Monday, May 12, 2008
Saturday, May 10, 2008
New York Kicking Small Smiles To The Curb
May 8, 2008
Steve Flamisch
The New York State Office of the Medicaid Inspector General is terminating Small Smiles Dentistry from the state Medicaid program effective May 24, CBS 6 News has learned.A spokeswoman would not confirm any additional details, citing the need to preserve the integrity of the ongoing investigation.
Three former employees and the parents of 82 patients accuse the Colonie children's dentistry clinic of performing rushed and unnecessary procedures on its young patients, all to make money. The ex-employees claim the dentists and other staff members earn lucrative bonuses for achieving certain "production numbers," though the company patently denies that claim.
Government sources confirm that Attorney General Andrew Cuomo's office is also investigating Small Smiles. Cuomo has the power to bring civil and criminal charges in Medicaid cases, though it remains to be seen whether that will be the case.The State Education Department, which licenses all dentists in New York, would not confirm an investigation, but did file a subpoena requesting all of the information CBS 6 uncovered. The station is cooperating, and - at the request of the parents - sharing that documentation with other state agencies, as well.
Small Smiles spokesman Don Meyer would not confirm the state's action, nor would he explain how 82 parents had come forward to corroborate allegations the company has dismissed as "baseless." In an email, Meyer said, "I have no additional information to share with you at this time."
Finally a state has stepped forward and working on putting an end to Small Smiles/FORBA barbaric back alley dentistry and abusing children in the process.
I'm looking for more states to follow New York's lead in the near future. Let all keep our fingers crossed and hope that North Carolina realizes Smile Starters is owned and operated by the same people and kicks Smile Starters to the curb as well.
Ok, let see what states follows New Yorks lead.
Next?
On a side note:
Dr. Randall W. Ellis, DDS referred to as reviewing the patient files internally for FORBA's (Small Smiles) is a Professor at (drum roll please...... ) Creighton!! And lives.....(drum roll again)...... Pueblo!
Friday, May 09, 2008
Obtained Small Smiles Patient Information Forms
Dropped Into a Small Smiles Clinic in South Carolina today and picked up some forms to pre-fill out prior to an appointment.
See the Forms here
The main forms for the patient to fill out is manila card stock patient folder. The front part is the only part the patient or guardian fills out prior to treatment, the signs at the bottom. It's not until the folder is open that the Patient Behavior Management Procedures are listed. Long after the parent or guardian has signed and consented to treatment.
I find this a bit sneaky.
As stated this in the patient file, the parent or guardian does not take any of this info with them. You can see in the picture when the folder is open on the left hand side lists the procedures and the right side is used to document appointments, visits and work performed.
What I find very misleading is that there is only one place for the parent or guardian to sign and it's only of the front just after the patients medical history has taken. Usually if there are other sections of documents that you need to read there would be a place for initials or a signature after that all important section.
At the bottom of the front page, the only page the parent or guardian fills in it says:
The way this is laid out it appears that you only read and fill out the front page. When you open the file folder it appears the inside is for the dentist to record the treatments.
This is a blanket signature agreement. Sections are not laid out clearly for the parents or guardian to read, sign, and understand to the full extent as it should be.
It's very sneaky to have a place for a signature acknowledging something prior to getting to that section. I don't know that I've ever seen any kind of treatment agreement, contract or other official document that has a place to sign prior to getting there, have you?
There absolutely should be a place to sign at the bottom of the second page acknowledging the parent or guardian has read the Patient Management Techniques and a place for the dental assistant or dentist to sign under it acknowledging that "techniques" were clearly explained and demonstrated.
See the Forms here
The main forms for the patient to fill out is manila card stock patient folder. The front part is the only part the patient or guardian fills out prior to treatment, the signs at the bottom. It's not until the folder is open that the Patient Behavior Management Procedures are listed. Long after the parent or guardian has signed and consented to treatment.
I find this a bit sneaky.
As stated this in the patient file, the parent or guardian does not take any of this info with them. You can see in the picture when the folder is open on the left hand side lists the procedures and the right side is used to document appointments, visits and work performed.
What I find very misleading is that there is only one place for the parent or guardian to sign and it's only of the front just after the patients medical history has taken. Usually if there are other sections of documents that you need to read there would be a place for initials or a signature after that all important section.
At the bottom of the front page, the only page the parent or guardian fills in it says:
I certify that I have read and understand the above. I acknowledge that my questions, if any, about the inquiries set forth have been answered to my satisfaction. I will not hold the dentist, or any other members of his/her staff, responsible for any errors or omissions that I may have made in the completion of this form. I have also read and understand the Pediatric Dentistry Patient Management Techniques on page 2 of this form and give my consent for their use.
The way this is laid out it appears that you only read and fill out the front page. When you open the file folder it appears the inside is for the dentist to record the treatments.
This is a blanket signature agreement. Sections are not laid out clearly for the parents or guardian to read, sign, and understand to the full extent as it should be.
It's very sneaky to have a place for a signature acknowledging something prior to getting to that section. I don't know that I've ever seen any kind of treatment agreement, contract or other official document that has a place to sign prior to getting there, have you?
There absolutely should be a place to sign at the bottom of the second page acknowledging the parent or guardian has read the Patient Management Techniques and a place for the dental assistant or dentist to sign under it acknowledging that "techniques" were clearly explained and demonstrated.
Small Smiles Of Aurora is 6th Street of Denver Dental Clinic, PC, a DeRose Company
Download Document Here
Small Smiles Dental Centers Of Aurora Colorado's True Name is "6th Street of Denver Dental Clinic, PC."
Note: The address is the same as the old DeRose Children's Dental Center is Nashville, TN.
Small Smiles Dental Centers Of Aurora Colorado's True Name is "6th Street of Denver Dental Clinic, PC."
Note: The address is the same as the old DeRose Children's Dental Center is Nashville, TN.
Thursday, May 08, 2008
FORBA, LLC Formed 1-2002 then renamed to LIC SAC, LLC
About the exact same time the DeRose's sold the assets of FORBA, LLC they changed the name of FORBA, LLC (For Better Access) to LIC SAC, LLC. (Lick Sack, nothing but class those nasty scumbags...I mean scum sacks) 10-02-2006. Notice on the documents the address is that of DD Marketing in Pueblo.
To See the documents click here.
10-01-02
FORBA, LLC Articles Of Organization Here, see Dan DeRose's name right here!
Dan DeRose, Michael DeRose, Ed DeRose, William Mueller, and Adolph Padula.
According To The Colorado Secretary Of State Website, FORBA, LLC, named changed to LIC SAC, LLC, 10-02-2006 is listed as stated below:
To See the documents click here.
10-01-02
FORBA, LLC Articles Of Organization Here, see Dan DeRose's name right here!
Dan DeRose, Michael DeRose, Ed DeRose, William Mueller, and Adolph Padula.
According To The Colorado Secretary Of State Website, FORBA, LLC, named changed to LIC SAC, LLC, 10-02-2006 is listed as stated below:
5-5-2008: Entity name and any active trade names changed due to failure to file annual report
Tuesday, May 06, 2008
Small Smiles In Kansas, Just Plain Illegal.
Kansas Law States the following in regard to Corporate Dentistry:
K.S.A. 65-1435 It unlawful for any person to practice dentistry under any name except such person's own name, with two exceptions:
1. subsection (b)(2) which allows two or more dentists to associate together for the practice of dentistry in a professional corporation, organized under the professional corporation law and under a corporate name that may or may not contain the proper name of any of the dentists.
2. (b)(3)associating together with persons licensed to practice medicine and surgery in a clinic or professional association under a name that may or may not contain the proper name of any such person or persons and may contain the word "clinic."
From the AG's Opinion:
Yes, there are a couple of Small Smiles in Kansas and at present they are under fire. They say the dentists who is actually working at the clinics "own" the clinics and has a financial interest in the clinic, but that is simply not the truth. But rest assured, if FORBA/Small Smiles/DeRose can find a way, they certainly will.
Hopefully Kansas will be paying close attention, listen to their citizens and run these people out of the state on a very long, far reaching rail.
With any luck at all, more states will take Kansas's lead here and change the laws, so that if a dentist has a licenses in your state and his name in hanging on the door under whatever cute little name he wants to call "his" clinic he better see patients there, so in case of mishap you don't have to run him down across several states to nail his butt.
update: 4-21-2010
Kansas is allowing FORBA to operate clinics in it's state and doing nothing to stop it.
K.S.A. 65-1435 It unlawful for any person to practice dentistry under any name except such person's own name, with two exceptions:
1. subsection (b)(2) which allows two or more dentists to associate together for the practice of dentistry in a professional corporation, organized under the professional corporation law and under a corporate name that may or may not contain the proper name of any of the dentists.
2. (b)(3)associating together with persons licensed to practice medicine and surgery in a clinic or professional association under a name that may or may not contain the proper name of any such person or persons and may contain the word "clinic."
From the AG's Opinion:
It is clear from the prohibition in K.S.A. 1994 Supp. 65-1435 that one dentist may not practice dentistry as a professional corporation and under a corporate name unless the dentist "associates" with one or more other dentists.Many states are not as strict with their regulations or wording which is why is some states the Corporation Umbrella that some of DeRose's clinics operate is under Michael A. DeRose, DDS PA. After he has his actual name established in those more lenient states he's ready to set up operation.
The act indicates a legislative intent to protect the public from the fraudulent practice of dentistry by a corporation or under a business name that indicates there is more than one dentist in that practice when in fact there is not.
In conclusion it is our opinion that dentists who want to incorporate under a corporate name pursuant to subsection (b) (2) of K.S.A. 65-1435 must join together for the common purpose of the practice of dentistry and so long as there is more than one dentist practicing dentistry in a corporation established in accordance with the professional corporation law, the requirements of K.S.A. 1994 Supp. 65-1435 (b) (2) are met.
Read the full opinion here
Yes, there are a couple of Small Smiles in Kansas and at present they are under fire. They say the dentists who is actually working at the clinics "own" the clinics and has a financial interest in the clinic, but that is simply not the truth. But rest assured, if FORBA/Small Smiles/DeRose can find a way, they certainly will.
Hopefully Kansas will be paying close attention, listen to their citizens and run these people out of the state on a very long, far reaching rail.
With any luck at all, more states will take Kansas's lead here and change the laws, so that if a dentist has a licenses in your state and his name in hanging on the door under whatever cute little name he wants to call "his" clinic he better see patients there, so in case of mishap you don't have to run him down across several states to nail his butt.
update: 4-21-2010
Kansas is allowing FORBA to operate clinics in it's state and doing nothing to stop it.
Monday, May 05, 2008
Western Dental Corporation Another Ruthless Dental Mill?
An Open Letter To Western Dental Reposted Here From The Hive Blog
Comments To Post At The Bottom, also reposted.
Here is the letter:
Please accept this letter as my personal and adamant request for the services rendered and the absolutely filthy conditions of your Western Dental office located on Briggsmore Avenue in Modesto California to undergo some SERIOUS investigation.
I would like to explain the circumstances which have brought me to this point of complaint... and I'm doing so PRIOR to having received the full service of my initial visit due to the fact that I am absolutely livid over the way in which my dental procedure and status as a patient has been treated by various members of the Western Dental Team which has revealed itself to be an obvious standard for all other patients as well.
My reasoning for visiting WD was purely out of need to be seen on a Saturday and to get a broken tooth fixed by crown procedure prior to my private insurance undergoing changes - regular dental offices are not open on the weekends so.... I made an appointment for 8 am on Saturday, Feb. 3, 2007.
The waiting room was to capacity when I arrived by other patients who had an appointment at either the same time or very near the same time as mine. I waited for over 1/2 an hour before I was even given initial paperwork. The condition of the waiting room was filthy and the staff was beyond disorganized in the procedure of caring for those that should have come first...their patients.
Nearly an hour later I was led back to get X-rays by a very kind technician... yet obviously in a huge hurry due to the large volume of work needing to be done... as a result - I had to be re-xrayed later in the day. It was nearly two hours of my arrival that I was even seen by a doctor. He came in and told me I needed a root canal. Then upon examining my tooth - he admitted that he'd misdiagnosed and that I only had a broken tooth.. This is what I'd already written in my paperwork and had explained to each staff member that I'd come into contact... yet another obvious sign that even the doctor had far too much to do - to the point where reviewing my chart prior to seeing me hadn't even occurred. Again - this man was very kind.
The condition of the facility, was again, very dirty. From the sticky floors to the dirty containers which held materials that were eventually needed in completing my procedure. The facility appeared to not have been cleaned in a substantial amount of time.
Having NO CHOICE but to proceed with this procedure at that time was very frustrating. In all of my years of having dental work done, never before have I ever experienced such deteriorated services and poor conditions in which to have my teeth worked on. I am in full understanding that these offices are typically used by those having state funded insurance programs... to me the treatment received by those people in this office IS SHAMEFUL!!! I feel that by way of lack of care for their scheduling and the lack of cleanliness of the facility your company is essentially telling these people that A. Their time is not important and B. Since they have no other choices, or may not know that they have other choices - they are forced to be treated in filth.
I was at your office for well over three hours and had to leave prior to even getting the cleaning which comes with the service I'd received. The dentist was VERY professional, however once he finished drilling down the broken tooth he left me in the care of, once again, a VERY nice woman who admitted to me that what she was doing, fitting the temp crown, wasn't within her scope of practice... however because of the over scheduling and lack of adequate staff members, she was forced to do the work she isn't even qualified for. It took nearly another 1/2 hour for her to trim the temporary down to even fit...
After I asked if I could do the cleaning at another time as I'd been at their offices for nearly FOUR HOURS - I was clearly told that the crown would be in within 1 to 1 1/2 weeks. I stopped at the front desk - had to actually request to be helped by two staff members who clearly knew I was there yet continued with a very personal conversation - I was told that my portion of the bill would be $400 - I wrote a check for $200 and left.
Four days later the temp fell off - I visited the office that night and was again helped by the same woman..although VERY NICE... admittedly unqualified to do what she was doing. She put a stronger adhesive onto the tooth and sent me on my way.... with a huge gap between the temporary crown and the tooth itself. She said it would be ok as the permanent crown was going to arrive in a couple of days. Well... it hasn't and it's not ok.. it is painful...
Being patient and a rule follower I waited for two weeks and I phone the office to find out where the crown is - I was informed by the woman that answered the phone that no one would have told me 1 1/2 to 2 weeks as it NEVER takes less than THREE weeks to get the crown in. Having NO choice but to wait... I did and in fact have received a bill for UNDER $200 - which makes me grateful that I did not pay the full $400 that they were requesting at my initial visit.
At three weeks, this past Saturday, I phoned again - and after 20 minutes on hold and being called by the incorrect name twice - I was told that it would be yet another week until the crown arrived from the lab.
This was enough. I asked to speak with a floor supervisor and after several minutes of bantering back and forth with this woman about my right to speak with a manager regardless of when the crown would arrive she finally told me to hold on... again placed on hold for a substantial amount of time - only to have the SAME woman pick up the phone and inform me that the floor manager found the crown and it would be in on Monday - period end of sentence. I told her that I still wanted to speak to her - she told me the manager was too busy and that I needed to call her back in 15 minutes. I told her that I would appreciate her taking MY number and having her call ME back when she was free. She never did.
I did lodge a complaint with your corporate office and they were in fact kind. I was uncomfortable when I was describing the current condition of the tooth as being painful and then being corrected by your representative to be told that "oh so it's annoying you?" I received the canned standard answers that are expected when this type of customer service disaster occurs.
Here is my MAIN ISSUE...
If this is honestly the type of service that people with medical are expected to accept than I am horrified by the sad sad misrepresentation which Western Dental is pouring all over the media... had I not had the verbiage and ability to insist that I be treated with the respect that I, as a customer, paying or not paying out of my own pocket deserves.. than I would still be sitting here today with no resolution to this matter - well, in fact I am still sitting here with no resolution to this matter as I still have an improperly fitted temporary - and no absolute security that this suddenly post complaint found crown is even really found at all.
I was told by your corporate office that I was in fact the second complaint about the same property that day... how this could possibly be the first time for this to happen - I find VERY difficult to believe.
What really bothers me are the looks on the faces of the other patients in that office... knowing full well that they are being treated disrespectfully yet perhaps not having the voice or option to speak up...it was a truly truly truly disturbing experience - to make it worse.. I still have to go back there to get the permanent crown placed... I was told by corporate that the staff at the office already knows that it was me complaining to them --- this makes me highly uncomfortable for my return visit.
Western Dental Corporate Staff... I am sincerely hoping that this type of inhumane service being provided to those less fortunate than others changes and changes VERY quickly... you are a huge company and the money is very important I'm sure... however the overworking of your staff in order to squeeze in as many patients that you can --- is, in the process, degrading the very people that pay your bills.
With HUGE hopes that this is resolved,
Comment 1
follow up on this complaint, Yo....don't let it slide. raise a banner if necessary. This should never be tolerated and I am so glad you did not do so for the sake of convenience.
Comment 2
Comment 4
more can be seen here....
Comments To Post At The Bottom, also reposted.
Here is the letter:
A letter to the corporate office of Western Dental... An absolutely INHUMANE treatment of low income patients by a facility that is advertised as caring for those with medi-cal or low income with respect and dignity AND great care... FAR FROM THE TRUTH
To whom it may concern:Please accept this letter as my personal and adamant request for the services rendered and the absolutely filthy conditions of your Western Dental office located on Briggsmore Avenue in Modesto California to undergo some SERIOUS investigation.
I would like to explain the circumstances which have brought me to this point of complaint... and I'm doing so PRIOR to having received the full service of my initial visit due to the fact that I am absolutely livid over the way in which my dental procedure and status as a patient has been treated by various members of the Western Dental Team which has revealed itself to be an obvious standard for all other patients as well.
My reasoning for visiting WD was purely out of need to be seen on a Saturday and to get a broken tooth fixed by crown procedure prior to my private insurance undergoing changes - regular dental offices are not open on the weekends so.... I made an appointment for 8 am on Saturday, Feb. 3, 2007.
The waiting room was to capacity when I arrived by other patients who had an appointment at either the same time or very near the same time as mine. I waited for over 1/2 an hour before I was even given initial paperwork. The condition of the waiting room was filthy and the staff was beyond disorganized in the procedure of caring for those that should have come first...their patients.
Nearly an hour later I was led back to get X-rays by a very kind technician... yet obviously in a huge hurry due to the large volume of work needing to be done... as a result - I had to be re-xrayed later in the day. It was nearly two hours of my arrival that I was even seen by a doctor. He came in and told me I needed a root canal. Then upon examining my tooth - he admitted that he'd misdiagnosed and that I only had a broken tooth.. This is what I'd already written in my paperwork and had explained to each staff member that I'd come into contact... yet another obvious sign that even the doctor had far too much to do - to the point where reviewing my chart prior to seeing me hadn't even occurred. Again - this man was very kind.
The condition of the facility, was again, very dirty. From the sticky floors to the dirty containers which held materials that were eventually needed in completing my procedure. The facility appeared to not have been cleaned in a substantial amount of time.
Having NO CHOICE but to proceed with this procedure at that time was very frustrating. In all of my years of having dental work done, never before have I ever experienced such deteriorated services and poor conditions in which to have my teeth worked on. I am in full understanding that these offices are typically used by those having state funded insurance programs... to me the treatment received by those people in this office IS SHAMEFUL!!! I feel that by way of lack of care for their scheduling and the lack of cleanliness of the facility your company is essentially telling these people that A. Their time is not important and B. Since they have no other choices, or may not know that they have other choices - they are forced to be treated in filth.
I was at your office for well over three hours and had to leave prior to even getting the cleaning which comes with the service I'd received. The dentist was VERY professional, however once he finished drilling down the broken tooth he left me in the care of, once again, a VERY nice woman who admitted to me that what she was doing, fitting the temp crown, wasn't within her scope of practice... however because of the over scheduling and lack of adequate staff members, she was forced to do the work she isn't even qualified for. It took nearly another 1/2 hour for her to trim the temporary down to even fit...
After I asked if I could do the cleaning at another time as I'd been at their offices for nearly FOUR HOURS - I was clearly told that the crown would be in within 1 to 1 1/2 weeks. I stopped at the front desk - had to actually request to be helped by two staff members who clearly knew I was there yet continued with a very personal conversation - I was told that my portion of the bill would be $400 - I wrote a check for $200 and left.
Four days later the temp fell off - I visited the office that night and was again helped by the same woman..although VERY NICE... admittedly unqualified to do what she was doing. She put a stronger adhesive onto the tooth and sent me on my way.... with a huge gap between the temporary crown and the tooth itself. She said it would be ok as the permanent crown was going to arrive in a couple of days. Well... it hasn't and it's not ok.. it is painful...
Being patient and a rule follower I waited for two weeks and I phone the office to find out where the crown is - I was informed by the woman that answered the phone that no one would have told me 1 1/2 to 2 weeks as it NEVER takes less than THREE weeks to get the crown in. Having NO choice but to wait... I did and in fact have received a bill for UNDER $200 - which makes me grateful that I did not pay the full $400 that they were requesting at my initial visit.
At three weeks, this past Saturday, I phoned again - and after 20 minutes on hold and being called by the incorrect name twice - I was told that it would be yet another week until the crown arrived from the lab.
This was enough. I asked to speak with a floor supervisor and after several minutes of bantering back and forth with this woman about my right to speak with a manager regardless of when the crown would arrive she finally told me to hold on... again placed on hold for a substantial amount of time - only to have the SAME woman pick up the phone and inform me that the floor manager found the crown and it would be in on Monday - period end of sentence. I told her that I still wanted to speak to her - she told me the manager was too busy and that I needed to call her back in 15 minutes. I told her that I would appreciate her taking MY number and having her call ME back when she was free. She never did.
I did lodge a complaint with your corporate office and they were in fact kind. I was uncomfortable when I was describing the current condition of the tooth as being painful and then being corrected by your representative to be told that "oh so it's annoying you?" I received the canned standard answers that are expected when this type of customer service disaster occurs.
Here is my MAIN ISSUE...
If this is honestly the type of service that people with medical are expected to accept than I am horrified by the sad sad misrepresentation which Western Dental is pouring all over the media... had I not had the verbiage and ability to insist that I be treated with the respect that I, as a customer, paying or not paying out of my own pocket deserves.. than I would still be sitting here today with no resolution to this matter - well, in fact I am still sitting here with no resolution to this matter as I still have an improperly fitted temporary - and no absolute security that this suddenly post complaint found crown is even really found at all.
I was told by your corporate office that I was in fact the second complaint about the same property that day... how this could possibly be the first time for this to happen - I find VERY difficult to believe.
What really bothers me are the looks on the faces of the other patients in that office... knowing full well that they are being treated disrespectfully yet perhaps not having the voice or option to speak up...it was a truly truly truly disturbing experience - to make it worse.. I still have to go back there to get the permanent crown placed... I was told by corporate that the staff at the office already knows that it was me complaining to them --- this makes me highly uncomfortable for my return visit.
Western Dental Corporate Staff... I am sincerely hoping that this type of inhumane service being provided to those less fortunate than others changes and changes VERY quickly... you are a huge company and the money is very important I'm sure... however the overworking of your staff in order to squeeze in as many patients that you can --- is, in the process, degrading the very people that pay your bills.
With HUGE hopes that this is resolved,
Comment 1
follow up on this complaint, Yo....don't let it slide. raise a banner if necessary. This should never be tolerated and I am so glad you did not do so for the sake of convenience.
Comment 2
Although, your letter certainly pointed out the problems your encountered during your visit to a Western Dental facility, I can tell you from personal experience and from all of the other complaints I have read about Western Dental, don't expect to receive any kind of acknowledgement or apologies from Western Dental. They are a shady outfit no matter what location you happen to visit.
My husband spent 9 hours at their office in Antioch, CA. According to the law, medical and dental practitioners cannot subject their patients to more than 3-4 hours of treatment or service in a 24 hour period. My husband's dental insurance policy pays contracted providers at 100%. Western Dental is a contract provider with United Concordia (our dental insurance carrier through California Field Inronworkers Union) and they were supposed accept the insurance payment as payment in full. However, Western Dental did not properly bill our insurance company for the services they provided to my husband and as a result, they were subsequently paid less than what they calculated.
Western Dental decided that they would try to bill us for the difference. They started sending us 2-3 collection letters a month and I would call them and explain that we owed them nothing because we had 100% coverage. Then they started making collection call to our home. They would call every other day threatening to send us to collections if we didn't pay. I call the ironworker union and United Concordia to let them know what was going on. However, there wasn't much they could do. I went around and around with Western Dental corporate billing office in Orange, California, and just about everybody I spoke to down there had absolutely no knowledge about the laws governing HMO providers.
Fortunately for us, this is what I do for living . . . . medical billing. I tried and tried to explain to them that what they were doing was against the law. Balance billing and HMO patient is a highly illegal practice. I knew that most patients don't understand the complexities involved in medical billing, so I decided to conduct a rather in depth investigation into Western Dental's billing practices and I discovered that they were doing the same thing to all of ironworkers and their families throughout the State of California.
I concluded that Western Dental practices this illegal billing tactic banking on the fact, that most people don't understand the medical billing and reimbursement policies associated with their insurance carrier. The majority of patients simply trust that their medical or dental provider wouldn't bill them (the patient) unless the amount was truly the patient's responsibility. I believe that Western Dental's main source of profit comes from two aspects of their bsuiness, 1) they provide shipshod treatment to the patients, and 2) they use highly illegal billing tactics in order to coerce their patients into paying them above and beyond the contracted rate that Western Dental has agreed to accept from the patient's insurance carrier.
In order for your story to have any affect on Western Dental, please file a complaint with the following agencies; 1) the ADA (American Dental Association), 2) the California Attorney General's Office, 3) the CDA (California Dental Association), 4) California Board of Dental Examiners, and 5) the California Dept of Consumer Affairs.
If I were you, I would seek out another Dentist's opinion of the work done by Western Dental and ask them to document their opinion in writing as your situation may eventually force you to file a malpractice suit due to the poor dentistry work and pain and suffering that you have already endured and still may endure in the future. Document everything that happens to you as a result of your visit to this Western Dental facility. If your teeth are not properly repaired , you could end up suffering from a multitude of other health issues that can be caused by poor dental treatment. I cannot stress to you enough to please protect yourself by following through with my advised suggestions above, otherwise you will no recourse in case something happens in the future.
Good Luck
Comment 3
My husband spent 9 hours at their office in Antioch, CA. According to the law, medical and dental practitioners cannot subject their patients to more than 3-4 hours of treatment or service in a 24 hour period. My husband's dental insurance policy pays contracted providers at 100%. Western Dental is a contract provider with United Concordia (our dental insurance carrier through California Field Inronworkers Union) and they were supposed accept the insurance payment as payment in full. However, Western Dental did not properly bill our insurance company for the services they provided to my husband and as a result, they were subsequently paid less than what they calculated.
Western Dental decided that they would try to bill us for the difference. They started sending us 2-3 collection letters a month and I would call them and explain that we owed them nothing because we had 100% coverage. Then they started making collection call to our home. They would call every other day threatening to send us to collections if we didn't pay. I call the ironworker union and United Concordia to let them know what was going on. However, there wasn't much they could do. I went around and around with Western Dental corporate billing office in Orange, California, and just about everybody I spoke to down there had absolutely no knowledge about the laws governing HMO providers.
Fortunately for us, this is what I do for living . . . . medical billing. I tried and tried to explain to them that what they were doing was against the law. Balance billing and HMO patient is a highly illegal practice. I knew that most patients don't understand the complexities involved in medical billing, so I decided to conduct a rather in depth investigation into Western Dental's billing practices and I discovered that they were doing the same thing to all of ironworkers and their families throughout the State of California.
I concluded that Western Dental practices this illegal billing tactic banking on the fact, that most people don't understand the medical billing and reimbursement policies associated with their insurance carrier. The majority of patients simply trust that their medical or dental provider wouldn't bill them (the patient) unless the amount was truly the patient's responsibility. I believe that Western Dental's main source of profit comes from two aspects of their bsuiness, 1) they provide shipshod treatment to the patients, and 2) they use highly illegal billing tactics in order to coerce their patients into paying them above and beyond the contracted rate that Western Dental has agreed to accept from the patient's insurance carrier.
In order for your story to have any affect on Western Dental, please file a complaint with the following agencies; 1) the ADA (American Dental Association), 2) the California Attorney General's Office, 3) the CDA (California Dental Association), 4) California Board of Dental Examiners, and 5) the California Dept of Consumer Affairs.
If I were you, I would seek out another Dentist's opinion of the work done by Western Dental and ask them to document their opinion in writing as your situation may eventually force you to file a malpractice suit due to the poor dentistry work and pain and suffering that you have already endured and still may endure in the future. Document everything that happens to you as a result of your visit to this Western Dental facility. If your teeth are not properly repaired , you could end up suffering from a multitude of other health issues that can be caused by poor dental treatment. I cannot stress to you enough to please protect yourself by following through with my advised suggestions above, otherwise you will no recourse in case something happens in the future.
Good Luck
Comment 3
Remember the twenty Modesto dentists who were arrested several years ago, for their horrible treatment of children, the elderly, and low-income people on Medi-cal? (As far as I know, they are still waiting for trial. Justice is slow.)
These scams have been popular for many years in other states as well--especially Florida. And that is what they are--scams, just for easy money. Unqualified people have pulled entire mouthfuls of teeth that should never have been pulled. Often screaming children and the elderly were not even given pain medication. In addition,conditions were filthy.
No, these conditions are NOT normal. A dentist's office must be spotless. Otherwise, diseases spread like wildfire. Everyone must know what they are doing. Of course, you should never go back there. It is too dangerous. You do need to see a REAL dentist.
A lot of con men are "very nice". That is why they are so successful. The "wolves in sheep's clothing" play their roles well. It is important to know who is putting their fingers in your mouth!
Comment 4
Well, if you are thinking of going back to that dentist, check out the really horrible complaints against Western Dental, all over California. In the computer search spot, type: "Complaints against Western Dental" or go to www.ripoffreport.com
One person had good teeth until Western Dental worked on nine of them. Then they had nine bad teeth.
They try to treat as many people as they can and do as many procedures as they can--even if the procedures are not needed, so they can bill for them.
In addition, the FBI is investigating them for insurance fraud.
******
One complaint was from Modesto. Even though the dentist never had time to see her (after a long wait in extreme pain), Western Dental sent her a bill. When she didn't pay it, they kept adding late fees. They have a long history of complaints about fraudulent billing.
******
One complaint was from Modesto. Even though the dentist never had time to see her (after a long wait in extreme pain), Western Dental sent her a bill. When she didn't pay it, they kept adding late fees. They have a long history of complaints about fraudulent billing.
A dental chain like Western Dental in Florida was even kidnapping low-income children from their yards to pull their teeth.
more can be seen here....
Sunday, May 04, 2008
Dentists React To Small Smiles
These are posts from a Dental Message Board in reaction to Small Smiles/FORBA
I personally LOVED This one!!!!
1. There is a small smiles clinic close to us and we see a lot of children who have been put through the ringer there. Most times the work is sub-standard and we are re-doing what wasn't done correctly the first time around. Many of the children who are referred are great kids and just need some TSD and patience. Unfortunately, at that point they are pretty traumatized. The thing that worries us here in our clinic is the disregard for max local anesthetic dosages, etc. It's hard to believe you can papoose a 3 year old and do 4 quadrants of dentistry in one sitting, staying within the safety limits for local anesthetic. I'm all for providing needed treatment, but I'm doubtful as to how much training and supervision there are at these clinics.
2. small smiles opened in our town about six weeks ago. a good friend of mine was working as a hygienist there--she quit after two weeks. i don't know how anyone can justify treatment like that. i see kids with medicaid as does another large pedo practice in town, as do several other family dentists i know. access to care isn't an issue in my area for these kids so they can't use the "we're your child's last hope" approach.
look at the aapd guidelines. they (small smiles) aren't compliant and i don't believe they provide the standard of care offered in my area.
previous to this story, i was talking with a friend on the local peer review on how to approach this group because i was concerned about what i was hearing.
I personally LOVED This one!!!!
3. At our SSPD meeting in September AAPD president Keith Morley said to watch out for these FORBA clinics. He said they are on the way to any rural area in which they can treat low socioeconomic children for Profit.
I too see Medicaid children b/c I feel it is my way of giving back to society. The News took the absolute worst parts of the entire story and put that on TV for everyone to watch. I've been in situations in which i've had to use a papoose board while the child screamed away b/c there was no other choice. I would think any of us pedos understand exactly what was going on there. Most of what they do may not be morally right and is against the ethics of the ADA and AAPD however it doesn't break any laws. We need to all band together and keep these clinics from opening in our areas.
4. Just completed 30 years of dealing with Medicaid. It tooks it's toll on me financially (somewhat), but more emotionally and physically (which is why I stopped). The stories I have heard even for adults can be incredible, and then we get to the "access to care" issue. Who in their right mind would like to stand in line for that kind of access?
I know that there are also some incredible providers of care to this population, adults and children. But, at times, it seems that as long as the care is being "provided" by a provider, that the state powers will look the other way. An acquaintance of mine who previously worked at a one of these facilities stated that some of the dentists, at this particular facility, should not have licenses to practice.
5. If providers would treat mediciad patients as a requirement for renewal of our state granted license to make money in this limited area, access issues would greatly diminish.
6. There is one down the street from me called Vital Smiles, formally the Tooth Zone. I used to say "Who else is going to treat these kids" (I take medicaid by the way) From seeing some of the dentistry, and hearing from patients, former staff members, and a former Dr. there, a lot of those kids would be better off if they had not even gone.
7. If the Democrates get the s-chip legislation passed they will providing about 1 million more American kids with the kind of treatment that is getting blasted. S-Chip in most states is lumped into medicaid. I could care less about Dem vs Rep, but this is to make legislaotors (sp?) look good by providing insurance to these poor kids. What kind of care will be provided? Will they have access to care with this insurance?
8. small smiles clinics do not sedate or offer GA. What upsets me is not the use of the papoose per say, but it is how the clinics are run. There are several Kool Smiles clinics in the area where I practice, and they are run in a similar fashion to Small Smiles. they over treatment plan just to do pulp and crowns. I see at least 3-5 patients from their clinics , and the parent shows me the tx plans. many times it is crowns, where simple ONE surface restorations suffice. These clinics do not have a good reputation where I live.
Warning To Dental Grads Being Wooed By Corporate Dental Companies
Be careful about how you interpret the word "guaranteed” income when being wooed by a corporate dental management company such as FORBA, Heartland or Western Dental. Read this next paragraph very carefully.
A lot of these corporate associateship contracts are set up so that you are guaranteed a certain salary based upon a specific (and sometimes unattainable) level of production. If you don't hit that level of production, you are still "paid" that salary, but you then owe the corporation the difference between the salary and what you actually produced.
So, in many cases it may seem that you will be guaranteed big dollars right out of graduation, but often that is based upon unrealistic levels of production. They spin it as "guaranteed" because you will in fact be making that money, but you will ultimately have to pay part of it back.
All those long months, days and years spent preparing yourself for a wonderful noble career is gone down the drain in less than 6 months. Not even mentioning the enormous education debt you’ve accumulated and now you won’t be able to get a job that would earn enough wages to make your loan payments let alone live, have a family or anything else. All those dreams of a fruitful life that got you through all those years of study are gone in a flash.
Lets say you don't like the procedures they teach you at their "training camps". What are you to do, you have signed a "non compete" clause in your contract. Then what are you going to do. Talk about stuck between a rock and a hard place!
There's no altruism involved in these corporations' business decisions. Corporate mills are notorious for encouraging over treatment in order to meet production goals. If you're seriously trying to come up with a minimally acceptable treatment plan for a Medicaid patient, you're looking at sealants vs. restoring every pit & fissure in the mouth, complex direct restorations instead of pressed ceramic crowns, periodontal debridement, flippers instead of implant-supported bridges, etc.
Heartland and Western shareholders are just like the ADHP proponents in that respect--they're out for their own best interests, not the public's, but they also know saying "it's for the greater good!" is a nearly impenetrable moral shield for them to hide behind.
The moral in both cases is that dentistry needs to start being proactive about figuring out solutions to the access to care problem, instead of letting other groups seize the initiative and then trying to fend them off while backpedaling.
Some companies like Kool Smiles ask employees to sign a 'restrictive covenant for 1 or more years in a radius of 5-10 miles. This mean you might be SOL if you want to work in that area.
A portion of Small Smiles / FORBA contract says:
...for a period of 2 years following termination, you can't provide dental services for Medicaid patients within 10 mile aerial radius of the Practice Location, or Employer's practice location on the date of termination if Employer has moved its location, or the location of any of the Employer's related practices.
Add this to the $500 a day penalty for not giving them a 90 day notice and you are just screwed! What if you had relocated! What now?
A Discussion on Corporate Dentistry's Workings
Click Here for the sales pitch so to speak about Heartland Dental.
Includes how it works, what cuts the docs get and Employee Stock Options.
But what I find interesting is this: (The Interesting Part, is the Investment Bank involved. They were at this site for several hours last week. Houlihan Lokey Howard & Zukin.
Anyway this is a information release concerning Employee Stock Option...
Includes how it works, what cuts the docs get and Employee Stock Options.
But what I find interesting is this: (The Interesting Part, is the Investment Bank involved. They were at this site for several hours last week. Houlihan Lokey Howard & Zukin.
Anyway this is a information release concerning Employee Stock Option...
EMPLOYEES ACQUIRE 38.5% OF DENTAL HEALTH RESOURCES, INC.
IN PARTIAL ESOP BUYOUT
EFFINGHAM, Ill. (January 21, 2004) – Employees of Dental Health Resources, Inc. (d/b/a Heartland Dental Care, or “Heartland”) have acquired a 38.5% ownership stake in the dental practice management company. The price of the acquisition was not disclosed.
Houlihan Lokey Howard & Zukin, an international investment bank, acted as exclusive financial advisor to Heartland. Houlihan Lokey structured the transaction, designed the ESOP security and arranged the financing for the purchase.
Heartland’s newly formed Employee Stock Ownership Trust, or ESOT, purchased convertible preferred stock representing 38.5% of the ownership of Heartland using senior credit and mezzanine funding. The transaction provided liquidity for certain selling shareholders, including Dr. Richard Workman, who founded Heartland in August 1997. The unique structure of the ESOP security and transaction provides the ESOP with an annual dividend yield while providing the company with significant future tax savings.
Workman, president and chief executive officer of Heartland, said, “Everyone is extremely excited about the ESOP and what it means for our future. The employees understand they have an opportunity to have a positive impact on the dental profession. They also realize they will create an economic interest for their knowledge by helping dental practices with management responsibilities.”
“We appreciate the dedicated professionals Houlihan Lokey Howard & Zukin assembled for the ESOP. The entire transaction team should be complimented for all their hard work and professionalism,” Workman said.
Lou Paone, managing director of Houlihan Lokey’s Washington, D.C., office said the transaction is expected to generate significant value to the employee owners in future years. “Heartland and its executive management team have a very strong employee ownership orientation,” Paone said. “The ESOP transaction and implementation marries a shareholder liquidity event with the corporate goal of aligning the employees with the future direction of the firm.” The Heartland transaction represents an innovative example of the growing trend of shareholders seeking liquidity by implementing a partial ESOP buyout structure, Paone said.
Patrick Hurst, managing director and head of Houlihan Lokey’s Healthcare Group, stated, “There haven’t been many liquidity events for shareholders of dental practice management companies in recent years. The ESOP structure is a creative alternative to selling to a financial or strategic buyer, and has the added benefit of giving the employees a real economic stake in the future success of the company.”
About Dental Health Resources, Inc.
Dental Health Resources, Inc. is a privately held company headquartered in Effingham, Ill., that provides a full range of management, administrative, and financial services to dental practices in the states of Illinois, Indiana, Iowa, Kentucky, Missouri, Ohio, and Tennessee throughout cities with populations that range from 40,000 to 500,000. By providing management services to handle the business aspects of the dental practices, the company allows dentists to use their management and business skills to be responsible for certain operations of the company and to focus primarily on delivering quality patient care. Heartland also provides capital for the development, growth, and acquisition of additional dental practices.
Houlihan Lokey Howard & Zukin, an international investment bank established in 1970, provides a wide range of services, including mergers and acquisitions, financing, financial opinions and advisory services, financial restructuring, and merchant banking. In 2003, Houlihan Lokey ranked as the No. 1 M&A advisor for transactions under $200 million and the No.4 advisor for transactions under $1 billion. The firm has been the No. 1 provider of fairness opinions for the past four years and has the largest financial restructuring practice of any investment bank in the country. The firm has approximately 600 employees in nine offices in the United States and the United Kingdom. It annually serves more than 1,000 clients ranging from closely held companies to Global 500 corporations. For more information, visit Houlihan Lokey’s Website at www.hlhz.com.
© 2004 Houlihan Lokey Howard & Zukin. All rights reserved.
Unauthorized duplication is prohibited.
IN PARTIAL ESOP BUYOUT
EFFINGHAM, Ill. (January 21, 2004) – Employees of Dental Health Resources, Inc. (d/b/a Heartland Dental Care, or “Heartland”) have acquired a 38.5% ownership stake in the dental practice management company. The price of the acquisition was not disclosed.
Houlihan Lokey Howard & Zukin, an international investment bank, acted as exclusive financial advisor to Heartland. Houlihan Lokey structured the transaction, designed the ESOP security and arranged the financing for the purchase.
Heartland’s newly formed Employee Stock Ownership Trust, or ESOT, purchased convertible preferred stock representing 38.5% of the ownership of Heartland using senior credit and mezzanine funding. The transaction provided liquidity for certain selling shareholders, including Dr. Richard Workman, who founded Heartland in August 1997. The unique structure of the ESOP security and transaction provides the ESOP with an annual dividend yield while providing the company with significant future tax savings.
Workman, president and chief executive officer of Heartland, said, “Everyone is extremely excited about the ESOP and what it means for our future. The employees understand they have an opportunity to have a positive impact on the dental profession. They also realize they will create an economic interest for their knowledge by helping dental practices with management responsibilities.”
“We appreciate the dedicated professionals Houlihan Lokey Howard & Zukin assembled for the ESOP. The entire transaction team should be complimented for all their hard work and professionalism,” Workman said.
Lou Paone, managing director of Houlihan Lokey’s Washington, D.C., office said the transaction is expected to generate significant value to the employee owners in future years. “Heartland and its executive management team have a very strong employee ownership orientation,” Paone said. “The ESOP transaction and implementation marries a shareholder liquidity event with the corporate goal of aligning the employees with the future direction of the firm.” The Heartland transaction represents an innovative example of the growing trend of shareholders seeking liquidity by implementing a partial ESOP buyout structure, Paone said.
Patrick Hurst, managing director and head of Houlihan Lokey’s Healthcare Group, stated, “There haven’t been many liquidity events for shareholders of dental practice management companies in recent years. The ESOP structure is a creative alternative to selling to a financial or strategic buyer, and has the added benefit of giving the employees a real economic stake in the future success of the company.”
About Dental Health Resources, Inc.
Dental Health Resources, Inc. is a privately held company headquartered in Effingham, Ill., that provides a full range of management, administrative, and financial services to dental practices in the states of Illinois, Indiana, Iowa, Kentucky, Missouri, Ohio, and Tennessee throughout cities with populations that range from 40,000 to 500,000. By providing management services to handle the business aspects of the dental practices, the company allows dentists to use their management and business skills to be responsible for certain operations of the company and to focus primarily on delivering quality patient care. Heartland also provides capital for the development, growth, and acquisition of additional dental practices.
Houlihan Lokey Howard & Zukin, an international investment bank established in 1970, provides a wide range of services, including mergers and acquisitions, financing, financial opinions and advisory services, financial restructuring, and merchant banking. In 2003, Houlihan Lokey ranked as the No. 1 M&A advisor for transactions under $200 million and the No.4 advisor for transactions under $1 billion. The firm has been the No. 1 provider of fairness opinions for the past four years and has the largest financial restructuring practice of any investment bank in the country. The firm has approximately 600 employees in nine offices in the United States and the United Kingdom. It annually serves more than 1,000 clients ranging from closely held companies to Global 500 corporations. For more information, visit Houlihan Lokey’s Website at www.hlhz.com.
© 2004 Houlihan Lokey Howard & Zukin. All rights reserved.
Unauthorized duplication is prohibited.