The document describes several products and services from P&R Dental Strategies for containing dental benefit costs, including:
1. A web-based claim review application that allows for increased productivity and comprehensive reporting on claim review selection and utilization review savings.
2. A claim review management system and rapid review imaging system to help dental consultants focus on clinical issues rather than administrative tasks.
3. A DentaBase database containing claims information from over 160,000 dentists for benchmarking, practice analysis, and determining medical necessity.
3. Web based claim review application for increased productivity and comprehensive reporting Smart claim review selection for maximum savings Utilization review savings with 100% compliance Web based interface to analyze cross payer utilization and claim review data X-ray and document digitilizer with image enhancement features Pronto Professional Claim Review Claim Review Management System Dentsource Rapid Review Imaging System DentaBase Cross payer claims database representing over 160,000 dentists Products to move your company in the right direction
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5. Watch Your Savings Increase with Seamless Integration... As you combine P&R ’s Products and Services
7. Patients should get every benefit dollar coming to them but not a penny more It is the only way to make a determination of medical necessity Effective mechanism to demonstrate to employer groups impact on controlling benefit costs Why Perform Claim Review?
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10. Professional Utilization Review should be viewed not as cost but a “Profit Center” Savings vary based on client UR criteria, plan design, philosophy and claim charges. Average numbers are presented here. Professional Claim Review Savings Based on P&R client experience
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12. A smarter way to select claims to maximize savings Pronto is the application of data analytics to prioritize claims for Utilization Review that have a higher probability of generating increased savings. Utilization Review Meets Artificial Intelligence… Introducing Pronto™
13. Standard Referral Guidelines – High dollar items and/or items subject to typical abuse - Crowns, Bridges, etc. Focused Review – Review of procedures that are typically not part of standard referral guidelines - Pulp caps, Crown Build-ups, etc. Typically driven by provider utilization profile. How to Select Claims for UR: Traditional
14. Number of Claims processed per year: 11,925,000 Number of Claims reviewed per year: 477,000 Total Savings per year: $51,000,000 How do you know that those were the right 477,000 claims to select? Customer Example: Traditional
22. A web based interactive platform for dental informatics Based on profiling of DentaBase, our large cross payor database What is DentSource
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24. Are the images you receive slowing your Dental Consultants down? Quality makes a difference in your savings Rapid Review Imaging System
25. Poor quality images cause pending of claims for additional information, which slows processing and significantly reduces profitability. The Rapid Review Imaging System is designed to enhance images, providing a more efficient process. Rapid Review Imaging System features: Ease of use Simple integration Barcode compatible Fast data capture Paper, Photos and X-Rays Auto Focus and Cropping Auto Enhancement Automated Before After
26. The largest, richest, most comprehensive, non payer owned dental claims database in the country. DentaBase
27. A unique dental database available for: National and regional benchmarking Practice pattern analysis Medical necessity determinations