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Medical Identity Theft: The Newest Threat to Your Practice

All small businesses have to worry about things like credit card fraud. Medical practices, however, have the added responsibility of guarding against medical identity theft. Medical identity theft is the illegal acquisition of a patient’s personal information–full name, Social Security number, health insurance number, and so on–with the intent to fraudulently obtain insurance reimbursements, prescription drugs, or the like.

Unlike fighting credit card fraud, which is common enough that even web hosts often feature built-in prevention tools, battling medical ID theft often falls to individual practices. There are some steps, of course, that can be taken at a higher level, such as working for change within the industry. In the end, however, most of the precautionary practices are ultimately implemented on a practice-to-practice basis. That means one more thing on the dentist’s already overflowing plate … one that is dangerously tempting to ignore.

But medical identity theft is a large and growing threat: In 2013, the health care industry accounted for 44% of all breaches, experiencing more data breaches than ever had before and surpassing total breaches for any other industry. Polls indicate that the Public at large that doesn’t believe their health information is being protected, and rightly so: the current system is riddled with loopholes and all but obsolete in a digital era.

Medical identity theft is particularly troublesome in that it victimizes not only the dentist and the patient, but other medical professionals as well. For example, when fraudsters steal data, they may either go to different medical establishments (such as another doctor) and use the phony information to illegally obtain drugs for themselves … or sell the information to other criminals who do so.

In another scenario, fraudsters may file bogus insurance or Medicaid claims to obtain settlements. Many in the medical and insurance fields have specialists trained to be on the lookout for monetary fraud, but when a patient hands over all the pertinent information, there is little seeming reason for additional proof to validate the patient’s identity.

More and more, criminals are discovering that billing insurance for goods and services ordered using fraudulent medical credentials is easier and more profitable than other crimes. In fact, it has been estimated that medical identities are 20 to 50 times more valuable to criminals than financial identities. The increasing need to digitize patients’ health information means the problem is only going to get worse.

Unfortunately, industry-wide updates to acceptable best practices are still a long way off. Health care companies could be doing more to prioritize information security, the way the credit card industry has migrated to EMV “chip” card technology … but so far, that isn’t happening.

Equally unfortunate is the fact that the antiquated system in the U.S. makes it nearly impossible to clear up a medical record once this type of identity theft has occurred. However unfair it may seem, for now, dentists are largely on their own when it comes to protecting patient data.

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5 Tips for Handling Patients Who Don’t Pay

According to the National Retail Federation, U.S. retailers suffered more than $260.5 billion in lost sales due to merchandise returns. Dental practices may not figure into that total specifically, but that doesn’t mean they’re off the hook.

As a rule, dentist don’t provide services that are returnable: caps, fillings, x-rays or orthodontia aren’t things aren’t things that patients bring back after two weeks and say “This really isn’t working for me, and I’d like my money back.” But that doesn’t mean there still won’t be issues with payment.

Every practice deals with unpaid bills. It’s an annoyance and a hassle but it’s not likely to go away. Even if you insist on payment up front, you’ll still have to contend with bounced checks and/or chargebacks (for a detailed explanation of chargebacks, see this post from last year.)

While there’s no surefire way to guarantee you’ll get paid, there are a few things you can do to help minimize your number of unpaid bills, and what to do with the ones you have.

  1. Sign on the dotted line. Each dental practice is unique, so it helps to Put your policies in a written contract that can be signed by both patient and dentist. Work with an attorney to create a document tailored to your specific practice; don’t use a generic contract. Make sure the document is easy to read and easy to understand, too: it needs to cover you, legally, but it shouldn’t be so loaded with legalese that patients can claim they didn’t know what they were signing.
  2. Give details upfront. Service details, options, and pricing should all be discussed in detail at the initial consultation. Dentists need to make sure patients understand the issues that need attention, pros and cons of different available treatment options, and the costs that will be associated with each option. Insurance, co-pays, and other financing issues need to be laid out in clear, concise language. And along those same lines …
  3. Make a plan. The bigger and more complicated the treatment, the more important it is to have a written treatment plan that includes details, approximate dates, and financing. A treatment plan doesn’t replace your standard contract; it’s a supplement catered to each patient. That means it is crucial that you listen carefully to the patients considerations.
  4. Do the legwork. If you do end up with a bad debt, don’t expect the patient to go out of his or her way to help. Your office should be expected to be the instigator of all communications. Make it as convenient as possible for the patient to pay–the ability to take credit card numbers over the phone is one example. It is essential that all contacts are made in the most professional manner, and that care is taken to verify the identity of the person you’re speaking to avoid breaching confidentiality.
  5. Leave it to the pros. Face it: you’re a dentist, not a bill collector. You’ve got better things to do. While your office should make the first few attempts, there comes a point of diminishing returns; if you decide the patient is deliberately trying to avoid payment, don’t be afraid to turn the case over to a collection agency. Take care to hire a firm experienced in medial collections to avoid any HIPPA violations.

When it comes to bad debt, the real work should happen long before the patient ever walks in. Don’t be afraid to Push patients to pay money they clearly owe. And if it gets to that point, call in professional help. That might upset the patient … but seriously, if it’s this hard to collect from him or her, you probably don’t want that person as a patient, anyway.

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Should Dentists Be Concerned about Potential Health Care Reforms?

On Capitol Hill, lawmakers are doing everything in their power to pass some kind of legislature regarding public health. Even without taking a side in the debate, there is a clear mood of desperation that many feel could create a “bad-to-worse” situation. This is true of people in the private sector, but also of professionals. Dentists around the country are aware that the dental coverage children receive — and the coverage some adults get through their state’s Medicaid plans — could soon disappear.  Read More

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New Benefits of Music in the Dental Practice

A recent post on Business News Daily asked 50 different entrepreneurs for their favorite motivational songs. The depth and variety of both the tunes and the individual reasonings demonstrated the effect that music can have on the human psyche … and underscored the dramatic role music could and should be playing in the dental office.

We’ve long known that music could produce a measurable anxiety-reducing response; we’ve also seen how the process of waiting for treatment can routinely create stress and anxiety in many individuals. In the last few years, studies have begun to address how these things could work together to create a more positive experience for patients. Read More

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Getting Prepared for Oral Surgery

Oral surgery is no fun. But, if it is a necessary course of action, getting prepared for oral surgery is advisable. We can offer you some valuable suggestions for that process.

Get a Consultation

Monica Eaton-Cardone says, “Getting a consultation with my surgeon calmed my nerves prior to oral surgery after a really bad car accident when I was 16.” Sitting down with those performing the surgery allows you to ask questions about the process and the medications associated with the procedure. This can help alleviate stress as it did for Eaton-Cardone. At that time you will be able to talk about your concerns and fears. Your surgeon or dentist will gladly answer all your questions and explain the entire course of events for you. Don’t forget to use this opportunity to talk about your options for sedation. Read More

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Dentists…Beware of Chargebacks and Friendly Fraud

Dentist visits often fill consumers with anxiety: What procedures will I need done? Will it hurt? Is it going to be expensive?

They hand over their credit card, anxious about their pressing dental needs and the potentially high bill they will receive. For some consumers, however, their mounting debt becomes overwhelming and they start to look for a way to alleviate some of the financial pressure they’re facing.

One method of dealing with financial stress is to use the credit card system against itself through the use of chargebacks. Read More

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4 More Dental Advancements You Need to Hear About

We recently published a piece on the top three dental advancements but felt like we were leaving some very significant innovations out. Also, as a dental site, we do want to make sure you take care of your teeth because dental health is far more relevant to your overall health than you realize. That said, here are 4 more dental advancements you need to hear about!

Better Tooth Preservation Thanks to Thinner Veneers

Previously, veneers required some rather extensive preparation. Dentist had to shape and scrape your actual teeth in order to prepare them for the protective coating known as a veneer. Given the thickness the shaping and scraping had to accommodate, some damage could be done to your actual teeth. Read More

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Top Three Dental Advancements

Going to the dentist is probably not on the top of your bucket list. No doubt it’s probably not even on your to-do list. Who wants to go to the dentist? However, given the multitude of advancements in dental procedures you might find yourself a more willing candidate. Ideally, you’ll make an appointment before things get too far out of hand. Unfortunately, a good number of us wait until we simply must have something done. So, for those pre-planners and those wait-until-the-pain-is-unbearable people, here are some of the newest dental procedures available for your well-being! Read More

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Scam or Legit: Do I Really Need that Dental Procedure?

Unfortunately, the practice of medical bullying runs rampant in some dental offices. Dentists rely on their perceived authority to intimidate patients. Unaware patients agree to procedures they don’t need—and often times, can’t afford.

These types of scams are both unethical and terrifying. Few of us have the medical knowledge necessary to determine when a procedure is warranted and when it isn’t.

Here is a list of the most common forms of dental scams. Stick around because we’ll also tell you how to detect, avoid, and report scams. Read More