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