Dentistat developed a proprietary Provider Utilization Pattern program. Dental Preferred Provider Organizations (PPO) receive a discount from a dentist in return for access to members that want to visit a PPO dentist. It is important to manage the utilization of the dentists in the dental network to ensure over utilization doesn’t offset the discounted fees. A dentist’s profile can be reviewed prior to acceptance into the network and on an ongoing basis.
We receive claim data from our clients. We gather each client’s data on a six month basis. We combine four 6-month segments into a “Big Mash.” The Big Mash is used to review utilization for a specific geographic area, individual dentist’s profile and more.
A strong Utilization Management program is an effective, long-term cost control strategy for every dental business. A UM program can also help differentiate you from the competition.