Dentistry has historically operated within a different billing and coding environment than the broader medical industry, as the sector is driven largely by commercial payers and Medicaid, not Medicare. Over time, this has shaped a general perception that billing risk in dentistry is more contained and predictable. However, recent enforcement actions and regulators’ increasing reliance on data analytics and artificial intelligence (AI) are challenging that assumption. This is particularly true in the context of Medicaid, where reimbursement is concentrated among pediatric patients and other vulnerable populations, drawing heightened scrutiny and enforcement interest.
Read the full article: Dental Spotlight: Billing, Audit Risk, and Enforcement Trends //
Source: https://www.lexology.com/library/detail.aspx?g=621dcd7f-21d5-4605-bce6-d1021297fbae