SKYGEN’s Provider Select Suite is a comprehensive solution designed to help dental payers improve access to high-quality, appropriate dental care, increase member satisfaction, and reduce healthcare costs. The suite aligns the interests of payers, providers, patients, employer groups, and state partners by identifying and recognizing high-performing providers. It includes three integrated tools—Ratings Tool, Recognition Program, and Enhanced Find-a-Provider—each available individually or as part of the full suite. By leveraging provider performance data, SKYGEN enables payers to shift members toward providers who deliver the most efficient and effective care, thereby reducing fraud, waste, and abuse while enhancing the overall member experience.

Features

• Ratings Tool
  • Measures and rates providers based on quality, appropriateness of care, efficiency, electronic adoption, and custom criteria
  • Configurable weighting to align with specific program goals
  • Identifies provider variances to detect and prevent inappropriate care
  • Enables shifting of members to high-performing providers
• Recognition Program
  • Recognizes and rewards providers delivering high-quality, cost-effective care
  • Supports gain-sharing and value-based reimbursement models
  • Promotes high performers through web recognition and preferred provider status
  • Automates reward mechanisms based on Ratings Tool results
• Enhanced Find-a-Provider
  • Directs members to nearby high-performing providers using proximity and ratings
  • Includes configurable travel tolerances by market
  • Randomizes search results to avoid overloading specific locations
  • Improves member satisfaction and reduces cost of care

Benefits

• Improved Access to Quality Care
  • Members are guided to providers who deliver appropriate and efficient dental services
• Cost Savings
  • Shifting just 3–10% of patients to higher-rated providers can yield annual savings of $291,000 to $970,000
• Enhanced Member Experience
  • Better care outcomes and satisfaction through smarter provider selection
• Operational Efficiency
  • Automated tools reduce manual processes and streamline provider management
• Fraud, Waste, and Abuse Reduction
  • Identifies and minimizes inefficiencies and inappropriate care
• Strategic Alignment
  • Aligns provider performance with payer goals and regulatory expectations