Dental Audits & Compliance

Overseas Outsourced Billing and Coding – Compliance Risks

(August 16, 2012):  Thinking of sending your medical coding and billing functions out of the country? You better think twice. While overseas outsourced billing is growing in popularity for medical office functions, this practice represents a unique and growing set of problems for both physician practices and 3rd party billers. And the news is just …

Overseas Outsourced Billing and Coding – Compliance Risks Read More »

There are Seven Compliance Plan Elements – Is Your Healthcare Company Compliant?

(August 2, 2012): Under the Affordable Care Act (ACA), which was recently upheld by the Supreme Court, the Secretary of the Department of Health and Human Services (currently Kathleen Sebelius) may require that all providers participating in federal health care programs implement an effective compliance plan. While regulations covering this issue have not yet been …

There are Seven Compliance Plan Elements – Is Your Healthcare Company Compliant? Read More »

Returning a Medicaid Dental Overpayment: Part II

(April 25, 2012): Yesterday we discussed issues surrounding returning an identified dental overpayment to Medicaid or other payors. Below is a continuation of this discussion.  Dentists, oral surgeons and their staffs may ask “What types of actions might constitute an “identified” dental overpayment?”  That’s a fair question, especially since the Affordable Care Act does not …

Returning a Medicaid Dental Overpayment: Part II Read More »

What are a Dentist’s Medicaid Overpayment Obligations? Part I

(April 24, 2012): While considerable attention has been paid to the Affordable Care Act (generally referred to as “Health Care Reform”) and its requirement that “identified overpayments” be promptly repaid to the government, it is important to keep in mind that this repayment obligation is not new – it has long been firmly in place.  …

What are a Dentist’s Medicaid Overpayment Obligations? Part I Read More »

Texas Medicaid Dental Claims Are Under Audit Scrutiny

(April 23, 2012): Texas dentists, orthodontists and oral surgeons are under considerable scrutiny by the government, and most practices don’t even realize it.  This article examines several one of the current tools being used by the government to calculate the alleged amount of “damages” (improper claims) paid to dental providers by the State under Medicaid. …

Texas Medicaid Dental Claims Are Under Audit Scrutiny Read More »

Components of an Effective Dental Compliance Plan

(April 18, 2012): To be fair, when most dentists and oral surgeons think of an effective Dental Compliance Plan, it wouldn’t be unreasonable for them to think that the primary risks facing a dental practice would be limited to: Violations of the rules and regulations enforced by the Occupational Safety and Health Administration (OSHA). Violations and / …

Components of an Effective Dental Compliance Plan Read More »