Providing Cost Savings to Dental Insurance Carriers While Adhering to State Compliance Laws

NEW YORK, July 13 /PRNewswire/ -- Faced with increasing costs and more competition, dental insurance carriers are constantly seeking a competitive advantage in difficult economic times. Add to these difficult economic times the regulatory requirements from a myriad of state laws and regulations and many payers find it difficult to operate effectively.  Moreover, employer groups are demanding that dental insurance carriers offer even lower cost plans.  How can a dental insurance carrier provide cost effective products while maintaining compliance with various state laws?

P&R Dental Strategies, Inc. (P&R) provides utilization review services with proven savings results while adhering to all state laws and regulations. The legal landscape is so complex but for P&R, the industry leader in dental benefits cost containment, an important value to its client insurance carriers is ensuring that P&R remain alert to that ever-changing landscape, and vigilant in adhering to the varying degree of rules and requirements from state to state.  At the same time, P&R's large network of licensed dentists provide medical necessity review of dental claims based on clinically accepted guidelines.  P&R completes these reviews in 1-2 business days.

"At this moment in time," says Cheryl Eckstein, Compliance Officer for P&R "twenty- five states require that review of dental claims be conducted by agents who have been certified by those states. In addition, there are fifteen states in which the dental consultant has to be licensed by its Board of Dental Examiners to review a claim from that state. There are quite a few additional regulatory demands that vary from state to state, and these rules are evolving all the time."

Being complaint is only part of the battle.  P&R has successfully merged the ability to remain compliant with proven cost savings results.  In fact, P&R leverages a cross-payer database and advanced analytics to increase savings over standard claim review savings results. This provides payers the cost savings needed to remain competitive in an increasingly difficult environment.

"P&R's utilization review infrastructure," says Mike Urbach, Vice President of Sales and Marketing at P&R, "can accommodate varying degrees of claim volume from large and small payers alike.  In fact, payers with larger volumes of claims to review will receive volume discounts thereby recognizing increased ROI."

For more information about the science of State-by-State compliance as applied by P&R Dental Strategies, Inc., please visit the website at pandrdental.com, or contact George Thomas Wilson at 917 716-4205 or [email protected].

SOURCE P&R Dental Strategies, Inc.