One of the most common patterns of dental fraud is related to billing. Some dentists may seek additional profit and perform services that are unnecessary to the patient. In other cases, a high number on a bill may be due to mistakes with coding. In either case, the situation is considered a fraud, and the provider may face legal charges. Hygienists, who work along with dentists, are often not responsible for billing and coding the services. However, they may be held accountable for any act of fraud if a patient receives a deceitful bill. Therefore, hygienists must possess enough knowledge to identify any issues related to coding and billing because ignorance cannot serve as an argument in a court trial.
Both dentists and hygienists need to provide codes for the work they have accomplished. Describing a particular service with another code that requires a higher price is a common form of dental billing fraud. Therefore, hygienists need to be careful and should use flowcharts provided by the American Academy of Periodontology. These guidelines help dental professionals describe their services accurately and avoid unintentional overbilling. Hygienists should also ensure that there are no communication issues between them and the dentist. In some cases, a misunderstanding between the two professionals may lead to unnecessary service being provided. While communication gaps lead to higher bills, in some cases, they may lead to unfavorable patient outcomes. Hygienists need to be aware of such issues and must ensure that patients receive only the interventions they need. Although not their direct responsibility, hygienists should know about recordkeeping. For instance, bills must have the same date as the date of the provided service.
Reference
Dental Fraud and Abuse. (n.d.). Dental Health Alliance, L.L.C. Web.