#USA #Nashua #SmartClaimFocus™ #Fluent™ #Dental Claims

Fluent™ Unveils SmartClaimFocus™

On September 16, 2025, Fluent™, recognized as a leading provider of AI-driven oral health analytics software and services, announced its latest innovation, SmartClaimFocus™. This advanced platform is designed to revolutionize the ways payers manage dental claims by identifying key opportunities regarding Fraud, Waste, and Abuse (FWA). The launch signifies a commitment to enhance utilization management and support smarter decision-making in the dental care industry.

A Closer Look at SmartClaimFocus™

SmartClaimFocus™ integrates seamlessly with DentaBase®, the largest multi-payer dental claims database. By leveraging Fluent's sophisticated algorithm-driven rules engine, this new platform aims to streamline the claims process, reduce noise, and sharpen decision-making for payers. The approach is structured around continual analysis of each client's paid claims history against practice pattern benchmarks to pinpoint significant statistical outliers, ensuring that payers can focus their resources where they will yield the most substantial return.

Key Features of SmartClaimFocus™

1. Provider-Level Breakdown: Users can dive deep into specific procedure rules to identify which providers frequently exhibit risky or outlier behavior, allowing for a targeted review strategy.
2. Rule Prioritization: The platform ranks rules based on their potential impact concerning FWA, helping users to first address the highest-priority issues.
3. Focused Review: After identifying high-impact risk areas, users can select specific providers and CDT codes for in-depth review, enabling them to monitor review volume and projected savings directly within the platform.
4. Processor View: This feature provides insights into where adjudication processes intersect with standard FWA processing rules, alongside details on the financial implications of these intersections.
5. Data Export Options: All views within SmartClaimFocus™ facilitate data export, simplifying collaboration among team members for follow-up actions.
6. FWA Impact Assessment: Users can estimate the potential impact linked to inactive rules, uncovering opportunities for enhanced efficiency and cost savings.

According to Paul Sheils, the CEO of Fluent™, "Payers require tools that bring clarity to complex claims data. SmartClaimFocus™ simplifies the identification of savings opportunities and missed prospects, allowing resources to be aligned effectively for maximum impact. It transforms claim review into a more strategic process rather than complicating it further."

Transforming the Future of Claims Management

SmartClaimFocus™ serves to illuminate inappropriate behaviors and unveil hidden risks, empowering payers with a comprehensive platform to detect, prioritize, and act on the most pressing issues in dental claims management. This product launch marks a pivotal moment in Fluent's innovation trajectory, indicating their ongoing dedication to establishing robust solutions for payer clients.

For additional information regarding Fluent and its extensive range of dental business intelligence solutions, visit Fluent.Dental. As they continue to lead in the dental analytics sector, the advancement of SmartClaimFocus™ is just one of many exciting developments on the horizon for Fluent™, aimed at improving overall operational efficiency and effectiveness in oral health care.

About Fluent™

Fluent™ is considered the trusted analytics platform in oral health, amalgamating comprehensive data with intelligent AI and professional services. With over 6.6 billion dental claims fueling their platform and an annual growth rate exceeding 10%, Fluent™ continues to support a vast network of payers, providers, and suppliers across the dental ecosystem. Their services not only enhance operational efficiency but also focus on improving the clinical outcomes for over 110 million commercially insured patients.

Contact Information

For business inquiries, please reach out to Fluent Business Development at [email protected].
For media inquiries, contact Ross L. Allred, Director of Growth Marketing at Fluent, directly at 1.609.783.9011 or via email at [email protected].

In conclusion, Fluent™’s SmartClaimFocus™ is set to redefine the landscape of dental claims management, paving the way for a more effective and efficient future.