3 reasons why dental providers may be flagged for potential fraud, per Texas OIG

The Texas Office of Inspector General runs claims analyses to identify dental providers that may be outliers of normal behavior and require further examination, according to a March 24 news release.

Below are three reasons providers may be flagged for a closer look, per the Texas OIG:

  1. A high number of procedure codes performed during a single visit without billing for sedation or general anesthesia.
  2. Tooth-specific procedures performed on teeth that should have already been shed.
  3. A high average number of resin restorations performed per client per visit.

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