Dental insurance fraud: Where does DCS draw the line? [Free guide]

Have you heard that, according to the Colorado Dental Association, between 20% to 60% of dentists will be affected by fraud over the course of their career?

Up to 60%? Those are huge numbers! As a dental professional, you likely know someone (or multiple someones) in your industry who have been impacted by dental fraud, maybe including yourself. 

Dental fraud mainly comes in two forms:

• Insurance fraud — inaccurately reporting things on claims, and
• Embezzlement — intentional theft of company funds.

As a revenue cycle management provider for dental businesses, DCS has zero tolerance for dental fraud of any kind. This article explains where we draw the line on fraud with the dental practices and dental groups we work with. 

You can also download Eliminate the Fraud Factor: 5 Ways to Safeguard Your Dental Practice Against Fraud to learn strategies for how to protect your business. Fill out the form below, and we’ll send your free resource directly to your inbox.

But first, let’s cover why DCS won’t work with clients who tolerate dental fraud… 

Fraud Factor #1. Point-blank: It’s illegal

When you incorrectly report information on your insurance claim, such as the treating doctor or the procedure codes, you might receive reimbursement that you are not entitled to. This is the root of dental insurance fraud, and it's illegal. 

While we aren’t here to defend dental insurance companies, we also aren’t here to rob them and get into legal hot water — and we don’t want you, your business, your team, or your patients to face legal troubles, either. 

We understand that, in some cases, you might think you’re helping your patient get more financial coverage by including certain codes, excluding others, and/or modifying reasons for their treatment. But you aren’t helping your patients when you submit fraudulent claims. In fact, you’re putting them at risk. 

Even the accidental use of incorrect codes is considered fraud — and accusers won’t accept “I didn’t know” or “It was just a mistake” as an excuse. Not only will you, your practice, and the treating dentist be in legal trouble, but your patient will be as well. This should be reason enough to avoid fraudulent practices at all costs. 

It’s certainly enough for us here at DCS, but there are a couple more good reasons that support our zero-tolerance policy on dental fraud… 

Fraud Factor #2. We are a reputable, reliable, and compliant dental revenue cycle management provider

DCS was founded in 2012 by three people who believed that dentists should be paid what they’re owed and nothing less — and also nothing more. 

Over the years, DCS has cultivated a reputation for being honest and reliable as an RCM provider. We’ve spent over a decade creating lasting relationships with dental teams by helping them efficiently and ethically collect their revenue. 

Related: 3 ways RCM services combat the risk of dental billing fraud at your practice

We will not risk the trust and goodwill we’ve cultivated to help a dental business get away with fraudulent claim submissions, or ignore signs of embezzlement. We will immediately inform the dental business owner if we spot anything suspicious, and in the case of mistakes, we’ll give their team a chance to make corrections and rectify the situation. 

Our goal is to help dental businesses maximize their revenue, but we will only do that from a place of integrity. We’re here to support your business growth, but we must also protect DCS and the people we provide jobs and livelihoods for.

Our mission, values, and priorities do not align with those willing to knowingly or accidentally commit fraud and/or embezzlement at their dental practice. 

Fraud Factor #3. You could lose your dental license and your practice

It’s not just about us: if you’re caught committing dental fraud, you could also ruin your own reputation, your ability to treat patients, and your chance to own a dental practice. Not only does fraud put you at risk as the dental business owner, it puts your entire in-house team in danger of losing their jobs.

The risk of fraud is not worth the “reward” of unearned money. 

If you find yourself thinking, “Why not cheat a little? What is there to lose?” here’s the full picture from Delta Dental, who phrases it perfectly: 

“Dentists found guilty of fraud face possible fines, attorney fees, the loss of their professional licenses, and jail time. Patients, office staff, employer groups, and brokers also face punishment if they are knowingly involved in acts of fraud.”

So if there is fraud or embezzlement happening in your practice — or even the consideration of fraud — keep in mind just how many people would be affected. You could lose the dental business you’ve spent years building, and everyone connected to your business would suffer losses, too. 

Now that you know where we stand: Download the Eliminate the Fraud Factor: 5 Ways to Safeguard Your Dental Practice Against Fraud

We’ve made it clear as day: DCS will not work with dental businesses that commit dental fraud. 

What we will do is maximize your revenue through honest means and help protect your dental business against the high-risk perils of fraud and embezzlement.

Download your free guide, Eliminate the Fraud Factor: 5 Ways to Safeguard Your Dental Practice Against Fraud for our top strategies to protect your dental business. 

Fill out the form below, and the guide will arrive in your inbox within minutes. 

DCS will help your dental practice collect more and remain compliant

To recap, DCS has a zero-tolerance policy against dental fraud because:

• Fraud Factor #1. Point-blank: It’s illegal
• Fraud Factor #2. We are a reputable, reliable, and compliant dental revenue cycle management provider
• Fraud Factor #3. You could lose your dental license and your practice

You deserve to collect what you’re owed, and dealing with insurance companies can be a pain. But there are ways to collect more revenue from payers that are far less risky than resorting to fraudulent actions that will drown you, your team, your practice, or group, and your patients in legal hot water.

Our suite of RCM services at DCS will help you not just collect what you have earned, but also remain legal and compliant throughout the entire revenue cycle. We will help your team avoid even the small mistakes that accidentally result in fraud, and advise them on compliant practices and workflows, as well as spot signs of embezzlement.

Our expert eyes on your revenue cycle will only enhance your compliance and increase your revenue. 

Get more cash flow with less worry about compliance: Book a free 30-minute call with DCS today.