Strategies for a Dental Practice to Prevent or Prepare for a Clinical Audit

By Christine Taxin

Commercial Supporter: KaVo Imaging

This article reviews the need for dental charts to reflect accurate procedural and diagnostic reporting for insurance reimbursement and for a practice to be prepared in the event it becomes audited. Factors involved in compliance and aspects of a clinical audit are discussed. The need for proper documentation and coding is emphasized, along with the importance of transparency. The article also describes the role of third parties in auditing claims and explains steps that can help minimize the risk of a practice becoming targeted for an audit.
 

LEARNING OBJECTIVES:

• Review how to ensure that the procedure and diagnostic codes that a practice reports are reflected in the documentation of services rendered.

• Describe adapting a compliance system for billing focused on the nuances between medical and dental reimbursement.

• Review the elements of reporting to ensure compliance and reimbursement. 

• Discuss the principles of documentation.

About the Author

Christine Taxin, Adjunct Professor, New York University, New York, New York