DentaLens

This dental provider bills for surgical tooth extractions far more frequently than other providers with the same specialty. By analyzing a large sampling of claims from similar dental providers, MultiPlan made sure this outlier did not go unnoticed. Our Dental Payment Integrity Services helped the payer to identify the billing issue. Now they can use our integrated behavior change service or otherwise work with the provider to ensure they don’t bill for surgical extractions when a simple extraction was performed. Learn more > https://www.multiplan.us/services/dental-payment-integrity/

This patient has just started grade school and enjoys art and playing soccer. She’s just gotten her first molar, but after a routine appointment the dentist billed for extraction of a wisdom tooth. MultiPlan’s Dental Payment Integrity Services flagged this impossibility. In fact we look at every CDT code billed on every claim to gauge the appropriateness of the service for the patient’s age. This way, payers don’t pay for a service that isn’t possible.