Improve Efficiency in the Dental Claim Review Process and Reduce Fraud

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.

In our recent Insights Series webinar “Clinical Review Practices: How Process Can Embolden Abusive Behavior,” we discussed how review decisions impact abuse and how payer organizations can review smarter through best practices and predictive analysis. With industry-leading dental informatics tools from P&R Dental Strategies it is possible to:

• Examine the differences in provider behavior across payers
• Understand how review procedures and enforcement practices create conditions for abuse to thrive
• Leverage our best practices combined with predictive analysis to improve efficiency and savings in the claim review process

  P&R Dental Strategies’ suite of utilization management, network development and fraud and abuse detection solutions are designed to provide the business critical actionable insights you need to meet your goals.

To request a demo of our solutions customized to your business, please complete the form below:

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