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News — Compliance

If You Are Buying a Dental Practice Beware of Caveat Emptor

I work with Private Equity firms as a partner in their due diligence processes. For my parts, office review and records audits, it is about identifying proficiencies and deficiencies (or what I call ‘opportunities’).

 Is the office compliant with OSHA, infection control, DEA regulations, radiation regulations, sedation safety/medical emergency preparedness, HIPAA, advertising/marketing, dental board rules/Dental Practice Act? What safety mechanisms are in place to ensure patient and employee safety? Does the practice code/bill properly? Using correct codes? Have adequate supporting clinical notes to support what is billed? Any overbilling or fraud issues? If so, are they isolated or systemic?

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DEA Compliance Tips You Can Use

There is no need to be afraid of using controlled prescription drugs legitimately but do take time to learn the rules and regulations and periodically evaluation your practice for compliance with controlled substance rules and regulations. Implement corrective actions as necessary. You don’t have to ‘do’ compliance alone. Build your team of experts to advise and support you, so you can protect your practice, and spend more time doing what you love.

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Why Auditing is Important and How It Can Impact Your Practice

Daily perspective (pre-bill) audits help identify and minimizes billing errors by ensuring the accuracy of claims before they are submitted. This step alone can help compliance programs pay for themselves. Periodic retrospective audits involve the detailed review of clinical and billing records for compliance with state and federal recordkeeping and billing requirements. Some items to check include verifying the quality and quantity of radiographs, consent for treatment, proper coding, clinical notes to support each claim that was billed, and medical necessity.

My mantra is: “If It Is Not Written, It Did Not Happen!” Record audits must be documented. In the face of a fraud allegation this documentation can help your defense attorney make their case.

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Is Your Consent Process Full of BARF?

No matter where you in the U.S. you practice dentistry, there are laws or rules that require you to obtain written, informed consent for treatment from your patients....which is express permission to do what your patients hire you to do for them. Gone are the days when a patients’ voluntary presence in your dental office, in your dental chair, is sufficient as ‘consent’ for treatment.

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Is Your Practice Safe?

If the government and third-party payors know you maintain an effective compliance program and have your ducks in a row, you are less likely to get picked on in the first place! We have seen it happen.

If you are an administrator or compliance officer for a dental practice and you are looking for solutions to concerns that keep you up at night or you’re looking for an ally for support or an existing compliance program or you are looking to develop a compliance program, but don’t know what to do or how to go about it, we will love to have a chat with you.

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