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5 Points Consulting, Inc.
Management & Strategy
Quality & Testing
Mergers & Acquisitions
U.S. based leading insurance company.
Worked with client to create the first ever credentialing process for Dentists. This was ground breaking for that the time only medical doctors went through a credentialing process before being added to a managed network. The process resulted in better dentist being selected for inclusion in the managed network products and increased customer satisfaction within the managed dental product set.
Dental Payment Gap Analysis
Worked with Aetna Medical, Dental, and Legal to close a gap in coverage when an insured who had Aetna Dental and Medical coverage suffered dental injuries in an auto accident as both policies as written excluded coverage assuming the other policy would cover the insured. This was a critical risk to the company at a time as the competitor was being sued by the Texas Attorney General for failing to provide coverage. At the completion of the project, the gap in coverage was closed and several other gaps were identified.
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