Maintaining Network Accuracy is Resource Intensive – But It Doesn’t Have to Be

Accurate, Compliant and Completely Turnkey

 

Maintaining & Documenting Directory Accuracy: An Ongoing Challenge

In 32 states, 35% of providers could not be found at the location listed by the plan [1]

Every network management department will benefit from P&R Dental Strategies’ Network Directory Accuracy Service. This turnkey solution maintains and documents directory accuracy by utilizing our exclusive claim review infrastructure and proprietary cross-payer database, DentaBase™.

Advantages

  • Utilizes DentaBase™ monthly updates
  • Leverages the P&R Dental Strategies account support infrastructure for provider outreach
  • Supports compliance with various network accuracy laws, including a documentation trail

What You Get

  • List of provider/locations to remove from your directory based on actual claims activity in our cross-payer database (list can go to Contract Management for updating)
  • List of all dentists/locations with actual claims activity at the location in the most recent 30 days of DentaBase™ claims data
  • Outreach documentation trail (including letter images and phone call documentation) captured by our Claims Review Management System infrastructure for compliance support
  • OPTIONAL: Augment your insights with a list to incorporate provider-level insights on Overall Abuse Scores and Financial Risk Scores
 		  

Network Directory Accuracy ServiceWe maintain and document directory accuracy so you don’t have to.

Contact us for pricing today.

 

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1 HHS, Office of Inspector General, State Standards for Access to Care in Medicaid Managed Care, Washington (2014).