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Dental Insurance Claim

Generate accurate and consistent data from any document, any layout.

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Insurance Document Intelligence

The world's best dental claim extraction

Accelerate dental claims processing with intelligent document automation. Extract patient information, procedure codes, tooth numbers, and billing data automatically. Improve claims accuracy and reduce processing delays.

dental-insurance-claim.pdf

Viewer

JSON

claim_number

DEN-2024-234567

claim_date

2024-03-05

policy_number

DDP-2024-890123

group_number

DENTAL-2000

patient_name

David Thompson

patient_dob

1990-11-15

patient_member_id

DT901115

patient_address

567 Smile Lane, Seattle, WA 98101

subscriber_name

David Thompson

subscriber_relationship

Self

dentist_name

Dr. Sarah Kim, DDS

dentist_npi

9876543210

dentist_license

WA-12345

office_name

Seattle Family Dentistry

office_address

100 Dental Plaza, Seattle, WA 98102

date_of_service

2024-03-01

Procedures

3 items

ada_code

tooth

surface

description

fee

D0120

N/A

N/A

Periodic oral evaluation

65

D1110

N/A

N/A

Prophylaxis - adult

120

D0274

N/A

N/A

Bitewings - four films

75

total_fee

260

other_coverage

false

{ "claim_number": "DEN-2024-234567", "claim_date": "2024-03-05", "policy_number": "DDP-2024-890123", "group_number": "DENTAL-2000", "patient_name": "David Thompson", "patient_dob": "1990-11-15", "patient_member_id": "DT901115", "patient_address": "567 Smile Lane, Seattle, WA 98101", "subscriber_name": "David Thompson", "subscriber_relationship": "Self", "dentist_name": "Dr. Sarah Kim, DDS", "dentist_npi": "9876543210", "dentist_license": "WA-12345", "office_name": "Seattle Family Dentistry", "office_address": "100 Dental Plaza, Seattle, WA 98102", "date_of_service": "2024-03-01", "procedures": [ { "ada_code": "D0120", "tooth": "N/A", "surface": "N/A", "description": "Periodic oral evaluation", "fee": 65 }, { "ada_code": "D1110", "tooth": "N/A", "surface": "N/A", "description": "Prophylaxis - adult", "fee": 120 }, { "ada_code": "D0274", "tooth": "N/A", "surface": "N/A", "description": "Bitewings - four films", "fee": 75 } ], "total_fee": 260, "other_coverage": false }

dental-insurance-claim.pdf

Viewer

JSON

claim_number

DEN-2024-234567

claim_date

2024-03-05

policy_number

DDP-2024-890123

group_number

DENTAL-2000

patient_name

David Thompson

patient_dob

1990-11-15

patient_member_id

DT901115

patient_address

567 Smile Lane, Seattle, WA 98101

subscriber_name

David Thompson

subscriber_relationship

Self

dentist_name

Dr. Sarah Kim, DDS

dentist_npi

9876543210

dentist_license

WA-12345

office_name

Seattle Family Dentistry

office_address

100 Dental Plaza, Seattle, WA 98102

date_of_service

2024-03-01

Procedures

3 items

ada_code

tooth

surface

description

fee

D0120

N/A

N/A

Periodic oral evaluation

65

D1110

N/A

N/A

Prophylaxis - adult

120

D0274

N/A

N/A

Bitewings - four films

75

total_fee

260

other_coverage

false

{ "claim_number": "DEN-2024-234567", "claim_date": "2024-03-05", "policy_number": "DDP-2024-890123", "group_number": "DENTAL-2000", "patient_name": "David Thompson", "patient_dob": "1990-11-15", "patient_member_id": "DT901115", "patient_address": "567 Smile Lane, Seattle, WA 98101", "subscriber_name": "David Thompson", "subscriber_relationship": "Self", "dentist_name": "Dr. Sarah Kim, DDS", "dentist_npi": "9876543210", "dentist_license": "WA-12345", "office_name": "Seattle Family Dentistry", "office_address": "100 Dental Plaza, Seattle, WA 98102", "date_of_service": "2024-03-01", "procedures": [ { "ada_code": "D0120", "tooth": "N/A", "surface": "N/A", "description": "Periodic oral evaluation", "fee": 65 }, { "ada_code": "D1110", "tooth": "N/A", "surface": "N/A", "description": "Prophylaxis - adult", "fee": 120 }, { "ada_code": "D0274", "tooth": "N/A", "surface": "N/A", "description": "Bitewings - four films", "fee": 75 } ], "total_fee": 260, "other_coverage": false }

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