Superior Dental Payer Functionality With Flexibility and Control

Architected for all lines of business, the Aldera payer platform has best-of-breed dental payer core administrative capabilities. When it comes to administering healthcare business transactions, now more than ever, dental payers need to innovate quickly and affordably as well as be future-proofed within a technology framework that will enable the flexibility and control to handle its needs both today and tomorrow. 
Aldera’s payer platform gives payers and administrators the ability to support all dental payer functionality requirements such as group maintenance, eligibility/enrollment, billing, customer service and claims operations while at the same time gives payers the opportunity to administer provider networks, contracts and credentialing with ease.
Aldera’s robust dental administration system enables payers to: 
  • Bring their products to market faster and at a lower cost
  • Develop products and business more rapidly with real-time rules architecture
  • Manage 100% real-time dental claims processing with an integrated workflow and extensive auto-adjudication rules across all product lines
Aldera has extensive experience supporting dental payers and administrators. Our platform supports the dental line of business with a powerful feature set, including:
  • Real-time tooth chart
  • Upgrade or downgrade procedures
  • Frequency rules to procedure codes or groups of procedure codes
  • Tooth and mouth location logic (Quad, Arch)
  • Bundle procedure codes
  • Pre-authorization of services and member notification by line of business 
  • Separate annual maximums for specialty services within the same plan