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.