Technology Delivers the Modern Dental Insurance Company

By Craig Kasten

Based on the increasing number of payers partnering with SKYGEN, there’s no question that digital transformation in dental benefits administration is underway. Still, the dental industry could save another $30 billion by adopting fully electronic benefit administration transactions. $30B. For the sake of members, providers, taxpayers and the sustainability of the healthcare industry, shouldn’t we make fully electronic workflows our goal?

At SKYGEN we are continually thinking about how we can assist healthcare payers and TPAs as well as their providers with this transition to fully electronic workflows. We believe technology-enabled connectivity will define the modern insurance company and transform the way specialty benefits are delivered. It’s happening at SKYGEN, where our own employee dental plan is becoming touchless, continuous, and configurable from cyberspace on a 24/7 basis. Eventually, every modern dental benefits company will look and act like this. Technology will enable them to be virtual, automated, configurable and scalable, providing access to quality care and satisfying member experiences efficiently and cost-effectively.

Are we there yet?
The dental industry is on the brink of a digital transformation that has already swept through other sectors (think financial services, retail). To be fair, healthcare is a different animal than other industries, and dental in particular is still recovering from being initially deemed “non-essential” during the pandemic in 2020.

Still, there are certain things that should be the norm in dental right now:

Virtual, touchless and continuous processing. We have the transformative technology at SKYGEN to dramatically reduce manual claims processing, even for complex benefits, with 99.9% accuracy. Our Enterprise System auto-adjudicates claims with pioneering functionality in automatic application of coordination of benefits, dual coverage, appropriate care rules and incentive benefits. Reducing the amount of manual work with virtual, touchless claims processing improves speed, efficiency and accuracy. Continuous claims processing enabled by technology reduces delays in payment and improves providers’ revenue cycle management.

Value-based payment options. We can’t allow the industry transformation from fee-for-service to value-based reimbursement to continue to be held up by inflexible payment options. Modern technology like SKYGEN’s Enterprise System supports any number of value-based reimbursement strategies including bundled or per member per month.

Actionable and accessible information. Think about the advantages if providers could determine the fees to collect while the patient is still in the dental office. Providers could be paid immediately, with no concern about uncovered or out-of-pocket expenses. Patients could see their financial responsibility instantly on their smartphone and get clarification if they have questions. How would dental benefit utilization and the member experience be transformed if members could access their benefits eligibility, even their ID card, in a language other than English, on their smartphones? All of this information is accessible and actionable with modern dental benefit administration technology, including our Member Mobile App, available right now to payers. Actionable and accessible information engages members and allows payers to become more consumer driven.

A connected dental marketplace. The dental industry is still siloed by legacy systems. Digital-age connectivity is the solution for reducing cost of care while at the same time, enhancing patient experiences and access to quality care. SKYGEN is transforming the dental industry with the SKYGEN Dental Hub™, a platform built to bring all dental stakeholders together in one place to solve problems and change how business gets done in the dental industry. Learn more about the SKYGEN Dental Hub.

We can do more with less
Our SKYGEN team has been advancing dental benefits administration for nearly 30 years. We care deeply about transforming the dental industry for all stakeholders – that has been our driver all along in developing innovative solutions that are ahead of the market. We are ready to deliver on these capabilities today to help payers move beyond the status quo and transform their business into a modern insurance company that routinely does more for less.