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¿Dentistry al sur?
Given the never-ending audits and claims reviews buttressing the insurance industry's culture of caution, anomalies are relatively rare. When they do appear, they tend to command immediate attention.
One such anomaly had been detected by First Dental Health, the San Diego-based dental network management company that operates in California and two other Western states. Data from several of its larger employer groups suggested that some dentists practicing in Mexico were submitting claims from U.S. addresses and getting paid in dollars. The Mexican dentists were accounting for as much as 10% of the groups' claims. Some bent insurance coverage rules by waiving deductibles and copayments.