PRONTO

Class [042]
Computer & Software Services & Scientific Services

Computer services, namely, providing search platforms to allow users to access profiles of dental provider practice patterns, denial rates and fraud and abuse gaming patterns for determining the likelihood that a dental claim will result in savings if reviewed; Software as a service (SAAS) services featuring software for providing online business intelligence and decision support solutions to the dental industry by combining information from various databases and proprietary algorithms to support the review and prioritization of daily claims volume targeted for clinical review and/or adjudication edits; Software as a service (SAAS) services featuring software for profiling of dental provider practice patterns into a proprietary predictive savings analysis that determines the relative likelihood that a dental claim will result in savings if reviewed; Software as a service (SAAS) services featuring software for providing access to an analytics engine which evaluates a dental payer's daily claims volume in near real-time, predicts which dental claims have the highest probability of delivering savings for the dental payer and which should be sent for utilization review