Dentist Accused Of Offering Cash To UPS Employees To Let Him Perform Unnecessary Procedures

Authorities in California say that a Sacramento dentist not only performed unnecessary procedures on patients in order to rack up huge payments from insurance companies, but that he also enticed UPS employees into undergoing unneeded work because the company’s dental plan had no co-pay and no maximum dollar limit.

CBS Sacramento’s Kurtis Ming recently uncovered a document from the California Attorney General’s office to the state’s Dental Board in support of the dentist’s suspension.

According to the document, the dentist would “send his employees to UPS warehouse locations with food and drinks to… pass out referral flyers and food to UPS employees and explain they could receive $200.00 for referring a fellow UPS employee for treatment at [the dentist’s] office.”

The referred patient would allegedly receive approximately $30.00 and a free Sonicare toothbrush.

“[The dentist] would use this referral tactic to attract UPS patients to his practice and proceed to conduct excessive and unnecessary treatments on the UPS patients because of their exceptional dental insurance coverage,” reads the document.

One of the doctor’s former dental assistants told investigators that people from the office would pay “weekly or bi-weekly” visits to the UPS warehouse and that the office treated between one to four UPS workers each day. In fact, says the former assistant, UPS employees were the “main focus” of the practice.

And it wasn’t just UPS workers that were getting unnecessary work performed. In addition to unneeded procedures, the dentist is also accused of billing insurance companies for work that was never done, sometimes on teeth a patient no longer had.

Between 2006 and 2009, the dentist’s annual charges to just one insurance company jumped from $154,000 to $870,000.

The state’s Dental Board suspended the doctor earlier this year, but he can’t be the only bad tooth-puller in the business.

Thus, Ming put together these tips for when you’re picking a dentist:

* Ask questions until the dentist has answered them satisfactorily
* Expect treatment plans to be explained clearly and understandably, including costs
* Get a second opinion – some plans require second opinions to be offered, while others allow for a second opinion to count as an examination
* Communicate expectations, goals and wishes – are perfectly straight, white teeth most important? Does it matter between silver-colored or tooth-colored fillings? Is a removable bridge preferred over a dental implant?

Call Kurtis Investigates: Drilling for Dollars [CBS Sacramento]

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  1. Nigerian prince looking for business partner says:

    I believe this is the ‘moral hazard’ economists refer to when a 3rd party pays for the entirety of anything. This used to be a very common Medicare & Medicaid scam in my area, with providers rounding up the homeless and giving them a cut for any treatment given.

    Plus, I can only imagine how much UPS is paying for this kind of dental insurance. The best quotes I’ve seen all cost in the $600/year ballpark, with a maximum annual payout of ~$1,000.

  2. u1itn0w2day says:

    I had worked out a payment plan with a dental school office manager as my insurance cap was getting low but needed alot more work. I had excellent credit at the time. I started making payments then get a letter stating they owed me money because I was payed up ie they billed my insurance without my permission.

    The DENTIST,not the office manager demanded that insurance be billed first. Dentist are just slimmy/ooozy when it comes to playing the insurance game/with insurance money. The funny thing is that my payments started coming in before they got reimbursed by my insurance. It’s like they’re addicted to the insurance. Never went back there again.

    • bhr says:

      I’m biased, as a sibling is in Dschool, but I’m not sure what is wrong with your situation? They billed the insurance, which repaid them, so you got your money back. Isn’t that a good thing?

      I don’t blame dentists for being aggressive though, they pay for 3 or more years of schooling and the reimbursement rates from any government and many private insurance plans are comically low. The only advantage they have over general practice physicians is that many people pay out of pocket and up front payments don’t have to go to collections.

      • u1itn0w2day says:

        Even though I eventually got a refund your missing the point of billing without the patient’s permission. Personally I was about to relocate which meant new dentists. Most new dentists will not see you unless you have current insurance. There are also plenty of other things I could’ve use that cash for as well. And they didn’t pay interest on the overpayment check either.

        But what gives any person or organization to essentially double bill the patient because that’s what it is. Purposely double billing is criminal fraud as far as I am concerned. They should’ve rejected my payment plan if they didn’t want to take cash or checks. Also note the procedures I went through with this office far exceeded my insurance cap and had already paid almost half the work in cash anyway. They had already voluntarily gave time in between visits to pay. I never started a new session with unpaid bills(no didn’t pay 5 minutes before a session either). So there was little to no question about paying or credit worthy. It also shows the lack of communication and/or authority with the office manager and dentists.

        To top it off if I wasn’t so busy at the time I would’ve taken the time to sue their butts off, especially my assigned intern dentist who was no puppy(ex dental assistant/military in her 40s). Her worked failed miserably in less than 2 months. I expected to get young eager motivated dentists bit the bums in this particular office acted as though they were it slugging out digging ditches everyday. I think part of the problem was this was newer satillite office. They seemed more interested in perfecting a corporate practice. It was before Enron so I guess they never issued memoes on fraud.

        • bhr says:

          What fraud happened? Maybe I am just missing it, but nothing you have described sounds remotely like fraud.

          • failurate says:

            By setting up a separate payment plan and working outside his insurance, he most likely violated the terms of his insurance policy.

            I don’t really understand what he planned to gain from paying first and billing insurance later. He created, with the help of the office manager, the problem of the dentist office owing him money.

            It also wouldn’t shock me if the dentist’s agreement with the insurance company was that he had to bill for all patients who have that insurance, that he couldn’t with-hold claims from the insurance company. Providers generally try to avoid violating their insurance company agreements.

            • u1itn0w2day says:

              A payment plan would have had to be arranged anyway since the total bill would’ve more than doubled the insurance cap. I let insurance pay the intitial visit and one procedure which took multiple visits. I stated before I wound up relocating and just to get in the door/start treatment with a new dentist you need insurance. Without valid insurance in the begining there’s a good chance that a new dentist would not have treated me beyond a consultation.

              As for required billing of a patient’s insurance policy I’ve had dentists and doctors in the past ask me are you paying for this or do you want your insurance billed. It’s the patient’s insurance policy and their debt.

          • u1itn0w2day says:

            So billing an insurance company for the entire bill AFTER knowingly receiving several payments regarding that same bill is not fraud because ?

    • ReverendTed says:

      There are practically no reasons not to take advantage of your insurance benefits if you have them available when you need them.
      You paid your premiums, so the benefit money is waiting there for you.
      If you paid the dentist cash for the work and left insurance benefits on the table, then those are dollars you could have spent elsewhere, which is exactly what the dentist eventually told you: “Hey, your insurance paid for this, go use your dollars on something else.”
      There’s also nothing slimy about that. If anything, the dentist gets less money if they’re in-network with your insurance. Otherwise it makes no difference to the dental office except the patient gets extra money in their pocket if insurance pays.
      And suggesting that a dental office wouldn’t see you if you don’t have insurance is…preposterous. Dental offices LOVE patients who don’t have insurance, because they pay in cash when service is rendered, rather than having to wait for an insurance company to decide they’re going to pay a claim.
      The only possible explanation I can come up with otherwise is that an office might be contractually obligated to take new patients from an insurance plan network they’re signed up with, but are otherwise booked solid. Even then, you’d expect (or possibly be contractually obligated) to call the insurance company and tell them you’re no longer accepting new patients.

      • u1itn0w2day says:

        Benefits were not left on the table the year they double billed. The whole point of the approved payment plan by cash was to reserve some of those benefits for later in the year. My actual dentist at that clinic was stunned I was paying as much as I was in cash earlier in the year. If they’re that into insurance spell it out to the patients that your benefits must be exhausted before you can get a payment plan. It still comes down to the patient to deciding when they will use/decide to the their bill with insurance.

  3. eddison72 says:

    I don’t know what UPS these people work for, but the UPS I work for does not provide a dental plan with no co-pay and no maximum dollar amount! Crowns and fillings are not even covered, since they are considered “cosmetic”. Yes fillings.

    • Ducatisti says:

      I agree. Our plan is the National plan and it only covers a specific amount every year. If you go in for regular check-ups that amount is increased but it’s still not unlimited. California UPS must either be on a different contract, or this whole story is bs.

  4. Blueskylaw says:

    “the company’s dental plan had no co-pay and no maximum dollar limit”

    Hurries to UPS website to fill out application,
    crosses fingers and promises he can lift 75 pounds.

  5. BadIdeaSociety says:

    I have never encountered a dental insurance plan that would allow the patient to get a second opinion. My previous plan gave me a whopping 20% payment for all services rendered, no other plan options.

  6. crispyduck13 says:

    …because the company’s dental plan had no co-pay and no maximum dollar limit.

    Damn, I should get my resume together.

  7. bhr says:

    paying rewards for referrals isn’t really wrong, nor is targeting a specific company for new clients. Where this guy is wrong is that he charged for services that weren’t required or performed.

  8. bsh0544 says:

    This is *exactly* why I haven’t been to see a dentist in years. All I ever hear are stories about how dentists everywhere are trying to extort as much money as possible from people. Are dental schools like this too? That’s all I can think to do.

    • redskull says:

      Shop around; there are a few good ones out there. About 10 years ago I moved to a new city and had to find a new dentist. I found one who wanted to put crowns on my two front teeth (which legitimately needed help, by the way) for around $2000. Not having an extra two grand lying around, I declined. Found a second dentist who fixed my two front teeth with veneers and charged me about $120.

      It was all I could do to keep myself from going back to the first dentist and punch him in the d*ck.

    • Nigerian prince looking for business partner says:

      In general, my anecdotal experience has been that dentists are generally more reasonable with cash paying customers. It’s people with Cadillac dental insurance that they go after with every conceivable treatment they can come up with.

      If a dentist recommends $2,000 worth of treatment, you’ll get a second opinion if you’re paying cash. If insurance is paying for it, most people will just agree without a second thought.

    • suez says:

      You do realize that the longer you put off that visit, the worse your bill will probably be, don’t you? Your logic is fail.

      • banndndc says:

        not necessarily true. i put off my dental stuff for a long time and then went in and got a big ole mess of stuff done. did the math when i got home and while it was a super expensive bill it was still actually less than it would have cost for twice yearly cleanups (and no work done) over the same time period.

        • u1itn0w2day says:

          Same here. I’ve had dentist insist I get stuff done immediately or I’ll be experiencing such & such trouble with in months. With certain issues I’ve gone over 10 years with no repair.

          I look at it this way. I’ve known too many people that haven’t had dental work for years and they didn’t have a heart attack from stroke or lose all their teeth in a domino effect because of one tooth.

          Big thing is brush teeth, lightly brush gums, floss, use a tooth pick and keep your mouth moist. I’ll do extended flossing sessions a couple of times of month and yet had dentist insist floss every single day(he said it’s better to over floss even if bleeding?) An irritated mouth can’t be that good.

          • ReverendTed says:

            Yes, flossing every day (or close to every day) is ideal.
            Now, overdoing anything is bad (by definition), but “over flossing” would mean flossing too aggressively (pushing too hard, or using a sawing motion) or too frequently (which would be several times a day).

            If you are flossing correctly and your gums bleed, it’s not because you’re injuring (or “irritating”) them, it’s because they’re unhealthy. Healthy gums don’t bleed when flossed or brushed.
            Flossing daily removes the bacteria adhered to the sides of the teeth which cause inflammation of the gums, allowing the gums to return to a state of health.
            These bacteria accumulate at the same rate as the bacteria on the outside of the teeth (or faster), in that recolonization begins almost immediately, with plaque obvious within hours. Would you go without brushing except a few times a month?
            Furthermore, the bacteria in these colonies changes over time to more destructive types of bacteria. Disrupting the colonies regularly keeps the numbers of these other types of bacteria down.

            A big part of this is “flossing correctly”. It’s pretty simple, but many people have never really been told the basics, and it’s easy to do it wrong. If you’re not sure, you can probably Google “flossing technique” or just tell your dentist or hygienist “I’ve been told to ask you for a quick primer on how to floss correctly.”

        • ReverendTed says:

          That argument is only valid if the only metric is money, disregarding “health” as having any value.
          You now have “a big ole mess” of dental work in your teeth, some of which (statistically speaking) is going to need maintenance (repairs or replacement) in the future, and these things tend to only get larger.
          On the other end, almost all dental problems were once smaller problems, and before that many of them were an admonition to keep a certain area clean or change certain habits before a problem developed in the first place.

      • bsh0544 says:

        I could use maybe one filling but other than that my teeth are serving just fine. I’m fairly sure they don’t just vaporize on their own. I do make sure to brush twice a day, use a fancy anticavity mouthwash, and floss probably less than I should, but occasionally.

    • Such an Interesting Monster says:

      Not all dentists are like that. If things don’t feel right at one then look for another.

      I had one guy that gave me a $4000 treatment plan, which is absurd. I said “look, you get to do whatever my insurance will cover and that’s it”. So I got a regular cleaning (not the super expensive “deep cleaning” he said I needed but wasn’t covered), two wisdom teeth extracted, and a replacement filling.

      And I never went back and let them know why. Despite repeatedly telling them I wasn’t interested in non-covered procedures they were always trying to push them on me. I come to the dentist to get my teeth looked after, not for a hard sell for procedures in which I have no interest.

      I get none of this nonsense from my current dentist.

      • Such an Interesting Monster says:

        Oh, and according to my current dentist I don’t need any of those expensive treatments as suggested by my former dentist. Imagine that.

      • ChuckECheese says:

        Your advice about “if you don’t like it go to another” is time consuming and expensive. Many dental plans won’t pay for multiple dentist visits. They can be sneaky like my old dentist, and be conservative at first, then play gotcha after a couple visits. Which is sort of like having a relationship with an abuser that was good for a year then suddenly got ugly. You’re confused, wondering what happened, and experiencing a sunk-cost fallacy, and not highly motivated to move on.

      • bsh0544 says:

        Last time I tried looking for a dentist (a few years ago) none of them would so much as give a price for a cleaning, even when told there was no insurance involved (my employer’s dental is terrible, $20/week for family coverage, $1000/person/year maximum benefit, 3 people in the family).

        • Nigerian prince looking for business partner says:

          It’s the exact opposite here.

          Dentists are ditching insurance entirely or at the very least going non-network and giving cash discounts. The overhead of taking insurance and dealing with contract rates is getting to be too much of a burden.

        • ReverendTed says:

          So, the math:
          $20/wk for a year of coverage for your family, which comes out to $1040/yr in premiums
          $1,000 annual max with three family members, that’s potentially $3000 worth of coverage
          $1040 for $3000 worth of coverage sounds pretty good at first.
          But that’s assuming that each of your family members needs anywhere from $1250 to $2000 worth of dental work (since the plan is usually only paying a portion of each procedure) in order for them each to reach the annual maximum.

          On the other hand, let’s say you’re all just getting routine cleanings and exams.
          Prices for dental procedures can vary widely depending on where you are and what type of dentist you see (e.g. an in-and-out chain vs a “personal time” dentist), so my calculations will cut a pretty broad swath.
          For most adults, we recommend a cleaning and checkup every 6 months, with a “checkup” set of bitewing x-rays once a year.
          Two cleanings, two checkup exams, and one set of x-rays might run anywhere from $280 to $360.
          Three family members might be looking at $840 to $1080 for a typical year.
          On the high end, it still justifies the premiums, and if anyone needs much dental work at all, it’ll probably pay for itself on the low end.

          Another few factors to consider:
          – The initial examinations are usually going to be somewhat more expensive, so the examxray costs for the first year are going to be elevated.
          – Some policies will have a waiting period on “major” work, so you might not be able to take full advantage of the benefits for crowns and bridges during the first six months, or possibly the first year
          – If you go to an “in-network” dentist, then your statement at the end of the year might LOOK like you’re not benefiting from the policy as much as you expect, because generally there will be lower negotiated rates at an in-network dentist, so what would otherwise be $280 worth of checkups and cleanings might show up on your insurance as $200.

      • ReverendTed says:

        There are a few aspects to the “deep cleaning” issue.
        – If you didn’t need it, then shame on them for recommending unnecessary treatment
        – If you absolutely need it and don’t get it, then you may be looking at tooth loss in the future
        – In between “don’t need it” and “absolutely need it” is a range of “almost, maybe, possibly” where some dentists will recommend treating immediately and some will advocate regular cleanings and monitoring based on their experience and interpretation of a host of factors

        Periodontal disease, like many dental diseases, is often sinister in presentation in that the patient is often unaware of any symptoms until the disease is far advanced.
        In this day and age, one of the tremendous benefits of new technology is that we can communicate what we see directly to the patient. “Here are your x-rays, and here are the photos of your teeth, and here is a graph of the measurements of your gums and here is the problem and here is what we can do to help you.”
        In the past, what dentists diagnosed and did in the mouth was often a mystery to patients (similar to auto mechanics), which breeds mistrust, and yes, also allowed for unscrupulous practitioners to do whatever would benefit them most, but these days we have the benefit of being able to bring the patient along in the diagnostic process, which enhances the patient’s understanding of their conditions and the trust in their practitioner.

  9. eezy-peezy says:

    Readers Digest did a story many years ago – took an average guy, had him checked out by a dental school dean, determined there was no work needed. Then he went to dentists in cities around the US, said he had just got a job with great dental insurance, and asked the dentist what kind of work he needed. The estimates went from $0 (the rare honest one) to tens of thousands of dollars.

    Hey what the heck, INSURANCE is paying!!

    • u1itn0w2day says:

      Exactly, too many look at insurance as free money. And as much as they complain about regulation or not being able to bill and treat they way they want to they seem to have no problems exploiting and abusing the system they voluntarily chose to use as the preferred form of payment.

  10. gman863 says:

    It sounds like the dentist charged an extra $40 so the patient had the option of picking up his or her extracted tooth at the UPS Store.

  11. ReverendTed says:

    I’m disappointed to see the poor experiences and mistrust of dentists in some of the posts above, especially knowing that in some cases it isn’t entirely unwarranted.
    I suppose I should feel privileged to practice in an area where most of the dentists around seem to be fairly conservative (as in, “not aggressive”), honest folks, but it’s always seemed to me that a few bad apples give everyone a bad name.

    Unrelated to that, though, I have seen many dental plans, but I have never seen one that “requires second opinions”. Allowing a second opinion to count as an examination really comes down to how the second dentist codes it and bills it – as a limited evaluation or a consultation, or comprehensive evaluation, and how the insurance plan deals with examination frequencies. Some pay for two examinations (at any time) in a year, some pay for one each six months, and a whole host of other iterations. So your first and second examinations might be free, but you could be out of pocket for the 6 month checkup.

  12. ganon446 says:

    Gotta love that every Dentist needs an X-Ray

    Me: “But I just got back from the Oral Surgeon who is going to do my surgery and already took X-Rays in which I have a copy of.”
    Nurse Pusher “We don’t use that size of X-Rays on our wall and its policy to get one for every visit.”

    Yeah basically they just want to screw us all and get as much money as possible

    • ReverendTed says:

      At our office, we always ask the patient if they have a current set of x-rays from another clinic, even if their new insurance policy would cover a new set.
      There’s even a principle in dental ethics for radiation exposure called “ALARA”, which stands for “As Low As Reasonably Acceptable”. Basically, we’re supposed to take x-rays only as often as necessary for consistent diagnosis.

  13. make7acs says:

    Will never understand how he thought a 700k annual cost jump wouldn’t be noticed.