Decoding Dental Insurance Claims Data for Oral Health Research and Policy: Challenges, Validation, and Opportunities in Biomedical Informatics—A Scoping Review
Scoping review identifies challenges in using dental insurance claims data for oral health research and policy implications.
Key Points
This review aims to identify the challenges affecting the use of dental insurance claims data in oral health research and policy.
Conducted a scoping review following PRISMA-ScR and Arksey-O’Malley frameworks.
Searched databases including Web of Science, Scopus, and PubMed for peer-reviewed studies until April 2026.
Two reviewers screened and extracted data from identified studies to highlight key challenges.
Out of 563 records, 389 remained after deduplication, and 45 studies met the inclusion criteria.
Identified six main challenges: coding errors, data validity, interoperability issues, fraud detection, analytical limitations, and policy insights on disparities.
Validation showed variable accuracy, with diagnosis codes being more reliable than procedure codes.
Cite This Study
Virupakshappa et al. (2026) studied this question.