iv. EM Clustering by Claim
Cluster 1: More than 3 procedures and no specialist-type work OR less than 4
procedures and some procedures that may be unbundled
Cluster 2: No unbundling and less than 4 procedures OR more than 3 procedures
and some specialist-type work
Cluster 3: Crowns and a high proportion of endodontic work
Cluster 4: Minor work, no unbundling, little or no lab work
v. EM Clustering by Tooth
Cluster 1: Preventative work performed
Cluster 2: Oral surgery performed, procedures that may be performed by specialists
Cluster 3: Crowns
Cluster 4: Little or no preventative work, no crowns, no specialist-type work
Cluster 5: Procedures that may be performed by specialists but not oral surgery
vi. EM Clustering by General (Non-Tooth Specific) Work
Cluster 1: Moderate to major work OR minor to moderate work and amount of
diagnostic work > $140 OR minor to moderate work and amount of preventative
work > $340
Cluster 2: Minor to moderate work, amount of diagnostic work < $140 and amount
of preventative work < $340
As proof of the effectiveness of the Claim Analytics analysis, below is a sample of 14
dentists that have been identified as having atypical claims activity.