
Randii Lei Adams, then 43, worked as the office manager of a dental practice in Upper Marlboro, Maryland, and used that position of financial trust to run an insurance-billing fraud against the practice’s insurer.
Between February 2005 and June 2006, Adams submitted false insurance claims in the names of her own family members. The insurer, Ameritas Life Insurance Corporation, reimbursed the dental office for the bogus claims by check; Adams then endorsed those checks over to her cousin, Belinda Diana Smith, who cashed them and split the proceeds with Adams. Investigators with the Insurance Fraud Division of the Maryland Insurance Administration and the Maryland State Police determined the pair stole $5,810.40 from Ameritas.
The scheme unraveled because the dentist grew suspicious of the billing and reported both women to the insurance company and the police — a reminder that a practice owner paying attention to the numbers is often the first line of defense.
Adams pleaded guilty to one count of felony theft and was sentenced to five years of probation and ordered to pay approximately $3,000 in restitution; the case was prosecuted by the Maryland Attorney General’s office. Her cousin and accomplice, Belinda Diana Smith, pleaded guilty to misdemeanor theft and received an 18-month suspended sentence, two years of probation, and 50 hours of community service.
Whether you're the victim of an employee's billing fraud or your practice is under scrutiny, Prosperident's forensic accountants can untangle complex insurance schemes and build the documentation needed for legal proceedings.