Software

Dental Claims Advisor

A SaaS-based customizable, rules-driven payment integrity solution that helps payers detect miscoded procedures and flag fraud, waste, abuse, and aberrant claims.

Advanceddental claims processing software

Expedited reimbursement

Process dental claims faster by helping eliminate manual processes, and avoid manual claim suspensions and overpayments by immediately identifying miscoded services.

Increased payment accuracy

Detect inaccurate coding patterns, miscoded procedures, fraud, waste, and abuse.

Reduced costs

Eliminate the need to manually review each claim for anomalies.

Promote correct coding behavior

Our dental claims software helps providers receive feedback on incorrect coding patterns to help induce behavioral change.

What’s included

  • Seamless integration

    • Delivered in a SaaS model that integrates with payers’ claim processing and payment workflow
    • All claims can be processed through our rules-based engine, regardless of which clearinghouse(s) you use
    • Easy integration with payers’ pre- or post-pay claim processing workflow
  • Customizable

    • Configurable plug-and-play rules for payers that validate dental service codes in claims using standardized reimbursement guidelines while accounting for the complexities of authoritative dental coding systems
    • Standard aberrancy rules can be augmented with payer-specific rules to address any claim patterns the payer would like to flag for investigation
    • Allows payer to turn rules on or off through a portal based on when specific rules are needed
  • Easy-to-understand reports

    • The results of the claims processed through the Dental Claims Advisor platform are available to the payer through an online portal
    • Payers have a dashboard for viewing the overall status of processed claims
    • Enables payers to drill down to understand why certain claims are being flagged for investigation and the charges associated with those claims

PRODUCT SUPPORT

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Our outcomes

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Let’s start a conversation

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Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

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Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.