DentSource® From P&R Dental Strategies Mines a Vast Cross Payor Database to Flag Potential Dental Insurance Fraud and Abuse

NEW YORK, June 23 /PRNewswire/ -- According to the American Dental Association, there are approximately 179,000 professionally active dentists in the United States*. Are some of them better at practicing dentistry than others? Could some dentists be submitting potentially fraudulent or abusive claims to dental benefit payors? How is a payor going to know?

As the nation's leading dental claim review specialist for the past 20 years, such inquiries have long been demanded of the professionals at P&R Dental Strategies, who pride themselves on delivering the ultimate in dental benefits cost containment to their clients.

Because P&R's data resource provides extensive information on every single dentist from every single state in the country, it offers insights into practice patterns on an individual provider basis. How can a payor access this wealth of information in a constructive, cost- effective manner?

P&R now offers DentSource – a powerful web-based application that can slice and filter this massive data asset to create meaningful reports and analyses that support almost any business objective. DentSource enables a payor to identify potentially fraudulent and abusive practices in a way that has never before been possible.

DentSource also provides a payor with the ability to benchmark its utilization data with that of national and regional norms.

"DentSource not only gives payors access to a wealth of information from the cross- payor database," said Mike Urbach, Vice-President of Sales and Marketing at P&R, "but it gives payors the ability to identify actionable information."

DentSource supports other functional areas in addition to fraud and abuse, including:

1. Marketing: DentSource allows the user to demonstrate optimal client management by generating custom reports for specific employer groups;
2. Network Development: With DentSource, network administrators have a valuable tool for identifying additional dental practitioners who are well suited to their networks;
3. Network Management: By flagging "outliers" who overuse or misuse certain procedures, DentSource signals the need for provider counseling;
4. Actuarial: The more complete the utilization information, the more accurately future premiums can be modeled and plans designed; and
5. Utilization Management: By taking individual provider claim review, results into account, standard claim review guidelines can be customized to streamline the process and increase return on utilization review investment.

There has never been a system for dental claim analysis quite like DentSource. Built as it is upon the depth and strength of P&R's long years in the dental benefit cost containment business, it is an invaluable tool for any dental benefits payor.

For more information about DentSource, or licensing the system for your company, contact P&R Dental Strategies, Inc. at 212 686-2777, or visit the website at pandrdental.com.

*"Distribution of Dentists in the United States, Historical Report 1998 – 2006," American Dental Association, March 2009

SOURCE P&R Dental Strategies, Inc.