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Reviewing dental claims for clinical and coding appropriateness before payment requires extensive in-house resources for dental plans, especially as the American Dental Association (ADA) adds or eliminates CDT codes each year. For one national dental payer with more than 6 million members across commercial, Medicare, and self-insured lines of business, turning to an outside partner to assist with dental claims review and reducing fraud, waste, and abuse has yielded significant savings.
Download our case study and learn how this plan achieved a significant annual savings rate, incremental to its internal editing system, and a low annual appeals rate.