Scion Dental’s file processing is a key component of our world-class dental benefit management solution. We provide comprehensive data management that is tailored to each client’s unique requirements, proprietary file formats, and customized reporting layouts and schedules. Our capabilities include reconciling individual claims/services with in HIPAA-compliant 837 encounter files to verify the data matches the HIPAA 837 Companion Guide requirements.
Our clients have real-time data monitoring and analysis tools for greater oversight of their dental benefit program management. We collect, process and analyze data all in one place, giving client instant access to the information they need to make informed business decisions – both day-to-day and long term.
Eligibility & Enrollment Data Management
As part of our claims processing workflow, Scion Dental verifies member eligibility for services based on plan design, date of service, member and dependent enrollment information and other data. Our management of eligibility data gives clients greater control over their benefit costs. When appropriate, Scion Dental also manages enrollment data, including collection of this data through our web-based Member Portal. With the Enterprise System, we offer clients access to real-time enrollment management reports and greater transparency into their dental benefit program.
Encounter Data Management
When encounter data reporting is a requirement, clients rely on Scion Dental’s ability to manage and submit accurate, thorough encounter data in a compliant manner. With the Enterprise System, encounter data management is a core function for Scion Dental. Our claims workflow is designed to ensure that every claim is tracked at every stage, and that claims rejected because they do not meet a client’s pre-defined business requirements receive the proper follow-up. At any time, clients can view real-time reports that spotlight any missing encounter data or indicate that all encounter data is accounted for.
Provider Data Management
Scion Dental streamlines provider management processes by bringing the data related to provider and clinic location information, fee and reimbursement schedules, and contracting and credentialing all online. Our paperless environment facilitates communication with providers and enables clients to manage multiple networks and network-level reimbursement with ease. We can also launch network-building campaigns that drive interested providers to a contracting web portal, automatically adjust the contract language presented to each provider based on nearly any variable, and perform hundreds of other provider management functions efficiently and cost-effectively.
Scion Dental offers comprehensive, flexible reporting capabilities that can be easily customized to meet clients’ specific requirements for data, layout and file format. Hundreds of standard reports, many of which are customizable through the user interface, are available on demand for immediate online access. Reports display real-time data drawn directly from Enterprise System databases, and most can be exported in a variety of file formats, including PDF and Excel. In addition to standard reports, data can be easily extracted and repackaged into client-defined report formats without a programming change to the system. All required reports are delivered on a timely basis, are HIPAA compliant and can be uploaded to a secure file transfer protocol (SFTP).