Dentist Accused of “Biggest Ever” NHS Dental Fraud

Dental fraud by NHS dentistA dentist in the UK has been charged with one of the largest NHS dental frauds ever committed. The dentist, now suspended, is accused of stealing £1million from the National Health Service.

The dentist submitted as many as 5,000 false invoices between 2006 and 2009.

The Birmingham cosmetic dentist also operated a medical spa and advertised her services for dental Botox and dental makeover options such as braces and veneers.

Read more: Woman dentist charged with stealing £1m in ‘biggest ever’ NHS fake invoice fraud

Dentists in New York Skim $3M from Medicaid?

New York state auditors have discovered some questionable billing practices among dentists. Officials say that the state may have paid $3 million in Medicaid claims for fraudulent dental procedures.

It's not always easy to spot Medicaid fraud, but some dentists get too greedy to overlook.

Remember the dentist who billed for 30 fillings for a single one-hour pediatric dentistry appointment? In this case, dentists filed claims for typical dental treatments.

The problem? None of the patients actually had teeth. Nonetheless, Medicaid was billed for natural tooth procedures for these denture patients.

It's not clear how widespread this problem, but the state comptroller has released information on the audits of 5 dentists. Over five years, these 5 dentists filed over $46,000 in improper Medicaid claims.

Read more about it

Confrontation Is Not the Way to Deal with a Thieving Employee

What to Do When You’ve Discovered an Embezzlement

Editorial
by Jim Du Molin

Now, finally, what to do when you think you are being embezzled by an employee? For reasons I do not want to discuss in a public forum, it is important that you DO NOT IMMEDIATELY CONFRONT THE SUSPECT with your concerns or evidence.

Step back, take a deep breath, and call your accountant. Discuss your concerns. Set up a meeting to review what you have found. If your accountant believes there is enough smoke to proceed, do an audit. But do it privately, after hours. Do not let the suspect or ANY other employees know that you have a concern.

Your main goal is not to be accused by the suspect of defamation! This is a common tactic of embezzlers. Once you have proof of the problem, you have two choices. Your path will depend on the size of the embezzlement. In either case retain an attorney to review your options.

If the amount is under $10,000, terminate the employee without getting into ANY discussion of your proof or suspicions. If you are in an “At Will” state, you don’t have to even give a reason. Just say that you “don’t feel the two of you are on the same page” and you are letting him or her go. Again, consult your attorney.

I know that this advice will frustrate many of you reading this. Yes, you may end up paying unemployment costs, but in the long run, it is worth it. The reality is that this is the least expensive, least stressful and least time-consuming approach to the problem. I have been through this many times with many doctors who wanted to crucify the suspect and run him out of town on a rail all the way to the penitentiary. The reality of that happening is nil, and your chances of getting any money back are less than 10%.

I know it’s hard advice to hear… but it is the most valuable tip I can give you.

Protect Your Dental Practice by Bonding Your Employees

Editorial
by Bryan Truitt and Jim Du Molin

Even if you have an internal controls system that makes embezzlement difficult, the danger of collusion still exists. (I’ve already told you that embezzlement is common, it can be detected, and it can be prevented.) One of the ways in which some dental practices protect themselves from employee dishonesty is by bonding their employees.

Bonding is the process by which an employer can be indemnified for the loss of money or other property sustained through dishonest acts of a “bonded” employee. Bonding can cover many types of acts including larceny, theft, embezzlement, forgery, misappropriation, wrongful abstraction, willful misapplication, or other fraudulent or dishonest acts committed by an employee, alone or in collusion with others.

There are several types of fidelity bonds. Discuss each with your agent to determine whether damages from negligence are covered. Basically, your practice has several options at its disposal:

  • Individual: covers one employee. Usually purchased by small practices or family-operated businesses with only one employee.
  • Name schedule or position schedule: covers either the employees or positions specified.
  • Blanket fidelity: covers all employees.
  • Commercial, blanket, and blanket position: provides multiple protection (comprehensive dishonesty, disappearance and destruction coverage, or a blanket crime policy).

There is wide choice in features and coverage as well as cost differences in bonding coverage. It difficult to understand why only two practices in ten have this economical insurance.

Next week, we’ll talk about what to do when you have discovered a problem.

How to Avoid Embezzlement and Keep Your Dental Practice Afloat

Establishing Internal Controls Against Theft

Editorial
by Bryan Truitt and Jim Du Molin

Previously, I told you how common dental embezzlement is and what some of the warning signs of dental embezzlement are. Embezzlement can be deadly to a dental practice and your retirement plans. Now it’s time to discuss what you can do to protect yourself.

There are four basic things that you can do in implementing an internal system of controls:

  • Screen applicants before they are hired.
  • Periodically examine canceled checks to see if there is anything unusual.
  • Take precautions in preparing payroll. Have more than one person prepare it, have several different people prepare it, oversee it yourself, or have it done outside.
  • Have two people sign off on checks, preferably in front of each other. Or better yet, sign all checks yourself.

While there is no foolproof system of accounting or internal control that will absolutely prevent employee dishonesty losses, an environment can be created where it is discouraged.

The first step is to review every area where potential dishonesty problems could arise, including:

  • bookkeeping
  • data processing
  • cash disbursements
  • purchasing
  • receiving
  • inventory control

The next step entails putting mechanisms in place to remove the temptations that could make an otherwise honest employee dishonest.

In setting up an internal audit system, it’s common to divide financial responsibilities and functions so that no one employee controls all aspects of a transaction. Hence, I recommend the following:

  • Require checks to be countersigned by two responsible parties. In addition, limit the endorsement of checks, by anyone other than the owner, to deposits for credit only.
  • If you must delegate check-signing authority, limit the accessibility and value.
  • Make it mandatory that all insurance claims are properly filed within fifteen days.
  • Delegate the responsibility for receiving checks and cash to someone other than the person who records incoming funds.
  • Require every patient to sign in and keep the sign-in sheets for your audit.
  • Mail statements to outside accounts directly at least monthly. Even better, pay your bills online using a secure service provided by your bank – but only if it is set up so that you are the only person authorized to make payments!
  • Examine payroll records periodically to prevent padding.
  • Make sure that employees responsible for ordering goods and supplies are not the same ones responsible for receiving them or paying for them.
  • Require backup documents to be attached to all payable checks for signing.
  • Do not give the person who has the authority to write off bad debts the authority to authorize credit or loan money to an employee.
  • If someone else does payroll, make sure you have access to payroll data on the computer and that no one changes the passwords or access requirements for that data. Consider an outside service for this and your quarterly reports.
  • Use pre-numbered receipts, checks and purchase orders. Use duplicate deposit slips and checks printed on special safety paper.
  • Cross-train and rotate personnel. Insist your staff take their vacations.
  • Review revenue, receivables, payables, bad debts, account balances, statement reconciliations and payroll monthly. This can be done in less than thirty minutes over that sandwich in your office with the door closed.

Dividing financial responsibilities and functions is not enough. The single largest problem is permitting one employee to handle all receivables and payables. In a small practice it is hard to do otherwise but there are ways to effectively monitor the activity. You have to monitor and want to do it properly every day. The commitment and follow-up starts at the top: YOU.

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