Benchmark your utilization management to optimize best practices

Introducing the Utilization Management Optimization Report from P&R Dental Strategies.

 

1. Assess clinical criteria and guidelines

2. Evaluate edit/processor effectiveness

3. Reduce/mitigate the impact of outlier behavior

Improve your organization’s understanding of its utilization management practices with this competitive landscape report. Delivering a comprehensive review of UM practices, see where your organization stands when it comes to:

  • Traditional claims processing/edit practices
  • Benefit design norms
  • Utilization review criteria best practices
 

Unmatched Insight and Industry Expertise

In my 30 years in the dental industry, I have seen many reports of this type but nothing as comprehensive and as detailed with as much data to support it as this one.

Powered by DentaBase®, our cross-payer database including utilization data on nearly every dentist in the U.S., the Utilization Management Optimization Report delivers exclusive insights.

  • Assess your processes and results in the context of a competitive landscape.
  • Receive in-depth analysis of your utilization management policies and procedures from our industry experts.
  • Uncover potential areas to lower and contain costs.
 

Evaluates Every Facet of Your Utilization Management

The Utilization Management Optimization Report is an extensive look at your organization’s operations that ensures no part of your utilization management processes is left unexamined. Each delivered workbook provides code-level evaluation of:

  • Benefit classification
  • Contract limitations, exclusions and frequency limits
  • Anonymized competitive comparisons
  • Recommended standard adjudication system edits/processor rules
  • Percentage of clinical recommendations for denial and/or alternate benefit coding
  • Standard documentation requirements for clinical review (where applicable) and comparison of clinical review guidelines/criteria
 

Recommendations Focused on Your Bottom Line: A Roadmap to Optimization

Utilization Management Optimization: A review for just one payer identified over $20 Million annually in cumulative estimated savings for implementing all identified processing/review guidelines in all procedure categories

Getting an expert perspective based on real data and in-depth analysis of an organization’s policies and procedures is a great way to uncover inefficiencies.

Based on the recommendations in the Utilization Management Optimization Report, our experts will work with your team to:
  • Ensure that you understand the projected savings related to cost containment of each procedure code used in your current review processes.
  • Suggest a plan of action for significant cost containment and quality improvement initiatives that streamlines the inefficient or unnecessary parts of your utilization review operations.

Complete the form below to request a sample Utilization Management Optimization Report featuring examples of our extensive procedure code analyses and recommendations or email us at insights@pandrdental.com.

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