Software

Dental Claims Advisor

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

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Advanceddental claims processing software

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Expedited reimbursement

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

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Increased payment accuracy

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

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Reduced costs

Eliminate the need to manually review each claim for anomalies.

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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’ or administrators' 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’ or administrators' pre- or post-pay claim processing workflow

  • Customizable

    • Configurable plug-and-play rules for payers and TPAs 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 and TPAs have a dashboard for viewing the overall status of processed claims
    • Enables payers and TPAs to drill down to understand why certain claims are being flagged for investigation and the charges associated with those claims

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Our outcomes

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On-demand Webinar

Eliminating Barriers to Dental Insurance Estimation

On-demand Webinar

Eliminating Barriers to Dental Insurance Estimation

This webinar explores how to accurately and confidently estimate dental insurance reimbursements and patient responsibility.

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e-Book

Automate and Accelerate Provider Dental Credentialing

e-Book

Automate and Accelerate Provider Dental Credentialing

See how the laborious, time-consuming credentialing process has been transformed by our Dental Credentialing Verification Organization.

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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.