Dentists who find they have been accused of insurance fraud in Texas are at risk of discipline and even of losing their licenses. If this happens to you, it is important that you immediately seek out an experienced dental license defense attorney who can make the case from the get-go that the medically necessary procedure you ordered does not meet the definition of fraud.
The majority of dentists have entered into agreements with insurance carriers to care for more patients. These contracts often detail the guidelines insurance companies have created for the sorts of services that they are willing to cover, along with when a dentist may bill for given patient services.
It’s when the question arises about the actual medical necessity for a procedure that things get hairy. Because the presumed alternative to “yes” often plays out, as far as an insurance company is concerned, as a hard “no.” Dentists, who care very much for the health and well-being of their patients, cannot help but take as insurance getting between their patients and the proper level of care they need.
So if you find that you are being accused of making decisions to provide unnecessary procedures to make insurance claims, it is on you—or on us together, should you decide to give us a call—to show that the procedure was necessary given the facts on the ground and that the insurance company’s decision that the procedure was unnecessary is more a difference of opinion than it is some conniving attempt to commit fraud.
So make the call. The attorneys at BERTOLINO LLP are experienced dental license defense attorneys. We are prepared to represent you at any legal hearing or proceeding regarding your license. BERTOLINO LLP represents licensed professionals across the entire State of Texas. To best serve our clients we have offices in Austin, Houston, and San Antonio. 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.