Dental Benefits Management

The Medigent® Dental Benefits Management module supports claim submission and adjudication in real-time and batch. The Dental module accommodates intricate layering of business and financial rules and incorporates fee code structures with numerous properties, such as age restrictions, frequency limitations, fiscal elements, and any other required properties.

The module is CDAnet compliant, allowing for the electronic submission of claims from dentist offices across Canada. The system also supports the pre-authorization process and has the ability to run trial adjudications on each request to determine submission outcome.

In addition, the Dental Benefits Management module includes a set of processes for managing the beneficiary and provider populations of a jurisdiction’s dental benefits program.