Dental Audit

Healthcare Horizons performs comprehensive dental claims audits for clients who provide self-insured dental benefits for their employees.

What We Test For

Among many other factors, we look closely at:

  • Eligibility
  • Dental coding accuracy
  • Duplicates
  • Excluded services
  • Coordination of benefits
  • Annual and lifetime benefit maximums
  • Patient responsibility (deductibles, coinsurance, co-pays)
  • Pricing

The Audit Report

When the audit is complete, we deliver a comprehensive report that details the findings of the audit, the areas we tested, and a list of erroneous claims. When applicable, we also identify root-cause issues and make recommendations for correcting these issues to reduce the risk of future overpayments.

To learn more, contact us.