Blog

We Need to Talk: It’s About Section 1557 of the Affordable Care Act and How It Impacts Your Dental Practice

Does your practice receive reimbursements from Medicare? Medicaid? C.H.I.P.? How about Tricare? If so, you need to read how this new law Section 1557 will impact your practice! Regardless of how you feel about it one thing is certain – the Affordable Care Act (ACA) is full of surprises! Let’s look at Section 1557. The [..]

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Government Fines Increasing (and Why You Should Take Note)

In less than 7 minutes I will convince you to get rid of Medicaid, Get a Compliance Program or Surrender your Dental License. Will you accept my challenge? OSHA’s Fine Increase OSHA recently announced they are raising their maximum fines amounts. Effective August 1, 2016 maximum fines for serious violations will jump from $7,000 per [..]

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Outliers and Auditors

Few people enjoy having someone look over their shoulders and mind their business. Now, more than ever, ‘outsiders’ will be minding your business. Insurance carriers, like Medicaid organizations, are watching dental insurance claims to identify ‘outliers’ or those who stick out as compared to their peers in the number and type of claims submitted for [..]

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Acquisition of Controlled Substances

by: Duane Tinker Controlled substances may be acquired only by an individually registered practitioner. They cannot be combined with those acquired under another registration. When multiple practitioners at one location wish to centralize controlled substances, they are allowed to do so under the concept of a “principal practitioner.” Federal regulations in 21 CFR 1301.22(b) allow [..]

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Dentist Faces 35 Years in Prison for Billing Errors You Have Probably Made this Week!

On August 11, 2015 the Hartford Currant published a news article that should terrify every dentist who participates with Medicaid. Whether you are a Medicaid provider or not sit down and read this! Dr. Thomas DeRienzo, owner of Plantsville Family Dentistry in Plantsville, Connecticut, “was charged with first-degree larceny by defrauding a public community, second-degree [..]

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Do You Offer Dental Services in TX? SOS Requires DSO Registration

Do you provide consulting or management services to Dentists in Texas? Texas has upped the ante for Dental Service Organizations. In the last legislative session, Texas passed the new DSO rule SB519. What does that mean to you? Do you provide the any of the following”Business Support Services” to Dentists? Office space, furnishings and equipment, [..]

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The Case for Dental Record Auditing

Sadly, few dental practices audit patient records. A lot can be learned from auditing including identification of incomplete or inadequate documentation/ paperwork, missed billing opportunities, issues that can result in recoupments (even criminal prosecution), and a host of other issues. Physician practices and hospitals routinely audit for compliance, risk management, revenue cycle and quality of care [..]

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