Keeping Your Doctor’s License Safe
Insurance codes and code interpretations are constantly changing with updates every year. Dental practices must always rely on the most current dental terminology (CDT) version when reporting dental procedures. Your practice should always report “what you do” and adhere to the current CDT codes.
The best resource in the industry for eliminating coding errors is Coding With Confidence by Dr. Charles Blair. This manual is updated every year with the most up-to-date information available. It is written to specifically predict, and therefore prevent, the typical coding errors and mistakes made by dental practices.
So, why is this so important regarding the dentist’s license? If coding errors are discovered in a random insurance audit, which is increasing nationwide, not only is the dentist liable for repayment of any claims paid from the errors filed to insurance, but the State Board of Dentistry views this as an act of negligent or intentional fraud. This can result in punitive action from the board ranging from fines to probation, suspension, or even revocation of the dentist’s license. Accurately coding insurance claims is critically important.
Protecting Your License with Due Caution
HIPAA and OSHA regulations seem so unnecessary, frivolous, and sometimes outright silly. But the reality is that failure to comply with these federal regulations can destroy the dental practice and threaten dental licensure.
Everything from protecting patient information and anonymity in the office, to unintentionally revealing their relationship to the dentist in casual conversations outside the office can result in huge fines as well as civil and criminal legal actions. Just the seemingly innocent act of taking cell phone photos in the operatories could inadvertently capture other patients in the clinic or a clinical day schedule with the names unmasked. Outside training by HIPAA and OSHA compliance consultants annually can help galvanize the dental team’s ability to avoid errors in these important areas.
Believe it or not, the dentist is seldom able to keep good records of classes and courses attended for continuing education. It is important for the office manager to keep good records of these CE credits and tender them to the State Dental Board as they are earned. Moreover, specific continuing education for Opioid Prescribing Guidelines, Basic Life Support, and OSHA/HIPAA training is required by most state dental boards. Failure to comply with these specific CE requirements as well as the total minimum CE hour requirements may result in the temporary suspension of the dentist’s license and possible fines. And of course, even if it is only a temporary suspension, the office is basically closed until the suspension is lifted.
Another business area the dentist is often completely oblivious to is payroll taxes. Again, it is the office manager’s job to see that these taxes are calculated and paid in full and on time. Unlike other types of taxes, failure to meet payroll tax obligations is viewed by the IRS and state tax commission with zero tolerance. The money withheld from office employee payroll checks is their money held in escrow by the office to be processed and sent to the tax agencies. If these tax payments are not made on time and in full, it is perceived as though the dentist/owner stole the money from the employees. With this perspective, the government imposes the highest penalties and interest assessments for such mistakes and can even close the office for such violations.
Also, it cannot be overlooked that most states’ tax laws provide statutes that will not allow a dentist to renew a dental license if a tax balance or warrant is pending. Working with the CPA and the dentist to see that this is handled properly is a must.
This list is certainly not complete, but it touches on some of the more common situations that threaten the dentist’s license. It is incumbent on the office manager to stay “ever vigilant” always considering the impact any decision, process, or procedure may have on the dentist’s license. Protecting that license might just be the most important responsibility of all!
About the Author
Teresa Berry Williams is the current office manager for Williams Dental & Orthodontics. She has been leading the business management team at Williams GP Orthodontic Seminars for the last 5 years. She holds degrees in Business Administration & Commercial Art. She and her late husband managed multiple businesses in Oklahoma, where The Journal Record named her Woman of the Year “50 Making a Difference.” Teresa married Dr. Brad Williams in 2012 and began to use her business experience in managing his practice. With his encouragement, Teresa developed Managing Orthodontics, a one-day training management seminar for fellow dental professionals.
Teresa is a lifetime AADOM member, receiving her Fellowship designation in 2018 and her AADOM Mastership (MAADOM) in 2021. Teresa was inducted as an AADOM Diplomate this year at the national meeting in Scottsdale in early September.