For Dental Payers:

Professional Claim Review

Manage utilization review efficiently by outsourcing to the dental claim review experts.

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Dental claim review is a resource-intensive process. Between fluctuations in volume and changing state regulations, maintaining efficient claim review operations takes a well-equipped staff of experts and reviewing consultants to handle cost-effectively.

Outsourcing your dental claim workload to Fluent’s Professional Claim Review service can be a cost-effective alternative to building and maintaining your own clinical team.
Fluent in utilization review

The dental claim review experts you can rely upon.

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Compliance with changing state utilization review laws and regulations is challenging for many payers to stay ahead of, but our compliance staff has you covered. With deep domain expertise in state utilization review laws and regulations, our team ensures that your utilization review is always in compliance.

Fluent has spent over 25 years perfecting the dental claim review process, handling the claim review operations of benefits organizations of all sizes. Our Professional Claim Review service can:

  • Improve an organization’s utilization review efficiency.
  • Help you maintain fraud, waste and abuse objectives.
  • Provide coverage across all 50 states, including in-state licensure where needed.
  • Give you access to our team of highly skilled dentists who expertly analyze claims and lighten a payer’s administrative load.
  • Ensure you’re not reimbursing for dental services that are not medically necessary or are improperly documented.

Streamline and effectively manage your dental claim review operations, no matter the volume you’re currently experiencing.

6 Ways Fluent's Professional Claim Review service supports your utilization review program:

Designed to Fit Your Needs

Whether you’re looking to outsource all or just a part of your claims volume, our Professional Claim Review service is designed to work best for what you need.

Quality Assured

Rigorous hiring, training and monitoring of consultants is integral to our program and ensures consistency of review within your program’s requirements (clinical philosophy).

Secure & Compliant

URAC accredited, HIPAA compliant and HITRUST certified. Licensed in all states that require UR certification and/or licensure.

Scales to Meet Volume Demands with Ease

Consultants across the U.S. and in all states requiring Home State Licensure gives you flexibility to meet demand.

Comprehensive Reporting Capabilities

Our Claim Review Management System gives you 24/7 access to a variety of standard reports from savings to turnaround time, as well as status updates.

Reduces Exposure to Costly Outliers

Highly skilled consultants ensure you only reimburse clinically necessary and properly documented claims.