Empowering Solutions That Fight Fraud and Deliver Incremental Savings

P&R Dental Strategies’ cross-payer dental claims database, combined with a sophisticated analytics platform provides unique insights into provider outlier behavior.


Download eBook - Claim Review, Fraud and Abuse: Is Your Process Part of the Solution or the Problem?Don’t operate in the dark: a cross-payer database and informatics services can help payers connect the dots to identify fraud, waste and abuse and address each before payment.

Predictive Analytics with Pronto™

Pronto™ is a data analytics solution powered by DentaBase™, P&R Dental Strategies’ extensive cross-payer claims database. Pronto’s sophisticated analytics engine evaluates all of a payer’s daily claims volume in near real-time, predicts which claims have the highest probability of delivering savings for the payer and which should be sent for utilization review.

Pronto’s Predictive Savings Analysis…

  • Automatically rank-orders and tags claims before payment, ending “pay and chase.”
  • Sends flagged claims for the dental consultants’ professional claims review, thereby maximizing ROI.
  • Offers a customizable rules structure based on the clinical and strategic objectives of the payer.
  • Can replace or work with an existing claims selection process, depending on the payer’s need
  • Delivers the insights needed by payers to partner with providers and address unnecessary services

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Utilization Management

With P&R Dental Strategies’ utilization management solutions, payers have the tools to profile dental providers, identify and prioritize outlier behavior, manage corrective actions and create actionable reports.

  • Provide payers with greater insight into dentist practices
  • Allow payers to prioritize and address over-utilization by identifying and segmenting behaviors

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Fraud and Abuse Detection

With P&R Dental Strategies’ fraud and abuse detection solutions, payers have a highly targeted means to detect and identify potential fraud, waste, and abuse.

  • Provides visibility into trends and patterns across payers
  • Alerts provide an early warning system of suspicious behavior and flag specific outliers.
  • Complements our utilization management solutions

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For more information about our fraud and abuse, predictive analytics and utilization management solutions, please complete the form below.