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
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 procedure 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
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.