PROCESSING MEXICAN DENTAL CLAIMS WITH DCAL™
THE PROBLEM
Insurance companies are being defrauded of millions of dollars by Mexican dentists and/or U.S.-based billing agencies charging U.S. prices for services rendered in Mexico.
THE SOLUTION
DCAL™ is a secure and innovative web-based system that allows the claims handler to quickly and efficiently adjudicate dental claims originating in Mexico. This simple, efficient, and reliable tool provides up-to-date reasonable and customary rates—by dental code—for the specific geographical zone where the dental service was provided.

DCAL™ helps ensure that our customers and partners are not defrauded by paying inflated costs for services received by their members in Mexico. All procedures are listed under treatment codes as set by the American Dental Association.
THE RESULTS
DCAL™ identified the following during our three-month beta period:
% of inaccurate claims 100%
Average overcharge per claim $927
Average % savings per claim 60%
Highest % a code was overcharged 325%
Three out of four billing agencies used the same TIN on different dentists
Three out of four billing agencies used different TINs on the same dentist
 
Key Features
Web-based platform
Secure, 24/7 online access
User-friendly
Real-time, interactive reporting
Accurate dental procedure pricing
License & TIN fraud detection
Multi-user environment
No hardware or software required
Nightly offsite system backups
Related Media
DCAL™ Brochure