This includes reviewing the clinical details of escalated dental and vision claims — procedure coding, clinical documentation, and carrier clinical/consultant review determinations — to confirm whether outcomes were applied correctly and to explain them clearly to members. Review the clinical details of escalated and denied dental and vision claims — including CDT procedure codes, tooth- and quadrant-level detail, clinical narratives, radiographs, and Explanations of Benefits (EOBs) — to determine whether claim outcomes were applied correctly (e.g., covered vs.