P&R Dental Strategies Insights Webinar Series
|Insights Series Webinar #14
Year-End Checkup: Diagnosing Market Vulnerability & Exposure to Outlier Abuse
Just as regular dental exams are critical to spotting oral health problems, pausing to take a look at the recent trends and forces impacting the industry can serve as a valuable barometer for what lies ahead and allows organizations time to prepare. In this webinar, we’ll dive into DentaBase®, the largest dental database in the country, for insights into several key areas: How will 2017 market movement affect 2018? Is your organization vulnerable to outlier fraud and abuse? What is the state of the DSO space and its impact on payers? — And more.
|Insights Series Webinar #13
Quality and the Consumer: Delivering Objective Price & Quality Information as a Differentiator in the Sales Process with Employers
Some consumers are satisfied with asking friends and family for advice on the best dentist to see. However, in order to find complete and objective dentist quality information, subjective measures like Yelp reviews and testimonials on provider websites are not enough. Consumers want their employer plans to provide access to information on dentists in an easy to digest format and employers are demanding that payers improve consumer engagement through transparency of information. This webinar will explore how payers can integrate flexible, objective dentist quality score card data into their member portal and how that can be a differentiator in the sales process with employers as well as a value-add for consumers.
|Insights Series Webinar #12
Mastering the Changing Dental Landscape: An Overview of Recent Market Trends
Many are familiar with the quote “The only thing that is constant is change,” and this is as true in the dental industry as anywhere. Everything from changing dentist workforce demographics to practice affiliations, utilization trends and other shifts present payers with new challenges — and opportunities, if they can learn to leverage the unprecedented amount of data available. This webinar will share insights from the dental procedure claims data in P&R Dental Strategies’ DentaBase™ cross-payer database to provide a “birds-eye view” of trends affecting the industry.
|Insights Series Webinar #11
Painting the Big Picture: Trend Analysis Driven by Cross-Payer Dental Claims Can Unlock New Product and Pricing Vistas
Regardless of your role within the business, having a sense of the “big picture” is important to staying ahead and operating efficiently. Many payers are asking questions like How are plan costs changing relative to the competition? How does this relate to utilization? Is this doing damage to our loss ratio? — without the broader insights needed to answer them. In this webinar Tim Downey, P&R Dental Strategies’ Chief Analytics Officer and our visiting speaker, Jeff DeCapua, Consulting Actuary from Actuarial Worksite Management Services, discuss how a “trend of trends” viewpoint encompassing historical and predictive perspectives could supply payers with guidance ranging from product development and positioning to competitive pricing strategies.
|Insights Series Webinar #10
Shining a Light on Fraud, Waste and Abuse: Connecting the Dots with Claim Reviews and Dental Informatics
News headlines regularly remind us that fraud, waste and abuse are a significant and growing problem for dental payers. This webinar will discuss the most common alerts and types of clinical observations made during claim review that suggest suspicious behavior. We will also present some eye-opening trends and examples of tools that provide a highly targeted means to detect and identify potential fraud, waste and abuse. > REGISTER TO VIEW ARCHIVE
|Insights Series Webinar #9
Better, Not Smaller: Minimize the Risk of Network Reduction Through an Optimized Network Accuracy Plan
It’s old news: finding and removing inaccurate access points from a payer’s network is critical for compliance with a growing number of state and federal regulations, as well as keeping groups and members happy with the plan. But no payer wants to be the first to make changes to their network and be at a competitive disadvantage due to network size. This webinar will discuss whether payers should build an internal capacity to maintain ongoing directory accuracy or outsource, as well as new options that allow payers to maintain — and even grow — the size of their network while ensuring compliance.
|Insights Series Webinar #8
The Difficulties of the Difficult Prophy: New CDT Code 4346
New CDT Code 4346 arrives in 2017. Has your organization considered the challenges of the difficult prophy in preparation for its arrival? In this webinar, P&R Dental Strategies’ Dental Director, Dr. Michael Fiorenza, discusses the origins and perceived need for the code as well as utilization trends for prophy and scaling & root planing procedures. The webinar concludes with an exploration of coverage planning implications for 2017 and beyond.
|Insights Series Webinar #7
Caries Risk Management and Adherence to Treatment Protocols: Insights and Opportunities in Commercial Dental Plans Using Informatics
Dental informatics have the potential to transform a payer’s understanding of the patient journey from initial treatment to future outcomes resulting from adherence (or its lack) to treatment protocols. With benefits changes driving utilization patterns that ultimately impact a payer’s costs, the potential for designing more efficient plans through informatics is wide open. In this webinar we examine national high risk, regional, group/employer and doctor norms to see what relationships the data can highlight, how to segment patients by risk using cross-payer claims data and whether it’s possible to steer patients to dentists who have the highest adherence achievements.
|Insights Series Webinar #6
Smart Claim Selection, Big Data & Analytics: Supplement Your Process and Optimize Outcomes
Relying solely on traditional screening processes to determine what a clinician needs to review can clog a payer’s workflow. While there are some cost-saving elements to engaging processors in manual review, even the best human reviewer can’t see the entire picture: who are the abusers and over-utilizers across the claims landscape? What upcoding, unbundling, and/or over-utilization practices are draining savings from the bottom line? This webinar will discuss smart claim selection using statistical analysis on big data sets as a powerful tool payers can use to supplement an existing review workflow and optimize outcomes. > REGISTER TO VIEW ARCHIVE
|Insights Series Webinar #5
Status Quo or Status Grow: Make Your Dental Plan Products Stand Out in a Commodity Market
There’s hardly been a more challenging time for dental payers. Squeezed by rising costs, employers shopping for a plan seem to base their buying decisions solely on price and access points, leading many payers to cut premiums and fill their networks with the same quantities of providers as their competitors. It’s a commodity market and payers that accept the status quo are rapidly losing market share. But it doesn’t have to be this way. In this webinar we’ll discuss strategies that innovative payers can use to fight the status quo, differentiate their dental products and grow market share. > REGISTER TO VIEW ARCHIVE
|Insights Series Webinar #4
Clinical Review Practices: How Process Can Embolden Abusive Behavior
Fraud and abuse are the cost of doing business for dental insurers — and as the media frequently reports, that cost is high and growing. Many payers don’t realize that their clinical review practices can create conditions ripe for abuse. Reviewing every claim isn’t practical and choosing to exempt entire procedures from review often encourages greater levels of abuse. This free webinar will look at how review decisions impact abuse and how payer organizations can review smarter through best practices and predictive analysis. > REGISTER TO VIEW ARCHIVE
|Insights Series Webinar #3
Recruiting and Outlier Behavior: Network Development Pitfalls
Expanding provider networks and contracting favorable fee schedules are key network development objectives for payers. But value is lost if dentists compensate for fee schedule discounts by over utilizing services. This webinar will help acquaint you with the financial risks and explain how payer organizations can avoid network development pitfalls using insights from profiling tools before you contract. > REGISTER TO VIEW ARCHIVE
|Insights Series Webinar #2
Validating a Moving Target: When Dental Associates Don’t Stay PutFrom dealing with dental network management challenges wrought by legislation to maintaining customer satisfaction, how do you keep up with dental associates who move from one location to the next? > REGISTER TO VIEW ARCHIVE
|Insights series webinar #1
Managing Payer Costs Through Effective Risk Prioritization TechniquesOf the $250 billion spent on dental care procedures annually, an estimated $12.5 billion is lost to fraud, waste and abuse – mostly in waste and abuse. But payer organizations can efficiently manage — and reduce — these costs by taking straightforward steps using effective risk prioritization techniques. > REGISTER TO VIEW ARCHIVE