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Insurance companies are using AI to evaluate dental x-rays, denying claims when specific landmarks aren't visible in the images. This shift means approximately 70% of claims are now processed through artificial intelligence systems that disqualify submissions based on technical deficiencies rather than subjective human review.

• Poor quality x-rays with cone cuts or missing apexes give insurance companies legitimate reasons to deny payment
• Clinical teams need training to understand what qualifying x-rays look like for different procedures
• Billing starts with proper clinical documentation and supporting attachments, not in the billing department
• Digital x-rays allow immediate quality assessment - retake poor images immediately
• Even the best billers can't overcome insufficient evidence when appealing denials
• Creating a list of procedures requiring x-rays and examples of qualifying images can help train staff
• When benefits are available and evidence is sufficient, insurance companies should pay claims
• Proper documentation creates leverage when fighting unreasonable claim denials

If you need help training your clinical teams on how to improve x-ray quality for insurance submissions, I have a step-by-step process available. Send me a message to discuss what's happening in your office.

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Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.

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Perio performance formula:

(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)