Posted and filed under FWA.

Multiple Sides to the FWA Story

Do you feel blog posts are all the same?  There are some truths and useful information, and some hyperbole. In 2020, I took my family’s dental fraud story public and then performed a deep dive into dental fraud, including issues around standards of care.  I personally formed a grim vision that nobody cares about dental FWA enough to…

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Posted and filed under Dental, Fraud, FWA.

Dental Horror: A Case of Life of Death

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…

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Posted and filed under Dental, Fraud, FWA, Medical Record Auditing.

Dental Fraud: Standard of Care Violations

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…

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Posted and filed under Dental, Fraud, FWA.

Fraud Spotlight: Why Dental Fraud is Overlooked & Ignored

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…

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Posted and filed under Coding, Dental, Fraud, FWA.

Dental Fraud: Isolated or a Pattern?

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…

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Posted and filed under Compliance, Dental, Fraud, FWA.

Dental Fraud from a Different Perspective

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 –…

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Posted and filed under Dental, Fraud, FWA, Medical Record Auditing.

A Frank Discussion on Dental Fraud

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…

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Posted and filed under Dental, Fraud, FWA, Uncategorized.

Rinse & Spit: Investigating Dental Fraud

Next Week On The Blog: Jeanmarie Loria sits down with her partner Eric Rubenstein, retired OIG Agent, to ask him why he had more cases on pharmacy pain management and DME than dental fraud.  Dental fraud stinks worse than the most severe case of halitosis.    Picture this.   Brooklyn NY 1960. All 5 of…

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Posted and filed under Dental, FWA.

Is Dental Fraud the New Normal?

As an auditing firm, we are well aware that dental fraud is alive and well in the American healthcare system. With so many American children covered by Medicaid, dentists have taken it upon themselves to begin offering unnecessary and Al-La-Carte services in order to maximize profits. Many offices justify this unethical practice by mentioning that…

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Posted and filed under Dental, Healthcare.

Our Oral Health is Determined by Our Zip Code

If you were ever subjected to the unsavory fluoride treatments at the dentist as a child, you’re probably one of many who are relieved to be receiving the same dental benefits in a manner that doesn’t assault your taste buds!  Now that fluoridated water is circulating through about 75% of public water lines, the population…

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