The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. Earlier in the week, this press release came out. We spent a lot of time looking through…
This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article rounds out lessons in dental misconduct involving fraudulent billing, medical records forgery/lack of documentation, and standard of care from a case in real…
Over the past few weeks, we have been engaging with clients on a variety of topics, the most recent being the discussion of “code rotation.” Some have asked what we mean when we discuss this term of art. We had often heard this term used by our retired OIG agents and thought it was an…
Should a patient who suffers a medical condition as a result of their treatment have to pay for the resulting treatment? Should the financial responsibility go to their insurance or the facility that caused the problem? Before everyone starts hitting the comment button and mentioning hospital-acquired conditions, let us set the stage for the scenario:…
Even more than money … what about the standard of care? This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article points out another violation of law related to dental misconduct in addition…
This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. …What do the records say? This article points out additional violations of law related to fraudulent dental misconduct – medical records forgery or simple lack…
Over the past few weeks, we have been blogging and posting about the “red-headed step-child” of healthcare fraud, dental fraud. One of our retired OIG agents recently heard this tale, which bears repeating: At a recent visit, his mother was told by the treating dentist that she had a gum infection and needed to see…
This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column next week for more examples of dental fraud from real cases! This article points out some basics of dental misconduct – fraud. A dentist who bills for services not performed is committing fraud. For example, billing for the…
This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column next week for more examples of dental fraud from real cases! This article points out a unique aspect about dental fraud that has significant impacts on the dental office and the dentist who practices there –…
Our Founder and Managing Director Jeanmarie Loria sat down with retired OIG Special Agent Eric Rubenstein to discuss dental fraud, unscrupulous dentists, and the claims-related intricacies of the dental industry. Here’s how it went… JL: My aunt in California paid an additional $10 for personal protective equipment (PPE) on top of her dental visit. Other members…