Dental claims are slightly different than other healthcare claims, and prepay review for clinical and coding accuracy takes extensive in-house resources for dental plans. Add to that the ever-changing CDT codes from the American Dental Association (ADA) each year and it quickly becomes clear that dental claims require targeted expertise to pay correctly. In addition, just like health plans, dental plans are also currently dealing with fallout from pent-up demand that accumulated during the height of the COVID-19 pandemic and beyond.
One major dental payer has successfully navigated these challenges with Cotiviti’s Dental Claim Accuracy solution. In our recent case study, learn this payer yielded significant savings by working with Cotiviti to assist with dental claim reviews and reduce waste and abuse.
See how the plan achieved:
- Increased prepay savings by avoiding improper claims payment
- Reduced cost and effort of postpay audit and recovery
- Improved compliance with CMS regulations, ADA guidelines, and more
- A low annual appeals rate