Practice Management Software can Lie

It’s something that we read over and over.  A dentist in a Facebook forum states that embezzlement cannot be happening in his or her practice because they “check their daysheet every single day.”


Broadly, there are two types of embezzlement.  The first takes place when the balancing process (in other words the daily and monthly comparison between software and financial accounts) is unsupervised or incomplete. In this situation, stealing is easy because a thief can enter all payments into the practice management software and then simply “short” the deposit. This leaves patient accounts balances accurate. This is important to prevent patients from complaining about their balances, repeated occurrences of which might get an embezzler caught.

But what if the balancing process is done with integrity, which means that it is complete and supervised? Does this mean that it is impossible to steal? Not by a long shot. It takes a bit more planning than pilfering from the deposit, but it is something that most would-be embezzlers can master.

Success at this kind of theft requires an embezzler to perform what shouldn’t be possible; he or she needs to teach practice management software to lie. This lying normally involves lowering a patient’s receivable balance in a way that does not simultaneously increase the amount that the software believes should be deposited.

There are many options for doing this. They range from the abuse of functions deliberately built into the software for other (legitimate) purposes to more creative avenues such as exploiting security weaknesses in the software.

It’s tempting to assume that practice management software, which is normally built at considerable expense by some pretty smart people, should be hard to outsmart, but we see it happen over and over.

For security reasons, we are not going to outline specific techniques used. If you are a dentist and interested in learning more, feel free to attend one of our doctors-only live presentations or to contact us directly at requests@dentalembezzlement.com

How to Protect Yourself

Here are some steps that practice owners can take to help ensure the integrity of the information in their practice management software:

  1. Print the reports you rely on yourself. Allowing a staff member to generate reports for you creates the potential for selective reporting, where you are seeing less than the full picture
  2. Protect your password. One of the best ways to defeat the security measures built into practice management software is to obtain the practice’s owner’s login information. Your password should never be shared with any staff member, and you need to be obsessive about changing your password regularly (changing it quarterly is the maximum interval that should be permitted). Frequent changes will minimize the damage done from compromise.
  3. While it is important to look at day-end reports, looking at monthly ones is vital. If your review is limited to the days when the office is open and no monthly verification is done, you open the door to extra activity performed on days when the practice is closed.
  4. On a monthly basis, the following need to be reconciled by you or an outside party such as an external bookkeeper to your practice management software:
    1. The bank account
    2. The merchant account (this is the facility used when patients pay by credit card)
    3. Any third-party financing or payment management company you use (e.g., Care Credit, Lending Club, or Orthobanc).
  5. You need to be aware of “timing differences” where the date when something is recorded by your practice management software is earlier or later than when the money reaches your bank account. Credit card payments are an example of timing differences because of the 1-3 day “processing lag” before money reaches your bank account. You need to keep track of these amounts and ensure that they reconcile properly.

The bottom line –nothing will prevent embezzlement. But you can detect it quickly if you approach it the right way.

Police found blank checks from the practice in UT office manager’s vehicle

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Nikki Lee Martinez

 A former South Ogden dental office manager is facing 28 felony charges after she allegedly used $96,000 of company money to pay for her personal expenses, including food, rent, cellphone bills and Netflix.

Nikki Lee Martinez, 40, was booked into the Weber County Jail Thursday on 25 counts of forgery, third-degree felonies; obstructing justice, a third-degree felony; unlawful use of financial transaction, third-degree felony; and theft by deception, second-degree felony, her indictment stated.

People became suspicious of Martinez after blank checks from South Ogden Dental were found inside her vehicle by police after a vehicle accident in August.

The dental office filed an official complaint against Martinez on Oct. 14 after she had been fired.

Her replacement contacted police after she found several discrepancies with checks. Martinez had applied to fraudulent loans and issued several checks to people who have never been employed or treated at the office, according to an arrest warrant. She also discovered a notebook where Martinez allegedly practiced patient’s signatures.

After reviewing the numbers, police discovered Martinez had stolen approximately $96,000 from her employer over the course of two years.

Twenty-nine checks totaling $13,700 had been issued between May 2018 and Aug. 2019 to an “Anette Christiansen” from the South Ogden Dental bank account. Police say there is no record of “Christiansen” being a patient or an employee at the business.

Upon further investigation, the American First Credit Union bank account, where the checks were being deposited, was found to belong to Annette Christensen, Martinez’s landlord.

Christensen told police she and Martinez had come to an agreement that the 40 year old would rent from her, even after a $1,000 check bounced. Martinez claimed her employer agreed to pay her rent out of her salary.

Court documents state Martinez would pay her landlord twice a month for rent, but the payment was never the same each time.

A series of 39 checks written personally to Martinez between August to October totaled $63,045.

Each of the checks, which all had forged signatures, were meant for Martinez’s pay check, the dentist told police. But, she had overpaid herself each time she handled the money.

South Ogden Dental also found approximately 429 duplicate checks written to Martinez and to other vendors and individuals.

An arrest warrant claims Martinez also used the company’s American Express credit card to pay for her personal cellphone bill, car payment, Netflix account, groceries, Uber rides and food purchases at Domino’s Pizza, Pizza Hut and Burger King. The total amount used came to $4,950.

A series of Walmart Auto Checks, that pass through a system after payment and are given back to the customer, were used by Martinez at Walmart and Sam’s Club. The former office manager allegedly used $4,590 from the company’s checking account to pay for the groceries.

Martinez’s electrical bill was paid for by the company for almost two years, totaling $5,031.56.

On Dec. 13, a patient at South Ogden Dental told police Martinez had been demanding payment for services and requested she deposit the money into a bank account. The former office manager said she would make sure the money would be given to South Ogden Dental.

An indictment was filed against Martinez four days later in the Second District Court in Weber County.

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Webinar on Properly Firing Staff


Content retrieved from: https://kutv.com/news/local/police-former-utah-dental-office-manager-stole-nearly-100k-from-employer


Editor’s note — a search of Utah criminal records shows a 2003 theft conviction for Nikki L Martinez, who has the same birthdate as the Nikki Lee Martinez referred to in this article.

Hoverboard Dentist Sentenced to 12 Years in Prison

Update February 2021:

Dr, Lookhart was sentenced to 12 years in prison for is convictions on charges including Medicaid fraud, embezzlement, reckless endangerment and unlawful dental acts. The State of Alaska is also seeking restitution of $2.2 million.


Original Story:

Many of us have heard about Dr. Seth Lookhart, the Alaska dentist who was on video showing him riding a hoverboard while extracting a tooth on a sedated patient.

As outlandish as this activity is, there seems to be more to the story. Dr. Lookhart is also accused of diverting over $250,000 from Alaska Dental Arts, the practice where he was working as an associate.

Information gathered by investigators from the State of Alaska’s Medicaid Fraud Control Unit in connection with some alleged Medicaid billing improprieties for IV sedation also suggested a plot between Dr. Lookhart and his office manager, Shauna Leigh Cranford, to bill some of their IV sedation work through a separate billing number and thus deprive the owners of the practice from their share of this revenue.

Shauna Cranford, who has also used the surnames Billings and Smith, was charged in 2017 for assault on a police officer.

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Shauna Cranford

The State’s investigators obtained a search warrant to seize and copy the phones of Dr. Lookhart and Ms. Cranford, and found the following exchange of text messages where the intent to divert some of the revenue from the practice is quite clear.

Ms Cranford entered a guilty plea in October 2019 for pushing excessive and often needless intravenous sedation for Medicaid patients. Her sentencing is scheduled for February 3, 2020. 

12/29/2015 8:55:18 AM(UTC-9), – (Seth Lookhart)
Weird side question but could we start running some sedation through my personal medi number
Status: Read
12/29/2015 8:55:23 AM(UTC-9), – (Shauna Cranford)
I agree. We are not here to kick start ADA as an IV practice and provide all of the leg work
Status: Sent
12/29/2015 8:55:42 AM(UTC-9), – (Shauna Cranford)
Yes we could
Status: Sent
12/29/2015 8:56:32 AM(UTC-9), – (Shauna Cranford)
I can send claims through their website for Lookhart Dental LLC
Status: Sent
12/29/2015 8:57:42 AM(UTC-9), – (Seth Lookhart)
I know it might prevent me from coming at them for back taxes with a law suit but it might be worth it
Status: Read
12/29/2015 8:58:12 AM(UTC-9), – (Seth Lookhart)
Our office production would drop and it would draw far less attention to the office
Status: Read
12/29/2015 8:58:25 AM(UTC-9), – (Seth Lookhart)
Will they be able to track it
Status: Read
12/29/2015 8:58:33 AM(UTC-9), – (Seth Lookhart)
I want it untraceable
Status: Read
12/29/2015 9:03:36 AM(UTC-9), – (Shauna Cranford)
They can’t look at your claims at all and the check would go to your house. If you are billing procedures as well as the sedation, only bill under your LLC for ones that don’t require auth
Status: Sent
12/29/2015 9:05:17 AM(UTC-9), – (Seth Lookhart)
Like sedation
Status: Read
12/29/2015 9:06:11 AM(UTC-9), – (Seth Lookhart)
It would be only sedation and probably not all of them
Status: Read
12/29/2015 9:06:21 AM(UTC-9), – (Seth Lookhart)
How would it look through dentrix
Status: Read
(Note: Dentrix was the internal tracking program used by the clinic)
12/29/2015 9:11:10 AM(UTC-9), – (Shauna Cranford)
We just wouldn’t flag them as sedation
Status: Sent
12/29/2015 9:11:37 AM(UTC-9), – (Shauna Cranford)
And not put in the sedation charges
Status: Sent
12/29/2015 9:11:57 AM(UTC-9), – (Shauna Cranford)
So it would look like you’re doing less sedation
Status: Sent
12/29/2015 9:18:01 AM(UTC-9), – (Shauna Cranford)
I’m surprised the power hasn’t gone out
Status: Sent
12/29/2015 9:31:08 AM(UTC-9), – (Seth Lookhart)
I think that’s what I’d like to do
Status: Read
12/29/2015 9:31:50 AM(UTC-9), – (Seth Lookhart)
Even if we only do 50% of the sedations it will drop their production to a more “normal/reasonable” level
Status: Read
12/29/2015 9:32:34 AM(UTC-9), – (Shauna Cranford)
I would keep a separate copy of the sedation records that you bill under yourself
Status: Sent
12/29/2015 9:32:46 AM(UTC-9), – (Seth Lookhart)
Sure
Status: Read
12/29/2015 9:32:57 AM(UTC-9), – (Shauna Cranford)
I can photocopy them and give them to you to store off site
Status: Sent
12/29/2015 9:33:33 AM(UTC-9), – (Seth Lookhart)
I guess they could catch on if they manually went through charts and saw scanned record and compared to the ledger and they weren’t showing there
Status: Read
Read: 12/29/2015 9:33:35 AM(UTC-9)
12/29/2015 9:34:11 AM(UTC-9), – (Shauna Cranford)
I don’t know that they are that smart
Status: Sent
12/29/2015 9:34:49 AM(UTC-9), – (Seth Lookhart)
I’m sure they aren’t
Status: Read
12/29/2015 9:35:42 AM(UTC-9), – (Seth Lookhart)
And as far as sedation goes it’s a pretty sure fire payment correct
Status: Read
12/29/2015 9:35:56 AM(UTC-9), – (Shauna Cranford)
As long as they are eligible
Status: Sent
12/29/2015 9:36:22 AM(UTC-9), – (Shauna Cranford)
It pays out right away
Status: Sent
12/29/2015 9:51:49 AM(UTC-9), – (Seth Lookhart)
How hard is it to set up?
Status: Read
12/29/2015 9:52:01 AM(UTC-9), – (Seth Lookhart)
And what’s the fee for 9243?
Status: Read
12/29/2015 9:52:24 AM(UTC-9), – (Shauna Cranford)
Set up what? You are already set up
Status: Sent
12/29/2015 9:52:45 AM(UTC-9), – (Seth Lookhart)
So it’s just start billing?
Status: Read
12/29/2015 9:52:50 AM(UTC-9), – (Shauna Cranford)
I would just have to login to their website and submit the codes manually through their portal
Status: Sent
12/29/2015 9:53:03 AM(UTC-9), – (Seth Lookhart)
Can they track that?
Status: Read
12/29/2015 9:53:45 AM(UTC-9), – (Shauna Cranford)
$170.76
Status: Sent
12/29/2015 9:53:56 AM(UTC-9), – (Shauna Cranford)
They meaning BS?
Status: Sent
12/29/2015 9:54:08 AM(UTC-9), – (Shauna Cranford)

BS cannot track it
Status: Sent

(Note — BS is an acronym for the names of the owners of the practice_
12/29/2015 9:56:39 AM(UTC-9), – (Seth Lookhart)
Yeah
Status: Read
12/29/2015 9:56:57 AM(UTC-9), – (Seth Lookhart)
Or anyone else
Status: Read
12/29/2015 9:57:13 AM(UTC-9), – (Shauna Cranford)
Just Medicaid would know
Status: Sent
12/29/2015 9:57:42 AM(UTC-9), – (Shauna Cranford)
The RA would get mailed to your house
Status: Sent
12/29/2015 9:57:57 AM(UTC-9), – (Seth Lookhart)
Sure
Status: Read
12/29/2015 9:58:00 AM(UTC-9), – (Seth Lookhart)
Let’s do it
Status: Read
12/29/2015 9:58:41 AM(UTC-9), – (Seth Lookhart)
Do we incrementally reduce volume or take a decent cut?
Status: Read
12/29/2015 10:01:19 AM(UTC-9), – (Shauna Cranford)
That’s up to you.
Status: Sent
12/29/2015 10:02:26 AM(UTC-9), – (Shauna Cranford)
A decent cut would draw some attention but you can have some excuse
Status: Sent
12/29/2015 10:03:03 AM(UTC-9), – (Shauna Cranford)
An incremental reduction would likely go unnoticed until a certain level
Status: Sent
12/29/2015 10:05:40 AM(UTC-9), – (Shauna Cranford)
Attrition
Status: Sent
12/29/2015 10:05:47 AM(UTC-9), – (Seth Lookhart)
Sure
Status: Read
12/29/2015 10:06:07 AM(UTC-9), – (Seth Lookhart)
I would say our numbers shouldn’t not increase
Status: Read
12/29/2015 10:07:41 AM(UTC-9), – (Shauna Cranford)
Lol it actually reminds me about a rant LJ had about the maid stealing his socks and undershirts. He compared it to attrition.
Status: Sent
12/29/2015 10:07:59 AM(UTC-9), – (Shauna Cranford)
It was funny. The rant went on for like an hour
Status: Sent
12/29/2015 10:08:52 AM(UTC-9), – (Shauna Cranford)
Yes I agree or the numbers should be around the average for sedation. Like $40-$50k
Status: Sent
12/29/2015 10:09:26 AM(UTC-9), – (Shauna Cranford)
I would throw out our high of near $80k
Status: Sent
12/29/2015 10:10:47 AM(UTC-9), – (Seth Lookhart)
I would say within six months 50% get billed out under the cartel
Status: Read
(Note: Cranford and Lookhart often refer to their business and practices as “the cartel”)
12/29/2015 10:11:00 AM(UTC-9), – (Seth Lookhart)
Reasonable?
Status: Read
12/29/2015 10:11:26 AM(UTC-9), – (Shauna Cranford)
Sounds good
Status: Sent
12/29/2015 10:12:12 AM(UTC-9), – (Shauna Cranford)
I’ll check out the portal a little today. I’ve never used it for sending claims but was trained on it by Joan. It was simple enough
Status: Sent

12/29/2015 10:13:55 AM(UTC-9), – (Seth Lookhart)
Lol
Status: Read
12/29/2015 10:13:57 AM(UTC-9), – (Seth Lookhart)
Ok
Status: Read
12/29/2015 10:15:37 AM(UTC-9), – (Seth Lookhart)
I would say we keep sedations around 25 a month under ak dental arts
Status: Read
12/29/2015 10:16:19 AM(UTC-9), – (Seth Lookhart)
And still keep a record on the sedation excel but may star those billed under the cartel
Status: Read
12/29/2015 10:17:01 AM(UTC-9), – (Shauna Cranford)
That’s around 20 sedations to ADA. So like month 1
Status: Sent
12/29/2015 10:19:13 AM(UTC-9), – (Seth Lookhart)
Wait what?
Status: Read
12/29/2015 10:20:22 AM(UTC-9), – (Seth Lookhart)
Over the last 6 months we have averaged around 40 sedations a month of say we keep around 25 going to BS and the remaining 15 to the cartel
Status: Read
12/29/2015 10:20:59 AM(UTC-9), – (Shauna Cranford)
Got it. I thought you were talking $25k
Status: Sent
12/29/2015 10:21:26 AM(UTC-9), – (Seth Lookhart)
Or perhaps better to do a percentage so that it will naturally eb and flow
Status: Read
12/29/2015 10:22:07 AM(UTC-9), – (Seth Lookhart)
And I wouldn’t have a day sheet on the cartel cases correct?
Status: Read
12/29/2015 10:22:50 AM(UTC-9), – (Shauna Cranford)
Correct. But I would make something so that tracking claims would be easier
Status: Sent
12/29/2015 10:23:18 AM(UTC-9), – (Shauna Cranford)
So you would have a day sheet. Just not a dentrix one
Status: Sent
12/29/2015 10:23:51 AM(UTC-9), – (Seth Lookhart)
Sure
Status: Read
12/29/2015 10:41:33 AM(UTC-9), – (Seth Lookhart)
Do you think 40% of sedations is reasonable and not noticeable
Status: Read
12/29/2015 10:41:50 AM(UTC-9), – (Seth Lookhart)
Start with 15% for jan
Status: Read
12/29/2015 10:42:09 AM(UTC-9), – (Seth Lookhart)
Then 25 for feb
Status: Read
12/29/2015 10:42:16 AM(UTC-9), – (Seth Lookhart)
Then 35 for March
Status: Read
12/29/2015 10:42:25 AM(UTC-9), – (Seth Lookhart)
And 40 for April and forward?
Status: Read
12/29/2015 10:42:30 AM(UTC-9), – (Seth Lookhart)
Looks great
Status: Read
12/29/2015 10:42:32 AM(UTC-9), – (Seth Lookhart)
Thanks

The Medicaid Fraud Control Unit investigators determined that a total of $250,686 was billed to Medicaid and sent directly to Dr. Lookhart’s home address. Based on the 70% share that belonged to the practice, this suggests embezzlement of about $175,000.

Dr. Lookhart was convicted on 46 counts, including felony medical assistance fraud and scheming to defraud, as well as misdemeanor counts of illegally practicing dentistry and reckless endangerment.

For an excellent discussion of the many disturbing aspects of this affair, please see Dr. Michael Davis’ article in Dentistry Today titled “Hoverboard Dentist” Found Guilty of Medicaid Fraud”. It can be accessed here — https://www.dentistrytoday.com/news/todays-dental-news/item/5901-hoverboard-dentist-found-guilty-of-medicaid-fraud

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What do You do When You Can’t Steal From Your Practice? Steal From a Patient!

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Lisa Campbell

Florida woman is charged with stealing $45k from a patient of the practice where she worked.


PALM BEACH GARDENS – Lisa Campbell, police say, handed a $45,000 check to a lawyer. She said the money, from a woman in her 90s whom Campbell had befriended, constituted gifts, but she felt bad and wanted to give it back.

It didn’t work. Campbell is charged with three counts each of grand theft of a person over 65, uttering a forgery instrument and criminal use of personal identification.

Campbell, 60, of North Palm Beach was booked Nov. 12 at the Palm Beach County Jail. She left the next day after posting a $27,000 bond. A call to a telephone number listed for her in a police report was not returned.

According to the Palm Beach Gardens police report, Campbell told investigators Nov. 12 that the woman wrote her the checks because she “wanted to do something nice for her.”

When pressed by a detective, the report said, Campbell admitted to the fraud. She said she was having financial problems and needed the money.

The Palm Beach Post is not naming the older woman, who is now 94 years old. The report said she told investigators that she’d met Campbell, who was a dental assistant, during a visit to her dentist in 2017.

She said she and Campbell became friends and Campbell began to help her with errands and appointments. The woman said she never paid Campbell, saying “it was all done in friendship,” the report said.

The woman was hospitalized in June and eventually moved to an assisted living complex. Longtime friends who knew the woman from the New York area went to court and obtained guardianship. They began checking the woman’s bank records and found checks written to Campbell for $2,000, $25,000 and $20,000.

The report said detectives later showed the alleged victim the checks, and she said, “Oh. She went for the gold.” She said she’d have no reason to write the checks to Campbell and the signatures were not hers.

In August, Michael W. Connors, a Juno Beach elder law attorney who represented the guardians, sent Campbell a “demand letter” for anything she had belonging to the woman.

Connors said Monday that Campbell came to his office with a personal check for $45,000.

“She handed it to me and said, ‘I feel bad that I didn’t mention these gifts,’ ” Connors said Monday.

Connors also said guardians cannot find cash and jewelry that had been in the alleged victim’s home, which had been empty since she went to the assisted-living complex.

“We’re at a loss as to how to pursue that,” Connors said.

He said the woman still is financial able to support herself but, “It’s still a terrible act. Like stealing candy from a baby. Maybe worse.”

Court records show Campbell was convicted in 2000 of grand theft and organized scheme to defraud more than $20,000 and was sentenced to 18 months of probation.

A Palm Beach Gardens report said the dentist for whom she worked at the time alleged she wrote herself $25,000 on company checks, and also made as many as 50 fraudulent purchases on his credit card. The report said Campbell later confessed.

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Content retrieved from https://www.palmbeachpost.com/news/20191119/police-friendrsquo-wrote-45000-in-checks-to-herself-on-older-womanrsquos-account


Editor’s note: A search of Florida criminal records reveals that a woman with the same name and birthdate as Lisa Campbell, living in the Palm Beach area, was charged four times for felony theft and fraud offenses in the years 1999 to 2000. This underscores the need to do a proper criminal records check as part of the hiring process.

First and Last Name Lisa J Campbell
Booked Sep. 27, 2000
Source Palm Beach County Sheriff’S Office – Arrest Records (Florida)
Charge 83102 – Utter Forged Instrument; 812014 2c – Grand Theft; 817034 3d – Organized Schemed to Defraud

First and Last Name Lisa J Campbell
Offense Oct. 10, 2000
Source Palm Beach Courts (Florida)
Charges/Offenses Grand Theft | Organized Scheme to Defraud>$20, 000

First and Last Name Lisa J Campbell
Offense Jun. 1, 1999
Source Dept Of Corrections (Florida)
Charges/Offenses Org.fraud – $20, 000 – 50, 000 | Grand Theft, 300 L/5, 000

First and Last Name Lisa J Campbell
Offense Aug. 26, 2000
Source Palm Beach Courts (Florida)
Charge/Offense Conversion: (812.014 (1, 2c)/ / /F/000/78 ) (Prob – X) Grand Theft

Prosperident Pulse #89 – December 2019

Dental Prosperident Pulse from Prosperident
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Issue #89 — December 2019
Podcast
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The terrific folks at Productive Dental Academy recently did great a podcast with David Harris. You can listen HERE.
Want an Engaging Speaker?
Did you know that there are some topics that we will ONLY discuss at closed-door, live events?
linda-gregg
This is Jennifer Leslie. She was recently convicted of stealing $420k. Hear her story, and many more.
See us live if you want the full story on embezzlement.
Here are some places where we will be speaking soon:
2020
Feb 19 Kamloops and District Dental Society, Kamloops BC
Feb 27 Ortho2 User Group Meeting, San Diego CA
Mar 9 Cloud9 User Group Meeting, Atlanta GA
Mar 11 Schulman Group, Laguna Beach CA
Apr 24 East Texas Study Club, Bullard TX
May 9 Smile Source Exchange, Atlanta GA
2021
Feb 25 Chicago Dental Society Mid-Winter Meeting, Chicago IL
To book us for your meeting or study club, click HERE or call us at 888-398-2327.
Did you miss a previous newsletter? We archive them HERE.

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Stuck on what to get your Favorite Dentist for Christmas?
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We are probably a bit biased, but we think our CEO’s book makes a great gift. It’s available both in paperback and Kindle formats, and it’s been getting great reviews on Amazon.
The Amazon link is HERE.
Guest Post – Be Aware Of Your “New Dental Plans”
There are some twists and turns in the world of insurance reimbursement that are not well understood by dentists. We asked our friend Chris Tayler of Cobalt Analytics to shed some light. He gave us some excellent information.
Navigating the world of dental plan contracts and reimbursements can be like reading legal documents written in Sanskrit through a tinted glass window. And yet the results can make a big difference in your write-offs and subsequent take home pay.
This is particularly true with companies that act as administrators/lessors and/or “networks” of dental plans. In essence these administrator networks sell and sometimes administer other dental plans.
The big question is which fee schedule the dentist will be paid from. This question arises because administrator networks and the dental plans which they sell have their own distinct fee schedules and often reimburse at vastly different rates.
Something to Talk About…
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Thanksgiving is over, and the frenzied rush towards Christmas is now upon us. Black Friday, Cyber Monday, and, just when your credit cards have had enough, Boxing Day, have become the media events of the season.
It’s not hard to get the idea that rampant consumerism has displaced more traditional forms of Christmas celebration. I can only imagine the pressure that sale flyers and ads can exert on embezzlers.
Since this is our last newsletter of 2019, on behalf of everyone at Prosperident, I’d like to that you for allowing us to be a part of your community, and to wish you a wonderful holiday season.
Sincerely,
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David Harris

We are Prosperident, Dentistry’s Embezzlement Experts

Guest Post – Be Aware of Your “New Dental Plans”

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Chris Tayler, MBA

www.cobaltanalytics.net


Navigating the world of dental plan contracts and reimbursements can be like reading legal documents written in Sanskrit through a tinted glass window. And yet the results can make a big difference in your write-offs and subsequent take home pay.

This is particularly true with companies that act as administrators/lessors and/or “networks” of dental plans. In essence these administrator networks sell and sometimes administer other dental plans.

The big question is which fee schedule the dentist will be paid from. This question arises because administrator networks and the dental plans which they sell have their own distinct fee schedules and often reimburse at vastly different rates. The difference in reimbursement for crowns alone can be in the hundreds of dollars. The point at which we attempt to determine the fee schedule used for payment is the point at which we jump into the rabbit’s hole.

When a dentist contracts directly with the administrator network she might be automatically enrolled with all dental plans within its network. Surprise!

To complicate matters, the administrator network may pay from its own fee schedule if the fee in question is lower than that of one of the dental plans within its network. However, what happens if the dentist is not directly contracted with the administrator network itself, but is contracted with one of the dental plans within its network? In that case he would most likely be paid from the fee schedule of the latter. To make things even more convoluted, at times a dentist is directly contracted with multiple dental plans sold within an administrator network, while not being directly contracted with that administered network. In that case, the fee schedule used for reimbursement is usually that of the dental plan which was directly contracted with first.

Most administrator network contracts state they administer and/or sell multiple dental plans (although they don’t always publish the full list.) Be careful, because they do not always spell this out. As a result, dentists could be paid from different fee schedules without even being aware that it’s happening, resulting in less take home pay.

You can opt out of unwanted dental plans associated with the administrator network after directly contracting with them, but it can take months for this to be finalized. In the meantime, most require the dentist to continue seeing their patients at the contracted reimbursement rates. To avoid this, you can opt-out of unwanted dental plans before directly contracting.

A key phrase here is “directly contracted.” Some administrator networks may attempt to auto- enroll (or contract) practices with the dental plans in their network without formal notification. Therefore, it is highly recommended to contact the administrator networks to find out if you are directly contracted with them, as well as with any dental plans they sell or administer. It is not uncommon to be told by the administrator network that you must reach out to a dental plan directly. If this occurs, tell the administrator network you first need to know if you are “directly contracted” with them. If they say yes, have them send you the fee schedule they are reimbursing you from (you could use this opportunity to opt-out of any of their associated dental plans.)

The next step is to reach out to any dental plans the administrator network may have mentioned to determine if you are “directly contracted” with them. This dental plan, in turn, may try to direct you to yet another dental plan, or back to the administrator. Keep in mind; however, that each one is responsible (and only able) to answer for themselves.

Most importantly, before contracting with administrator networks it would be immensely helpful to determine which dental plans are the most profitable for your practice. Having this information gives you control (and protects your take home pay) by allowing you to make informed business decisions about the administrator networks and dental plans you wish to work with.

For more information, check out Cobalt’s website at www.cobaltanalytics.net or call 801-953-9777.

Brian Nordan, Former Manager of Indiana Practices, Convicted of Embezzling $3 million. Sentenced to 42 months

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Brian Nordan

Update July 2021:

Brian Nordan has been sentenced to 42 months in federal prison, supervised release of 2 years following his incarceration and has been ordered to pay restitution of $2.9 million.


Original Story:

The former general manager of Afdent Dentistry, which has offices in Mishawaka and Fort Wayne, has been charged in federal court with defrauding the company of more than $3 million over six years.

According to an indictment filed in federal court, Brian Nordan, 42, embezzled money from Afdent beginning in 2012 for the benefit of himself, his partner and spouse, Dustin Coleman, and his sister, Angela Jasinski.

In addition to creating a separate company that sold marked-up toothpaste to Afdent for $25 a tube, federal prosecutors allege that Nordan used company credit cards to pay off his personal credit cards, make purchases at Lowe’s and pay his husband and sister salaries while they weren’t working for the company.

According to a separate civil case filed by Afdent, Nordan was terminated in June 2018 after the company discovered Jasinski and Coleman had been secretly receiving pay. Legal filings state that Afdent’s owner was unaware of Jasinski and Coleman’s ghost employment.

Nordan, Coleman and Jasinski were all arrested on multiple felony wire fraud charges on Monday and Tuesday, according to federal court filings.

“Employers hire individuals with the understanding that they will be honest and not exploit them for personal financial gain,” said United States Attorney Thomas L. Kirsch II. “When, as alleged in this indictment, individuals do exploit their employers for illegal financial gain, my Office and our law enforcement partners will investigate and prosecute.”

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Content retrieved from https://www.southbendtribune.com/news/business/former-afdent-manager-accused-of-million-fraud/article_24bbfe97-296c-518e-8970-4ecb7f9432b9.html

A Non-dentist Owner of a Minnesota Dental Practice is Charged with $100k of Medicaid Fraud

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Nadine Royter

According to the Minnesota Attorney General, Nadine Royter, 57, of Plymouth, an owner of Willow Grove Family Dental, billed for over $100,000 of services using the identity of dentist B.L. who had resigned from Willow Grove due to concerns with Royter’s unethical business practices. In one instance, Royter billed for dentures purportedly provided by B.L. to patient W.B.  W.B. told investigators he never received dentures.

Content was retrieved from https://www.ag.state.mn.us/Office/Communications/2019/09/27_MedicaidFraud.asp


A bit of digging on Ms. Royter reveals that this is not her only legal trouble. She is also facing a 2018 shoplifting charge:

Nov. 1, 2018, 400 Prairie Center Drive: Eden Prairie police responded to Von Maur at 400 Prairie Center Drive on report of a theft, according to a Hennepin County criminal complaint. Upon arrival, officers learned that a woman later identified as Nadine Royter, 57, had shoplifted items with a total value of $1,001, the complaint said. Security video showed Royter selecting items throughout the store and leaving without attempting to pay. In a search related to arrest, officers recovered the stolen items from Royter, the complaint said. She is charged with felony theft.

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Content retrieved from https://www.swnewsmedia.com/eden_prairie_news/news/public_safety/police_reports/police-report/article_4b4b8f16-f614-5507-81b0-5ee21437207a.html


There was also a person with the same name with several charges in Minnesota from 2000-2001:

First and Last Name Nadine Royter
Charges Filed Nov. 16, 2000
Source Administrative Office Of Courts (Minnesota)
Charges/Offenses Theft – $201 – $500 | Disobeying Stop or Yield Signs
Match Rating Based On:
First Name
Last Name
DOB
Age
County

First and Last Name Nadine Royter
Convicted Apr. 5, 2001
Source Dept Of Public Safety (Minnesota)
Charge/Offense Theft – Acts Constituting


Indiana Woman Charged with Embezzling $300k from Orthodontist

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Malinda Downey

A long-time employee of a local dental office has been arrested in connection with the alleged theft of nearly $300,000 from her employer over at least a four-year period beginning in 2015.

Malinda A. Downey, 47, of Madison, has been charged with one count of theft, a Level 5 felony, but additional charges could be forthcoming as accountants, Indiana State Police and the Jefferson County Prosecutors Office continue investigating the case.

Downey is currently free on a $10,000 cash bond. She appeared in Jefferson Superior Court Friday, for a reading of the charges and a “not guilty” plea was entered with her trial date set for 8:30 a.m. on Thursday, Jan. 16, 2020.

Downey, who was arrested by state police Wednesday, had been employed as an office worker at Pawlak Orthodontics, 160 Demaree Drive, Madison, for 17 years using both Ortho-Trac and QuickBooks programs to track customer payments, services and patient information before depositing receipts in the bank account for the business.

According to a probable cause affidavit, Dr. Elizabeth Pawlak, owner of the practice, had suspected discrepancies in receipts and deposits for some time but on July 11 and July 12 discovered that cash payments from two new patients were not properly documented. Pawlak then conducted a review that confirmed payments recorded in Quickbooks did not match those recorded in Ortho-Trac and an estimated $150,000 could not be accounted for.

At that point, Pawlak asked Indiana State Police to investigate the case and Det. David Makowsky advised Pawlak to seek a complete audit of her books.

The affidavit said Pawlak spoke with Downey about the discrepancies on Aug. 12 with Makowsky present and Downey indicated that she must have recorded the transaction incorrectly. When confronted with other discrepancies, Downey did not have an explanation for the missing funds.

Eventually, Makowsky asked Downey how much money was missing and she told him she “did not know.” He asked if she had taken any money prior to 2014 and she said she “didn’t think so” and that she “did not remember if she ever put any money back,” the affidavit said.

At that point Downey said she did not want to speak to Makowsky any further. They set up a time to meet the following day but prior to that Downey notified Makowsky that she did not want to meet with him further.

Autumn Dean, an accountant with Hartman and Williams LLC, completed an audit of the records at Pawlak Orthodontics and, based on a summary between the Ortho-trac and Quickbooks records, $292,251.32 was found missing between 2014 and 2019, the affidavit said.

Dean’s report indicated that a sample comparison of Ortho-Trac entries made under Downey’s login credentials compared to payments recorded in Quickbooks from 2015 to 2019 showed that payments were recorded in Ortho-Trac but not in Quickbooks and that $74,078.00 was missing in Quickbooks. Additional transactions still are being scrutinized.

The investigation led to Wednesday’s warrant issued for Downey’s arrest on the Level 5 felony charge of theft (over $50,000). She was booked at the Jefferson County Jail and later released on bond.

Pawlak has since issued a statement to reassure patients that the thefts that are charged were from Pawlak and not customers.

“We at Pawlak Orthodontics want to thank our patients for being dedicated to our office. We appreciate the loyalty you have shown us. We have had an unfortunate situation occur. A former employee has been charged with theft of funds from our office. We want to assure everyone that this has not affected any patient’s accounts. These were cash-only payments and only affected the bottom line for Dr. Pawlak.

“We want to assure everyone that we have taken measures to make sure that something like this will not occur again. Again, we sincerely appreciate the support and patience we have received from everyone while we deal with this issue.”

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Content retrieved from https://madisoncourier.com/Content/News/News/Article/Employee-charged-with-300K-theft-from-local-dentist/178/961/117559