In the world of dental finance, things are really changing, and as an oral healthcare provider, you need to be in the know. There have been real challenges in reimbursement for providers, and the technology surrounding your industry is developing rapidly. Those two shifts are causing a transformation in how insurance companies pay out, so it really does pay off to stay in the loop. And when you find yourself lost, know where to turn.
With Dental Auditing Solutions, you have a team that understands where to get the information and how to help you manage your financial cycles. Our office works with providers and their staff to help them navigate the nitty gritty, and we’re here for our clients. From regulations targeting AI usage in healthcare settings to increased scrutiny regarding Virtual Credit Cards, there’s a lot to keep an eye on right now. Let us help you to understand the landscape.
Are you ready for a more compliant 2026? Schedule a compliance review with Dental Auditing Solutions and work toward a stronger practice.
Artificial Intelligence And Claims Adjudication
It seems like AI is just about everywhere these days, right? Well, it’s now affecting your industry, and there have been legal responses to it. Artificial intelligence and machine learning are becoming more commonplace during claims adjudication, creating potential tension. Insurance payers want to see more automation and efficiency in the claim process, but as a provider, you want to do what’s best for your patient.
There is evidence that AI programs designed by payers are intended to deny claims, rather than to simply improve efficiency. These models are also unable to understand the context of your decisions in the same way that a fellow human could. As legislation regarding this practice develops, keep your eye on AI and claims. Some states have passed laws that require human interaction along with AI.
Do You Accept Virtual Credit Card Payments?
If you’re not familiar, virtual credit cards are single-use credit card numbers that can be used by offices for reimbursement. That can create a significant financial burden for offices, as they are subject to a merchant transaction fee, which takes 2-5% away simply for processing the reimbursement. Many providers are seeing more of these transactions, and if you’re like them, then it’s important to know the laws in your area.
Just this year, twelve states filed virtual credit card bills, and eight of them have passed so far. Some of these states are big ones, too, like Virginia and California. These laws sometimes force insurers into offering a non-fee payment option, like an ACH or an EFT. If virtual credit cards are affecting your business, let’s talk about them.
This is also a possible source for embezzlement in your practice because there is limited tracking. Ensure you have good checks and balances to make sure the deposits in the bank match the payment posting. If you’re not sure how to implement this process, give us a call.
Understand Regulation With Dental Auditing Solutions
The landscape is evolving, and without effort, your office could fall behind. To find out more about current regulations related to AI or virtual credit cards, call Dental Auditing Solutions at (972) 459-1508 today.