A Claims-Based Review of Patterns of Billed Dental Services and Pricing Since 2016
Tuesday, September 19
4:15 PM - 5:00 PM (PT)
From the nation’s largest private healthcare claims data repository, this presentation will share information from a claims-based review based on trends noted in dental services since 2016. The session will examine how new technology, new research, and the COVID-19 shutdown in 2020 modified trends in the utilization of dental services, with attention to routine preventive and emergency dental care and more complex care situations. In the session, the results of the claims-based data review will show potential impacts on patients’ care offerings and providers’ utilization/charges during 2016-2022. The data results will support visibility into changes in the frequency and method by which some procedures were billed.
In addition, the session will cover trends in charges and allowed amounts from four years before the COVID-19 shutdown (2016) and during the shutdown in 2020 through 2022. The results will include everyday dental service items, such as pediatric bitewings, occlusal guards, replacement teeth, surgical implants, implants versus standard dentures, periodontal maintenance, and caries risk assessments. Results shared will be stratified by age, gender, and geographic regional differences. The session will demonstrate how claims-based data may be used in various ways, including, but not limited to, helping inform benefit design, network development, and pricing of dental plans for multiple procedures. This session will be helpful for all dental care stakeholder groups, including policymakers, insurers, providers, service organizations, and researchers in the dental health sector.
Donna Smith
Chief Client Officer, FAIR Health
As chief client officer at FAIR Health, Donna Smith maintains an effort to bring value to the various stakeholders that cross multiple market segments in the healthcare ecosystem. Donna has over 25 years of experience in the healthcare industry, concentrating on benefits administration, managed care, payor, and claims solutions. Before joining FAIR Health, she was an independent consultant to various healthcare and benefits sector entities, including health plans, third-party administrators, and other companies serving the health insurance payor and self-funded employer markets. For these entities, her consulting services concentrated on marketing, sales, and organizational strategic planning. In addition, Donna also served the provider community, working with small physician group practices to evaluate electronic medical record (EMR) solutions based on meaningful use evaluations. Earlier in her career, Donna served as senior vice president of sales and marketing for a technology company, SBPA Systems, a role she retained when the company was acquired by SunGard, a leading technology and services provider of employee benefits, healthcare claims adjudication, business process automation and reporting solutions for the health and benefits insurance industry. In addition to focusing on business development, sales, and marketing, Donna developed customer service, implementation, account management teams, and executive and customer advisory groups. Donna has participated in several key industry associations—including the Self-Insurance Institute of America (SIIA), Health Care Administrators Association, America's Health Insurance Plans (AHIP), Institute for Healthcare Consumerism (IHC) and Institute of Medicine (IOM)—by serving in many capacities, such as focused panels, workshops, task groups, and committees, including a Board of Directors appointment with SIIA. Donna continues to participate and speak at various industry forums representing the many sectors FAIR Health serves. She holds a BS in Business Management and Marketing from Louisiana Tech University.
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