A dentist who has achieved licensure will have gone through a great deal of education and qualification to earn their right to practice their chosen profession. Having earned that license, you should do nothing that can put your livelihood in jeopardy. In the normal course of doing business, a practitioner will be required to interact with insurance carriers so that patients can have their dental care covered.
In general, an insurance company will provide a dentist with a set of guidelines that lay out covered procedures and when a dentist may submit bills for services. It is absolutely necessary that you do not engage in practices that raise questions of whether any procedures you perform are necessary — nor that you bill for such procedures. Suspicions that you are doing so may raise questions of fraud — and put your dental license at risk of revocation.
Naturally, the determination over whether a procedure is in fact medically necessary may be a subjective one. The Texas State Board of Dental Examiners, though, is likely to side with insurance companies when a dentist is accused of performing unnecessary procedures in order to claim insurance money — because the Board exists for the protection of the public, not the professional, and it is essential that procedures not necessary to the health or true benefit of patients be performed on them — as this constitutes a doing of harm. Under Texas Occupational Code section 263.002(a), TSBDE can engage in a range of disciplinary actions from probated suspension to full revocation of a practitioner’s license. In the case of insurance fraud for the performance of unnecessary procedures, the latter is the more likely outcome.
This is why, when faced with a complaint before the Board accusing fraud, it is necessary for a dental professional to contact a professional license defense attorney at the earliest possible moment. We will need time to put our considerable experience to work at formulating a solid defense against these spurious claims.
Hire the Experienced License Defense Attorneys of BERTOLINO LLP
The attorneys at BERTOLINO LLP know how to carefully research every potential case. We know where to look for evidence and how to use that information to build a successful legal strategy. Our firm is prepared to represent you at every stage of the complaint process. Our results speak for themselves.
If your professional license is at risk of suspension or revocation, BERTOLINO LLP can help. With offices in Austin, Houston, and San Antonio, we represent licensed professionals across the entire State of Texas. Our honest, experienced attorneys will fight aggressively on behalf of your license and reputation.
Contact us today or call (512) 717-5432 and schedule a case evaluation.