Level 2 Services

Claims Adjudication Pre-view:

Using a defined sample of claims, Barron's will review each dental claim submission for over-billing, plan abuse, and fraud. The sample of claims can be reviewed before or alter submission to your insurer or third party administrator. This review will give you a clear indication of the degree of savings that Baron's team of professionals can generate for you.

Service Verification

On a current basis, Baron's will directly contact claimants to review and verify the services provided by the dentist and to match those services against what was billed. In a professional and polite manner, our call centre team will conduct phone interviews to verify the services provided.

Patient Profile

Barron's will establish an onsite profiling station staffed by our team of dentists where the oral health status of plan members will be measured and recorded. Each member will be given an overall rating and offered suggestions on how to improve their oral health. Plan sponsors will receive an overview that if conducted on a regular basis, will allow them to determine the true value of the dental services rendered to their plan members. Future claim submissions will both be measured against this profile as well as used to up-date the profile.
 

Dentist Audit

Given a sufficient amount of claims data by dentist, Barron's will conduct an audit of a dentist's billing practice in conjunction with the sponsors dental plan. It is not uncommon for dentists to make restitution should questionable billing practices be identified.

Verification of Lab Claims

Bills submitted by dentists for lab services will be verified with the lab using a unique procedure.