Dental Informatics Solutions to Manage Performance

P&R Dental Strategies aggregates vast amounts of de-identified dental claims data from over 70 national and regional dental plans, but we don’t stop there: we help you derive actionable insights from your own data and leverage the vast benchmark database, DentaBase®, to optimize your organization’s performance on many levels.

P&R Dental Strategies’ dental Claim Review Management System (CRMS), Pronto®, analytics products and supporting infrastructure have earned Certified status for information security by HITRUST. The HITRUST CSF Certified status demonstrates that P&R Dental Strategies has met key regulations and industry-defined requirements and is appropriately managing risk.

  • Scoring Dental Quality

    As the dental market shifts toward value-based care, how can I accurately measure dental quality under a pay-for-performance model? How can I enhance consumer engagement? P&R Dental Strategies' unique DentaQual® platform, an industry first, transforms how dental payers support member engagement. By publishing quality ratings in your provider directory, you stand out during employer conversations. DentaQual also provides an ideal foundation for accurate internal quality assessments and value-based care initiatives.
  • Eliminate Unwarranted Payments

    How can I determine which claims should be held for review prior to payment in an accurate and efficient manner? P&R Dental Strategies' Pronto® helps identify, in near real time, if a claim that has been submitted should not be paid — prior to payment of the claim.
  • Contract With The "Right" Dentists

    How can I contract with dentists whose discounts are most favorable to my business model? P&R Dental Strategies' Network Development Module helps you segment dentists in a specific geographic area into clear categories (e.g., utilization patterns and discounts) that show which dentists best meet your plan’s business objectives for that market.
  • Price New Products

    How do I price a new dental benefit in an area where I have no utilization history? Will in- and out-of-network fee trends change? Use our Actuarial Intelligence Module to assess current utilization trends to determine optimal premiums for a given market. Or plan for the future with our DentalMarketWatch® Forecasting Report of 12-month rolling projections on dental utilization, procedures and fees.
  • Identifying Outlier Abuse

    How can I tell which dentists in my network are practicing outside the norm? Identifying outlier abuse within your network is key to keeping your business as profitable as possible. Our Utilization Management Module identifies dentists whose claims activity may indicate a history of upcoding, unbundling and overutilization to help you identify potential outliers.
  • Finding Potential Fraud

    How can I identify potentially fraudulent behavior in a more efficient and accurate manner? Fraud is a challenge in our industry, but P&R Dental Strategies' Fraud and Abuse Detection Module makes identifying and reducing fraud much easier by clearly tracking and highlighting patterns of potential fraudulent behavior.
  • Current Market Fees

    How does my cost of in-network dental services compare across the U.S. or across a state? Align your in-network fees with costs and the expectations of your market. P&R Dental Strategies’ DentaFee™ In-Network Report is a reliable source for non-imputed, in-network market data, driven by the power of DentaBase® our multi-payer, fee-for-service claims database from over 65 national and regional payers with valuable practice-level data on over 190,000 dentists.