The Claims Processing Metrics Report is one of the series of reports NADP publishes to provide benchmarking data and common practices in the dental benefits industry.  This report focuses on the claims processing operations of dental plans and includes the following topics:

• Claims processing metrics and performance
• Electronic Claims capabilities and volume
• Metrics and processes for the Coordination of Benefits (COB)
• Metrics and processes for the delivery of electronic Explanation of Benefits (EOB)
• Auto-adjudication metrics
• Processes and metrics for Real Time Adjudication (RTA) and Real-Time Predeterminations
• Use of Artificial Intelligence (AI) in claims review and processing
• Electronic Data Interchange capabilities and Payment Modalities, and Performance Guarantees.

For questions, please contact Jerry Berggren, NADP Director of Research & Information