With the Utilization Management Optimization Report, You Could Discover Savings and Efficiency Opportunities in Your UM Program
Optimize now and prepare for the unexpected. The Utilization Management Optimization Report is a first step any dental benefits organization can take towards a more analytics-informed, optimized and efficient utilization management program.
Put Big Data to Work.
“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.”
— VP, Dental Networks and Professional Relations at a large payer
Our Utilization Management Optimization Report takes an objective, data-based look at your operations to uncover inefficiencies and show you where you can begin to optimize. This turnkey report provides easy-to-understand, actionable reccomendations that any dental payer organization can implement to see immediate improvements.
We leverage big data from the largest dental database, DentaBase® our vast, multi-payer dental claims database contaiing data on over 200,000 active U.S. dentists and billions of dental claim records. This report benchmarks your utilization management operations and provides answers to the big questions:
- Is my utilization management as effective as it could be?
- Is my benefit plan aligned with best practices?
- What codes should I include or not in my utilization management?
- Are there opportunities for incremental savings?
- And more…
What You Get in the Utilization Management Optimization Report
Identification of reviewable clinical procedures for utilization review
Evaluation of traditional platform edits
Insight on emerging trends
Benefit plan alignment
(Exclusions, limitations and/or frequency limits, where applicable.)
Optimized utilization review outcomes
Benchmark comparisons to DentaBase® averages
…Plus: Incremental savings opportunity
A Powerful Report that Analyzes Every Aspect of Your Utilization Management
What does the UM Optimization Report look for? We break it down to the individual CDT code and evaluate your:
- Clinical criteria and current guidelines
- Contract limitation, exclusions and frequency limits
- Benchmark comparisons to Utilization Review outcomes
- Edit/processor effectiveness
- Standard documentation requirements for clinical review (where applicable) and comparison of clinical review guidelines/criteria
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