eBook: Addressing dental overbilling to improve payment integrity

Dental payers face consistent challenges as fraud, waste, and abuse (FWA) continue to escalate costs and threaten the integrity of the system. In 2023, dental expenditures in the United States reached $174 billion, accounting for over 3% of total healthcare spending, according to the American Dental Association. As dental claims continue to grow in both volume and complexity, plans face difficulty identifying improper billing practices amidst the evolving landscape of FWA schemes. Understanding and addressing current dental claim schemes is critical to ensure a fair and transparent environment for payers and providers while protecting member benefits.