Dental services audits are a critical component in maintaining the excellence and integrity of healthcare. BCA’s Compliance Audits offer a meticulous blend of document review and data analysis for both the dental provider and the dental hygienist, ensuring a thorough evaluation of adherence to dental documentation and reporting standards.
Common Challenges
- Frequent changes to CDT codes, making it difficult to stay current.
- Confusion between similar codes contributes to coding errors.
- Incorrect CDT selection which can result in denied claims or financial loss.
- Unbundling of procedures, which can be seen as fraudulent by insurance payers.
- Keeping up with ever-changing regulations and ensuring compliance.
- Coding inaccuracies, patient information errors, and insurance mistakes.
- Lack of documentation to support the services rendered.
Compliance Audits
- Enhanced Patient Safety: Dental compliance audits are essential for ensuring that practices adhere to the highest standards of patient care, minimizing the risk of infections and other health hazards.
- Regulatory Adherence: Regular audits help dental practices stay up-to-date with the latest regulations and avoid costly fines and legal issues.
- Improved Practice Efficiency: By identifying areas for improvement, compliance audits can streamline operations, leading to more efficient and productive dental practices.
- Financial Health: Audits can uncover billing and coding errors that may otherwise lead to denied claims or revenue loss, thus improving the financial stability of the practice.
- Patient Trust and Satisfaction: A commitment to compliance demonstrates to patients that the practice prioritizes their well-being and adheres to ethical standards, fostering trust and loyalty.
- Risk Management: Proactive compliance audits can help identify potential risks before they become problems, saving time and resources in the long run.
BCA Compliance Audits Target Areas
- Documentation Review
- CDT and ICD-10-CM Code Evaluation
- Service and Diagnosis Capture
- Medical Necessity Validation
- Documentation Specificity
- Trend Analysis
- Authentication Timeliness
- Claims Review