The affiliated Delta Dental Plans of Indiana, Michigan, New Mexico, North Carolina, Ohio, and Tennessee have established the Focused Review program to help monitor claims and ensure accurate processing and contract fulfillment.
Of the very few providers that are placed on Focused Review, the majority are randomly selected. An even smaller number of providers may be on Focused Review because a claims analysis shows a statistical difference from their peers or a complaint has been filed against them.
Providers selected for Focused Review will receive a packet of information, including a list of procedure codes requiring additional documentation and how to submit claims to the Focused Review Department. Review this information carefully to ensure a smooth process and timely claims payment.