Tuesday, June 17, 2008

United Health Care Still Using Small Smiles: What The Hell Are They Thinking?

Despite Doral Dental, a sub-contractor for Maryland's Medicaid System, terminating 4 dentists and suspending Small Smiles for another 3 months for highly irregular and questionable practices, United Health Care, another sub-contractor doing business as Americhoice, finding more than $250,000 worth of "questionable treatments" will still send it's medicaid members to the following Small Smiles dental Clinics in Maryland for treatment.


  • GRIGORYAN, OVSANNA
SMALL SMILES OF LANGLEY PARK PC
GENERAL DENTISTRY
  • KING, TRACY S.
SMALL SMILES OF NORTH BALTIMORE PC
GENERAL DENTISTRY
  • MILLS, LINISHA Y.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY
  • PARIRENYATWA, SIMBARASHE
SMALL SMILES OF NORTH BALTIMORE PC
GENERAL DENTISTRY
  • PARIRENYATWA, SIMBARASHE
SMALL SMILES OF BALTIMORE PC
GENERAL DENTISTRY
  • PFEUFFER, DAVID J.
SMALL SMILES OF NORTH BALTIMORE PC
GENERAL DENTISTRY
  • ROBINSON-WARNER, GILLIAN A.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY

  • TOLER, KENYATTA M.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY
  • TOLER, KENYATTA M.
SMALL SMILES OF LANGLEY PARK PC
GENERAL DENTISTRY
  • TYLER, DAWN L.
SMALL SMILES OF OXON HILL
GENERAL DENTISTRY
  • UMEOZULU, OKEOMA N.
SMALL SMILES OF BALTIMORE PC
GENERAL DENTISTRY

In Washington DC they will gladly send you to:
  • MILLER, JULIAN P.
SMALL SMILES, PC
GENERAL DENTISTRY
  • MUNDEY, SHAKEYA
SMALL SMILES, PC
GENERAL DENTISTRY
  • STEPHENSON, KESHA J.
SMALL SMILES, PC
GENERAL DENTISTRY
  • VENIGALLA, LAKSHMI Informed They Are No Longer Employed With Small Smiles
SMALL SMILES, PC
GENERAL DENTISTRY

What the HELL is United Health Group thinking! Hopefully you are one of the lucky recipients of Doral Dental and won't be sent to any of the above dentists and your child will be spared the torture and abuse of unnecessary dental treatment and being tied to a papoose board just for the ease of it all.

I suggest if your linked up with United Health/Americhoice you exercise your American Choice and call, write or email United Health Group and demand better service for yourself and your children.

If you are a dentist and no longer associated with Small Smiles please email me, state when you left and I will note that you are no longer employed with Small Smiles.



Email Me

Update 9/9/2008

I received the following email and after weighting the request I decided there was no real benefit in not granting the request.

Dear Ms. Hagan/To Whom It May Concern:
As best as we are able to discern, the "Dentist the Menace" web site is maintained by a Debbie Hagan. This email is intended to reach all persons responsible for the content of the site.

This law firm represents Sanam Toufanian, D.D.S., whose name appears on the June 17, 2008, "Dentist the Menace" web site posting regarding Small Smiles entitled, "United Health Care Still Using Small Smiles: What the Hell Are They Thinking?". Dr. Toufanian no longer is employed with Small Smiles. During her employment at Small Smiles, Dr. Toufanian at all times acted in the best interests of her patients, and there is no allegation that Dr. Toufanian engaged in any improper conduct. Your web posting is false, misleading, and highly damaging to Dr. Toufanian's reputation. We therefore demand that you remove Dr. Toufanian's name from the June 17, 2008 posting immediately.

Sincerely,
Caroline Judge Mehta


Caroline  Mehta  202.778.1836 cmehta@zuckerman.com

Sunday, June 15, 2008

Mom upset with Small Smiles New Albany


Here is a case of a mother who took her child to Small Smiles New Albany in New York:
Since Small Smiles is no longer a Medicaid provider in New York one mother asked for her child’s records.
What she got were x-rays and nothing more than a spreadsheet of sorts, listing dates of visits, (every 6 months regularly), procedures, service codes for billing Medicaid, and initials of doctors who did the work.
Looking over the so called medical records (1 full year of them) a pattern clearly emerges.
The first visit, the child was give
1. Hygiene instruction: How much instruction do you think a three year old understood after all the parents are allowed back there. (was Medicaid billed for that as well or is that included in the cost of the visit?)
2. Fluoride
3. Exam
4. Cleaning
Exactly 6 months later the child returned, got the same as above with added x-rays and low and behold cavities were found because the next week the child was in for 3 filling! Three!! Wonder how they missed those on the first visit, or do you think the hygiene instruction wasn’t clear for the child to have gotten that many cavities in that short of time.
By the initials of the dentist, Dr. Laura did these fillings.
Another 6 months pass, more hygiene instruction, fluoride, exam, and cleaning and there again, they found another cavity. This time it was Dr. NL who did they work. All this doesn’t say much for Small Smiles “hygiene instruction now does it”.
Since Small Smiles tries to keep their torture clinics friendly they just use the first names of the doctors, Dr. Laura for example so this mother has no idea what the real name of the dentist actually could be.
What really concerned this particular parent is this:
  1. She was told they did NOT use a papoose board on her child. She asked since her child came out very upset and said the dentist was “mean”. Yet according to this “record” behavioral management” of some type was used and it appears billed Medicaid for doing so. So they are lying to someone, either they used the papoose board and lied to the mother or they billed Medicaid for something they didn’t do.
  2. She is also concerned, and rightfully so, that these records seem to be a bit incomplete to say the least! Where’s the notes taken during the exam there has to be more than a tiny spread sheet don’t you think!
This is not long ago people this is current stuff, so don’t by the sales job they are trying saying they are “improving” anything cause they aren’t improving anything.
I’m wondering if Small Smiles/Albany Access Dentistry even have this child’s original records, documents showing where this child’s mom signed consent for anything at all to be done, where is all this stuff, could be in a heap of shredded documents for all we know.
I’ve been at this for months with these people and I’m not seeing any improvement, even with the Fed’s snooping through the records across the county nothing is getting a bit better!


Full Size image here

Thursday, June 12, 2008

Michael DeRose Living "Two" Carefree

I'm telling ya, life is just so strange and at times just down right funny. We've all heard about "vanity license plates", but what about "omen addresses"?

I found that a one Michael A. DeRose lived at....

....get this....

....are you ready?

2 Carefree Lane

Pueblo, CO 81001

at ancestry.com records say he lived there in 1993 & 1994

That should have told him all this would come to an end one day cause he was living too carefree LMAO LMAO

Wednesday, June 11, 2008

Is Carolina Smiles a DeRose Clinic?

Today I noticed there is a dental clinic in North Carolina that accepts Medicaid called "Carolina Smiles". Now this wouldn't be odd if DeRose and FORBA didn't have clinics in Oklahoma called "Oklahoma Smiles" and the clinics in Texas called "Texas Smiles".

Now I'm not saying Carolina Smiles is another FORBA/DeRose clinic, I'm just saying the name is following they usual names.

Small Smiles New Albany Has Changed It's Name: Surprise Surprise

A month or so ago if you rang up Small Smiles in New Albany you would get the "Hello, Small Smiles" when the phone was answered. Then a couple of weeks ago that dropped to "Dental Office" we now it's "Albany Access Dentistry".

Looks like FORBA and Michael DeRose and Company have not learned any new techniques to cover their butts. Again, they just change then name, don't bother with changing the phone numbers or address, just slap a new name on the door, keep the same employees and go on about their business.

BEWARE, New York the name has changed but that's about it.

Does that word "Access" ring any bells with my readers, well it certainly rings a few of my bells.

Remember Tish Ballance in Asheville, NC who was fined 10 million dollars and was a business partner with Michael DeRose in the Smile Starters, Medicaid Dental Center and Carolina Dental Center, isn't her new state of the art clinic she's opening up in Asheville called "Access West"! Yep, I just checked, that's the name she's advertising!


Update:
Appears only a coincidence with the name "Access".  "Appears" being the operative word.  Tish went on to open Carolina West Dentistry in Waynesboro, NC under the business name of Ballancing Act.  In July 2010 she registered a business named CanHouse Sudios, it too in Waynesboro.  


Tish Ballance dose NOT live even close to Waynesboro ( or at least didn't two years ago).  She lives on the southern outskirts of Charlotte, NC about150 miles away.






Small Smiles Denying Some Parents Access To Medical Records

I'm getting a lot of email from parents who are having problems with Small Smiles handing over those medical records. You are entitled to a complete copy of those records. HIPPA laws have statues that cover this as well as many states have set their own standards. To the right in the Links section you will find a link to information and links to each states rules. Also in the download section is a sample letter for your use.



arrowarrowarrowIf you are denied access, you can file a complaint with the U.S. Department of Health and Human Service's Office of Civil Rights at:

U.S. Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C., 20201
Phone: (866) 627-7748
Web: www.hhs.gov


Sunday, June 08, 2008

DeRose Companies, LLC

DeRose Companies, LLC was formed by Mark DeRose and operates under the name of ServiceStar Development Company. See Here and Here

DeRose Family Federal Champaign Contributions

According to Newsmeat.com the DeRose family spread the contributions around but one stuck out in particular to me, that was Sen. Ken Salazar.

Out of all the federal campaign contributions listed for some reason the ones to Sen. Ken Salazar struck me as a bit odd. In most the other contributions they always donate to the republican party, however that's not the case with Sen. Ken Salazar.

See the list here

Sen. Salazar is on the Senate Committee on Finance:
...which has jurisdiction over tax policy (including the IRS), Social Security, Medicare and Medicaid, customs, trade agreements, general revenue sharing, and tariffs and import quotas. Senator Salazar is a member of the following subcommittees:
  • Energy, Natural Resources, and Infrastructure
  • Health Care
  • Taxation, IRS Oversight, and Long-Term Growth

Sunday, June 01, 2008

Forba Hires Donna Gilley. Now this is either to help them defraud more efficiently or help them hide what they've done a bit quicker. What is th

FORBA Dental Management Recruits Top Regulatory Expert as Chief Compliance Officer

Donna Gilley to lead regulatory complianceat nation’s largest dental practice management company focused on Medicaid and SCHIP Children
August 15, 2008 - Nashville, TN – FORBA, the nation’s largest dental practice management company focused on high-quality [laughable]dental care for underserved communities, today announced that Donna Gilley has joined the company as Chief Compliance Officer.
Gilley will report directly to Michael Lindley, FORBA’s Chairman and CEO, and will lead initiatives designed to ensure that FORBA-managed dental centers continue to comply with applicable federal and state laws and regulations, and cooperate with the agencies overseeing dental care for low-income children. [continue to comply...?? Oh dear God! They only want to see if there are other ways to screw the system!]
“FORBA’s mission includes a pledge to make certain that the centers we manage act as effective stewards of the public resources committed to children’s dental health,” said Lindley.
[Bull!]
“We have asked Ms. Gilley to lead our compliance unit and use her considerable experience and skills to ensure that FORBA-managed dental centers continue to meet and exceed applicable federal and state standards and provide high-quality care.”
[ I hope Ms. Gilley is ready to call her career quits, because not a soul I know so far has ever come to Forba or any of it's dental clinic and been able to leave with much of a career, most try to hide the damn fact they ever worked there for heavens sake!]
[Now they have a papoose board expert and a compliance expert on board, I can see they are gearing up for even more abuse and fraud]
Gilley, who holds multiple certifications in healthcare compliance, joins FORBA from LBMC Health Group, LLC, a Nashville-based consulting firm that has managed administrative, financial and compliance initiatives for major hospitals, healthcare systems and providers in Tennessee and across the southeastern United States. With more than 15 years of industry experience, her expertise includes Medicare, Medicaid and managed care regulatory compliance, payment methodologies and guidelines. She has also handled external compliance for multi-hospital, multi-state systems on matters related to HIPAA and other healthcare regulations, and is experienced in risk assessment, auditing, statistical sampling and other healthcare regulatory compliance activities.
Gilley has also held positions with TN Healthcare Solutions, Saint Thomas Health Services, and Columbia/HCA. She is a member of the Healthcare Financial Management Association, the Association of Certified Fraud Examiners, the American Health Lawyers Association, the Nashville Health Care Council; and is Co-Chair of the Health Care Compliance Association Southeast Planning Committee.
“I am excited about the opportunity to join a healthcare company that is serving the public interest,” said Gilley, “and I am proud to be part of a team that is working hard to help children from low-income families.”
[Woman you need to see a shrink!]

FORBA PR Machine At Work

After watching boards across the Internet for the last few days I can see FORBA-Small Smiles-DeRose have put the big PR firms to work but they are gaining little ground.

I swear I think they have actually hired people to spend their days getting out and making positive posts or try to find fault in what parents are finally speaking about.

The most common posts are:

1. We are trying to hire compassionate and quality staff. (How long does it take, they said that three years ago, two years ago, and last fall) They can't change a thing until they change to powers that be, and that hasn't even come close to happening. Those in power in 2000 are still there. It's clearly documented on this site with references that shows the same names of the same good ole boys at the same addresses.

2. It was an isolated incident. Whatever how many thousands of complaints for how long do they consider it to be a bit more than "isolated"

For Heavens Sake, the government set up a Hot Line to report abuse from these places!

Once again I can't stress enough that private dentists are doing this same crap. Be on alert!

3. Just a bad apple in the bunch. A bad APPLE!! Well, yeah! Lots of bad apples. When you set up shop in Pueblo Colorado and send out demon seeds across the country, to plant more diseased trees! Clearly some bad apples, from the bottom of the tree straight to the top!