RE: [ACEsthetics] "Insurance Only"

I was told by two different pharmacies here that it was illegal for me to treat my wife.  My wife’s question was, is there someone better than Guy in Douglas to do that root canals.  “Well, we don’t know anything about dentistry so we can’t answer that question.”.  My wife’s answer was, “you are absolutely right.  You know nothing about dentistry so I see anyone that I want to treat me.  Are you depriving me of my freedom of choice?”.  They should have known better because they know my wife. 

 

I got on the phone and called the Georgia Board of Pharmacy and the Georgia Board of Dentistry.  Both had the same answer.  If you wife is a patient of record and you are providing routine dental care within the scope of your practice there is not one damned thing illegal about treating your wife.  Now I admit that it is not a damned good idea to treat your wife but my question is this.  I have a lady who has been my assistant for 22 years.  I saw here five days a week for at least 8 hours a day.  That meant that I probably have spent more time with her than my legal wife.  Why can I treat her and not my wife. 

 

The board of pharmacy told me the story.  A local physician had been writing Tussinex scripts for his wife, children, employees, etc and taking that “liquid gold” himself.  The board of pharmacy had roared into Douglas and had given the pharmacies a lesson in observation.  The fact that five different people employed by or living with this physician had come in on the same day with a script for Tussinex at the same pharmacy.  Someone should have smelled a rat…they ignored it until the hospital turned him in.  It was an overreaction on their part telling me that I could not treat my wife.  I cannot write scripts for birth control pills for my daughter or estrogen for my wife because that is outside of the scope of my practice.  Diflucan is not outside the scope of dentistry because we treat monoliasis of the oral cavity.  I think any country that forbids a spouse to treat another member of their immediate family would lose in a court of law. 

 

Guy W. Moorman, Jr., D.D.S.

The Swamp

Douglas, GA 31533

912-384-7400

 

 

 

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From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On Behalf Of Ashley Goodman
Sent: Tuesday, January 29, 2013 12:54 PM
To: spikedds@gmail.com
Cc: smilestylers@gmail.com; drrodgers@drrodgers.com; tonganoxiedental@aol.com; drjackpweiss@gmail.com; hameldds@gmail.com; bigdrtim@hotmail.com; acesthetics@googlegroups.com
Subject: Re: [ACEsthetics] "Insurance Only"

 

If you did a restoration on your wife in Canada, it's sexual abuse.

 
 
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Ash
 
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Ashley Goodman, DDS
8736 Lake Murray Blvd.#108
San Diego, Ca 92119
Phone:  619-697-6677
Fax:  619-697-6632
Email: agoodman@agoodmandds.com
Web:  www.agoodmandds.com
------------------------------------

On 1/29/2013 9:43 AM, David R. Boag DDS wrote:

Can I throw a monkey into the wrench: If I do a restoration on my wife, and I only take what the insurance covers (her job offers dental insurance as part of health beneys), am I fraudulent? If she then pays me, does that make it okay, because she's paying me with my money? Is it just semantics? What if she doesn't pay me in dollars? ;-)

 

If a bear poops alone in the woods, does it stink?

--

David R. Boag, DDS

 



 

On Jan 29, 2013, at 12:16 PM, Howard Hoffman <smilestylers@gmail.com> wrote:



If you sign a claim form that attests to your fee, that is your fee. Done deal. If you give the patient a break on the fee, wasn't the reduced fee your real fee? Why did you tell the carrier it was something other than what you actually charge, and not pass on the discounted fee to them? Their obligation is to pay whatever they are responsible for, based on your fee. If you have an arrangement with the carrier to offer a reduced fee all the way around, that's a different story.

I believe that you must keep the balance on the books and make an effort to collect it. How well your collection process goes before you give up on attempting to collect it (or write it off) is another story.

Howard

 

 

 

On Tue, Jan 29, 2013 at 12:05 PM, Jeff Rodgers <drrodgers@drrodgers.com> wrote:

Well…I completely agree with you in principal.  But when you fill out an insurance form it asks for the fee for whatever you did.  If you report one fee, knowing full well that is not the fee, then is that not fraud?  It is a deception of the insurance company in an effort to gain some benefit for you or the patient.

 

Now…if the patient is the one filling out the form then you have no control over that.  :]

 

Jeff

 

Jeff L. Rodgers, DMD, PC

Atlanta, GA

 

On Jan 29, 2013, at 11:37 AM, TonganoxieDental@aol.com wrote:



I appreciate you bringing this up, Jeff, as this is my dilemma.

 

Let's take a hypothetical case for a person who doesn't have insurance.  They come in to replace a chipped composite that was done recently enough that I feel badly charging them the full amount, but long enough ago that I feel I am entitled to something.  So instead of charging $250.00, I charge $125.00 and write off the other $125.00.  I am in no way misrepresenting fees; I'm just denying myself the extra $125.00 "out of the goodness of my heart."  Likewise, if they have insurance, pay the premiums, and are entitled to their benefits, then they should receive them.  When I write off the balance, I am still denying myself the remainder "out of the goodness of my heart."  I am the only one who is "short-changed" in this transaction, as I see it.  My intention is never to defraud an insurance company or misrepresent what I do; my intent is to use my right as a business owner to reduce the amount owed to me.

 

But I see all sides.


Grant

 

In a message dated 1/29/2013 10:30:33 A.M. Central Standard Time, drrodgers@drrodgers.com writes:

 I hate to play devil's advocate here but if you represent to the insurance company that you are charging one thing knowing full well that you are actually charging another and the sole purpose is to get the insurance company to pay enough so the patient doesn't have to is really the definition of insurance fraud isn't it?

 

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--

Howard J. Hoffman, DDS, PA

21110 Biscayne Blvd, Ste 402

Aventura, FL 33180

ph: 305-933-3070 (o)

ph: 305-467-6343 (m)

fax: 305-933-2230

 

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Unknown ● Tuesday, January 29, 2013

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