Dental plan audits, which can result in demands for fee repayments, often focus on recordkeeping deficiencies rather than the quality of dental services. Dentists should be aware of key points regarding these audits, including the timing, the nature of audit findings, and the lack of immunity from prior authorizations. Dentists should also request clarification when the audit results are unclear and seek explanations for alleged deficiencies. The audit process may lack a comprehensive explanation, suggesting that the primary goal for dental plans is financial recovery rather than the correction of errors or documentation improvement.
Schulte, Daniel JD
"Dentistry and the Law: Understanding the Dental Plan Audit Process,"
The Journal of the Michigan Dental Association: Vol. 104:
9, Article 5.
Available at: https://commons.ada.org/journalmichigandentalassociation/vol104/iss9/5