Maxillofacial surgeries and advancements with cutting edge technologies have evolved into an area of cosmetic and non-covered benefit abuse when billed to medical plans. Venture capitalists are disrupting the dental industry by purchasing large practices, promoting unnecessary procedures and opening Wellness Centers within dental practices. This presentation will identify the most common oral surgery procedures billed to medical plans, identify clinical schemes and misrepresentations being used to bypass edits. Holistic dental procedures will be addressed. This will allow medical review staff to gain an understanding into the complex language of dentistry to enhance investigations.
Session Topics:
Payment Integrity
Speaker(s):
Rae A. McIntee, DDS, MD, MBA, FACS, CPE
Medical Director Clinical Solutions (Supporting Payment Integrity & SIU)
Louisiana Blue