Scion Dental Executives Address NHCAA on Preventing Pediatric Overtreatment in Medicaid Dentistry
In their presentation "Potential for Abuse in Patient Restorative Services" Kasten and Schaak began by explaining the important differences between working with
Download a copy of the presentation at: http://skygenusabenefitmanagement.com/sbm/Knowledge-Center/Presentations/Pediatric-Restorative-Benefits-Potential-for-Fraud-Abuse-Part-2.htm
After setting this baseline, Kasten and Schaak then detailed several heartbreaking stories of children who had likely been abused by unscrupulous dental providers. Included were instances of children being painfully over-treated, sometimes without even the benefit of anesthesia, as a way of increasing dental provider revenue at the expense of
"What makes this abuse particularly tragic is these young patients usually have no other options for dental care since only 15 percent of dentists participate in
The final section of the presentation offered a three-part game plan that NHCAA members and other healthcare and insurance executives can follow to discover and help prevent fraudulent and abusive practices. The plan includes education about the abuses and how to recognize them, industry collaboration between the NHCAA, the
Among the technologies recommended is the use of a web-based portal that can generate profiles showing the frequency with which a given dentist provided a particular service, or services, within specific age bands compared to other
"The fee-for-service reimbursement system continues to reward overtreatment at the expense of many dentists who do a terrific job in rendering care to this vulnerable population," Kasten said. "Taking advantage of anyone seeking care for financial gain is not just illegal; it is morally and ethically wrong. But taking advantage of children from under-served populations, and putting them through this type of unnecessary suffering, is simply unconscionable. Yet it goes on because certain providers have been able to hide in the shadows."
Added Kasten: "We hope that by showing how technology can shine a bright spotlight on those perpetrating fraud and abuse, and highlighting those doing it right, we can help ensure the children of
Tweet this: Scion Dental execs present webinar to @NHCAA members on #Medicaid #pediatricdental fraud & abuse. http://bit.ly/1eFXIlz | #healthcarefraud
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