Fighting Dental Fraud, Waste and Abuse

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

Don’t operate in the dark: a cross-payer database and informatics services can help payers connect the dots to identify dental 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.

P&R Dental Strategies Learning & Informatics - About the Annual Event

Mark Your Calendar for June 26th – 27th, 2019

By popular demand, on June 26th and 27th, 2019 we’re heading back to The Thompson in Chicago, Illinois for the 4th Annual P&R Dental Strategies Learning & Informatics Summit.

The Windy City’s Gold Coast will be the backdrop for two days of learning and discussion tailored to helping your organization become more data-driven. Registration is now open, so visit the information page and complete the registration form to join us at this exclusive event!

Get Social

Are you on Twitter or LinkedIn? Check out all of our 2019 Learning & Informatics Summit postings by following hashtag #PnRSummit19. You can also stay informed of postings on dental data insights from our Learning & Informatics Discovery Hub by following #DiscoverDentalData.

About P&R Dental Strategies

P&R Dental Strategies is the premier dental insights company delivering customized, actionable business intelligence powered by DentaBase®, our national multi-payer claims database. P&R Dental Strategies’ flexible, cutting-edge technology platform provides an enterprise-level suite of quality measurement, claim review and utilization management, provider profiling, fraud and abuse prevention and network development solutions to customers seeking to contain costs and maximize efficiency across their businesses. P&R Dental Strategies customers can depend on the support of an industry-leading team of dentists, consultants and statisticians to focus on their unique challenges.

Background and Overview

P&R Dental Strategies created the Learning & Informatics Summit in 2016 to introduce professionals at payer organizations to the transformational potential of information science and analytics in their business.

During the Summit, we share current market trends and insights derived from DentaBase®, the largest multi-payer dental database, so attendees can understand what’s on the horizon. Data and trend information conveyed at the Summit is balanced with hands-on learning sessions using game changing business efficiency solutions.

Our goal is for attendees to leave the Summit with a sense of the power of Big Data and a familiarity with the tools needed to help their organizations become more data-driven.