AI In Insurance Use Case #10: Bento

  • 17 July 2019
  • Sam Mire

This interview is part of our new AI in Insurance series, where we interview the world's top thought leaders on the front lines of the intersections between AI and insurance.

In this interview, we speak with Ram Sudireddy, co-founder and CEO of Bento, to understand how his company is using AI to transform insurance, and what the future of the insurance industry holds.

1. What’s the story behind Bento? Why and how did you begin?

RS: We started Bento almost two years ago, but I've been thinking about the problems with the insurance market for many years. At the last company I ran, we had a great benefits package for our employees, and our premiums were relatively low. When we were acquired, our premiums actually went up. I couldn't believe it. If a company has more employees they should have the power to get lower premiums. After that, I spent a lot of time trying to understand the market.

During my research, I came to the realization that dental insurance isn't actually insurance. It doesn't cover you after your deductible. In fact, once you hit your annual max, you're completely out of pocket. Dental is just a pre-paid benefit with a series of plan-based restrictions. When I came to that realization, I knew we could solve the problem with technology.

2. Please describe your use case and how Bento uses artificial intelligence:

RS: Bento is a technology company that replaces dental insurance and saves individuals and organizations a considerable amount of money with a self-funded benefit while making oral care more accessible and transparent. Our system builds an encrypted Patient Profile for each of our members. That profile consists of many dimensions of data, including their dental service history, location, current and past benefits, etc. This Patient Profile constantly evolves as patients seek and receive care, and by applying machine learning to the rich data we collect it enables us to improve the experience for everyone.

For example, our settlement algorithm gives an instant understanding of benefits in real-time so our members and their dentists know exactly what a service will cost and whether or not it is covered by the plan. Another example is how we compare profiles and services by zip code so we can spot anomalies across a population – like one dentist who may be doing 100 fillings per month when the average in that geography is 10.

We can also compare against ADA guidelines, so we understand things like the time period a filling on each tooth should last. If someone got a filling on a tooth last year that’s supposed to last five years, we know something's up if they’re about to get another filling on the same tooth, and we can look into it. Examples like these save the patient and the plan money, might stop a patient from undergoing a procedure they don’t need, reduce clerical errors, and in some cases, even prevent fraud. Ultimately we believe that a patient-centric approach, enhanced by AI, will lead to better outcomes.

3. Could you share a specific customer/user that benefits from what you offer? What has your service done for them?

RS: We give people immediate access to price and procedure information, as well as their entire dental history in the app. That's really powerful. It helps ensure they get the right care when they need it and are charged accordingly.

For example, one issue we see somewhat regularly is patients who go to the dentist for a regular cleaning and are charged for a deep cleaning. Most plans or individuals would just go ahead and pay that bill because the difference in the billing code or description is so slight, they just don’t see it. We’ve also made patients aware of care they didn’t even get, but were accidentally billed to them.

In one case, a patient was billed for having two teeth extracted when they actually only had one removed. Our customer success team called the dentist that day and immediately sorted things out. It turned out to be a clerical error. If this had been an insurance company, this patient would have received a bill thirty days later, and because they weren't out of pocket for anything, they would have thrown it in the trash. So, Bento saved the employer money on this procedure, and more importantly is reducing costs and streamlining care for us all in the long run.

About Sam Mire

Sam is a Market Research Analyst at Disruptor Daily. He's a trained journalist with experience in the field of disruptive technology. He’s versed in the impact that blockchain technology is having on industries of today, from healthcare to cannabis. He’s written extensively on the individuals and companies shaping the future of tech, working directly with many of them to advance their vision. Sam is known for writing work that brings value to industry professionals and the generally curious – as well as an occasional smile to the face.