in higher-risk cohorts—while improving transparency for providers and citizens.
Transparency about status
Current status
- HexaShield is in an early outreach phase
- We do not yet display logos or public centers of excellence
- Pilots start with narrow scopes, clear baselines, and shared success criteria
What HexaShield is not
It's not a magic gatekeeper that auto-rejects claims, nor a replacement for medical expertise. It's a decision support layer that brings images to the center of evidence—where they belong.
Getting started
Discuss a feasibility pilot via damx.ai. We'll map your claim flow, define measurable outcomes, and run a time-boxed evaluation with clear governance.