Thursday, March 26, 2009

Your Tooth Dollars at Work

[Welcome Industry Radar readers!]

Many may not know it, but Medicaid covers dental care. This taxpayer funded program for low income people has pretty good benefits . . . if you can find a dentist willing to accept the low reimbursement levels.

In Georgia the number that seems most accurate hovers around 4% of dentists are willing to treat Medicaid patients.

Apparently there are some dentists in New York who are more than happy to treat Medicaid patients.
Earlier this year, auditors from the state comptroller’s office noticed that a Brooklyn dentist, Dr. Alan Zukor, had billed Medicaid for giving several patients fillings for all 32 of their teeth on a single day.

When they looked a little closer, they noticed that in several of the cases, Dr. Zukor had also submitted a claim for pulling those same teeth — all of them — from the same patients. The records seemed to show a bizarre and painful waste of dental care.
The bizarre part I get. It is the painful portion I don't.
“The human mouth typically holds 32 teeth,” Mr. DiNapoli said in a statement. “Billing Medicaid for filling and then pulling all 32 teeth from seven different patients within a few weeks should have raised a red flag.”
Red flag? Yes, you would think . . .

According to Mr. DiNapoli, in one instance, Dr. Zukor claimed he filled 30 teeth for one patient in two office visits. On a single day in January 2008, he claimed he filled 243 teeth for 18 patients; a month later, in February, he claimed he extracted 256 teeth from eight patients, or 32 teeth per patient.

Jewish people refer to this as Chutzpah.

I just call it incredibly stupid.

But apparently this is not the only N.Y. dentist who is creative in his Medicaid billing.
ALBANY, N.Y. Auditors say the state Medicaid program may have overpaid $2.9 million for services like teeth cleaning for toothless patients.
Do they floss too?
Auditors identified almost 22,000 questionable services for about 6,500 patients with dentures during the five-year period ending June 30, 2008. That included almost 1,500 dentists who billed Medicaid $863,000 for cleanings, fillings, extractions and X-rays for about 5,000 patients with full dentures.
You just can't make this stuff up.
blog comments powered by Disqus