P&R Dental Strategies designed this flexible system to give dental consultants all the tools necessary to complete a claim review, including access to images, policy information, compliance with state laws and patient history.

Automate the Claim Review Process

Any business anywhere would like to increase productivity and lower costs. There's a remarkably simple way to do both with P&R's Claim Review Management System (CRMS). If you automate your review process, you'll instantly see the value in doing so. Clients who use our system report they double the number of claims they review per hour and make fewer mistakes.

The CRMS provides a complete audit trail and comprehensive data storage solutions that can be customized to fit whatever your needs may be. If you're looking for the best possible way to streamline your dental claims process, you've just found it with P&R's Claim Review Management System.

Customize

Our highly sophisticated, industry-tailored program was designed to give clients the utmost in maneuverability and customization. You can set up your CRMS for the desired degree of dental director participation; monitor the quality of dental consultant review; track prior claims, letters and phone calls; generate letters to providers and patients as required by law; meet deadlines with a built-in alert system that keeps track of turnaround requirements and create information request letters and "pend" letters with P&R's letter writing wizard.

Compliance

Compliance is a bothersome fact of life for everyone in the dental claims industry. P&R Dental Strategies designed a web-based application to make compliance simple. Our Claim Review Management System allows dental consultants to spend their time on the review itself-determining the medical necessity of services-instead of wasting time on the bureaucratic process.

Return on Investment

Have you quantified the number of claims your consultants review in an hour? Do efforts to increase productivity end up meaning more mistakes during claim review? Automating the claim review process with the CRMS will significantly reduce process errors and there will be no more thumbing through thick benefit manuals or searching databases for patient histories.

By using the CRMS, P&R consultants average 25 to 40 claim reviews per hour. Quality is not sacrificed for this increase in productivity as P&R has one of the lowest provider complaint ratios in the industry.* How much more productive could your consultants be with this system?

* American Academy of Periodontology - Member Complaint Report, 2007

Web Application

P&R's Claim Review Management System is a web-based application, which means there's no software to install. We stay on top of any changes to state laws this way, which means you'll be certain to be in compliance and will thereby avoid heavy penalties.

Also, the user-friendly interface allows clients to get instantaneous claim status. An easy-to-use query tool gives you the ability to search individual claims by procedure type, consultant, claim status, etc. P&R's application also comes with an easy-to-use tutorial and sample claims for training purposes.

A built-in reporting section enables you to track savings on a per claim basis. You can quickly assess those procedure types yielding the highest return for your claim review dollar. You can also follow the impact of appeals and decision reversals. The CRMS will help you create reports to track turnaround time by individual state to ensure complete compliance with state laws.