Follow us :

Call Us

+62 234 6754 345

Here’s Your Guide To Avoiding Dental Billing Frauds

An average business – be it a dental practice or something else – tends to lose around 5% of its revenues to frauds every year. With technological innovations bringing a lot of great benefits to business – it’s also causing a great chance for dental fraud. And so, adequate measures have to be taken in order to avoid fraud and restore the revenue at your dental clinic. It’s high time that dental clinics accept this hard truth – the very fact that dental billing frauds can cause a major downfall to their practice.

Though outsourcing dental billing process to a professional company can almost prevent you from frauds – this blog post highlights some common reasons why dental frauds occur and a few ways to tackle them the right way.

What Are The Possible Ways Of Dental Fraud Occurring At Your Clinic?

Regulatory bodies of a state keep tracking down dental clinics and ensure none of them are a part of dental frauds. If they find such a practice – they’re always active in penalizing and even shutting down the practices. And so, it’s important to ensure that your dental practice avoids any and every kind of fraud. A few possible ways a dental fraud can occur at your practice may include –

  • Sending false bills with an additional fee to the patients against services that haven’t been provided.
  • Replacing low-cost services with those high cost to claim for massive reimbursements.
  • Submitting hefty reimbursement claims against fake clients.
  • Charging excessive copayments.

As a dental practitioner aiming to run your clinic in a smooth manner – you must keep track of the above-listed situations. If something like that is happening at your dental clinic – you’re more likely to be caught by the authorities against the charges of dental fraud. As an outcome – you might pay a massive penalty, or even your dental clinic could be closed.

Top Five Ways To Avoid Dental Frauds At Your Clinic

The first thing you can do to avoid dental fraud at your clinic is to be actively involved with the management and administration. As the owner of your dental office, you must know exactly what’s happening around you and keep track of operations as they process in alignment with ethical and legal requirements.

Because be it you or someone else from your office behind the dental frauds – the authorities would penalize only you and your overall dental practice. So, it’s you who’s responsible for avoiding the fraud.

Take a look at these five amazing ways to avoid dental fraud at your clinic and get inspired!

1)Upgrade Your Hiring Process

A common reason why dental frauds occur at your clinic is the dishonesty of your employees. No matter how strict and quality policies you implement, you cannot prevent fraud from happening unless there’s not a single dishonest employee working at your clinic. Thus, you need to upgrade your hiring process.

The best hiring process is one that ensures conducting a thorough background check of each candidate appearing for the interview. From their academics and career history to their family background and criminal records – everything plays an important role in determining if they’re the right fit.

Even if a candidate has the best academic and working background – you cannot avoid their personal and criminal records if found negative. A great way to verify the candidates’ backgrounds adequately is to hire a third-party company. They have professionals hired in the team to conduct thorough background checks of the candidates and have access to much broader data than a common individual. Thus, their verification could result in much efficient outcomes than yours.

Specifically, when you’re hiring someone who’s to manage the bills directly, you must ensure following a very strong and thorough method of hiring. Leaving behind even a single loophole could lead to dental billing frauds, and you would definitely not pay your hard-earned revenue in the form of penalties or lose your entire practice against hiring a dishonest candidate.

2)Implement A Strong Code of Conduct

Now that you’ve put in every effort to hire the most honest employees, you must be expecting no frauds occurring at your dental practice. The hard truth is – even an honest employee could be tempted to do fraud when the money is involved.

That is where you’ve to act proactively.

Implementing a strong code of conduct against dental frauds can really help you prevent them from occurring at your clinic. You can simply jot down the policy stating that none of the billing experts are allowed to do dental frauds on your premises. And extend that policy by stating hard punishments against the crime.

In addition to that, you can also introduce rewards for the billing professionals who always submit honest and accurate claims – encouraging them about their honesty towards the job. Appreciation and encouragement against the good efforts of your employees are the finest way of building their loyalty. It can help uplift their morals and make them feel valuable for their efforts.

The higher would be their loyalty towards the practice; the bigger are the chances of them being honest and avoiding making dental frauds.

3)Track Down Your Billing, Daily

As mentioned above, involving yourself actively with the management and administration of your dental practice is very important to avoid dental billing frauds. The more you’d delay tracking down your bills, the bigger would be the chances of fraud.

The best way to keep track of your bills is to check them on a daily basis. Set your schedule in a manner, you get some lapse to review all the bills, payments, and claims made during the day. This way – you can determine if there’s anything suspicious in the billing the same day and make efforts to make that right.

If you don’t keep track of your billing on a daily basis – there’s a great chance, you’ll miss on the suspicions only to end up regretting when caught by a regulation authority and charged.

4)Maximize Patient Awareness

A great way to prevent dental frauds from occurring is to maximize your patients’ awareness. As a professional dental practice, your staff shall be fully trained to guide the patients.

They must inform each patient about their insurance coverage and benefits in detail as soon as they come in for their appointments and treatments. You can also provide them with a written or printed explanation of their coverage and benefits to avoid confusion in the future.

The more informed your patients would be about their insurance benefits, the lesser the chances of dental fraud. An informed patient could claim against copays that aren’t aligned with the treatment, or they can even point out mistakes in the claims and save you from drowning in the howl of dental frauds.

In addition to that, providing proper insurance information to your patients also helps build a trustful relationship with them. And a trusting relationship with your patients is a key to the success of your dental practice.

5)Monitor Your Finances, Monthly

Another quick way to track whether there’s any dental billing fraud occurring at your clinic or not is to monitor the finances on a monthly basis. The more aligned your profits and losses would be, the bigger the chances there’s no fraud.

When you monitor the finances every month, you’d be able to identify any or everything that’s unusual such as adjustments, debts, discounts, etc. The sooner you’d be able to identify the unusual, the quicker you’ll be able to resolve the problems and prevent dental frauds.

If you neglect to check your finances for a longer period of time, there are chances you’ll miss the unusual signs and won’t be able to prevent fraud from happening at your dental clinic.

Avoid Frauds With DentalRevu Dental Billing Company

Though the above-mentioned ways are best to avoid dental billing frauds, you may find them exhausting along with the daily tasks you’ve to perform at your clinic. The great  dental billing services we offer at DentalRevu can save you from exhaustion. We have the finest billing experts in our team who can tackle all required to avoid frauds without hassle.

From collecting patient information and verifying their insurance benefits to creating and submitting the most accurate dental claims – we ensure performing each process with 100% transparency. The core objective at DentalRevu is to ensure your dental practice reaches incredible heights in the most legal and ethical manner. And we do everything to achieve that!


Sign up now to get a FREE A/R Audit and 15 Days Free Service!