Audit of .....??

Now lets' say that you are signed up with UCCI (United Concordia),
this means they send you patients, and you have a contract with
them. In the contrat i8t statyes they can audit, ask for you to
mail records to them, or they can come in and look through charts.

Next, let's say you are NOT signed up, as I never was.
I still treated the patients, only UCCI would not "honor
assignment." This means the patient gets the
check not the doctor.

But no audit.

"WE WANT TO AUDIT ...." YES, right after YOU pound sand.

Joel

     Joel344
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       #4       Today, 01:40 PM
           Sue
           Member   Join Date: Oct 2004
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     I am still trying to understand this. What prompts an audit in the
first place? Are these done at random or are these done because of a
complaint made.

     Thank you.

     Sue
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       #3       Today, 12:20 PM
           barry1818
           Member   Join Date: Dec 2004
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      boards

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     Boards are state agencies, at least in Ca., that are staffed with
governmental appointments.

     So it still is an ethical situation, where if you think it fair that
the state can come in and audit you, and if you prove yourself not at fault,
they can reverse that decision, so that they can collect a fee for that
investigation,

     seems that we are getting people on the board that would never want
that situation for themselves, but can change it and don't.

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       #2       04-22-2005, 11:30 PM
           Sue
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     Sounds like the board rules... no matter what. Sounds like the board
has special privileges....

     Who is the board anyway? Is this made up of dentists?

     Sue
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       #1       04-22-2005, 12:49 PM
           barry1818
           Member   Join Date: Dec 2004
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      ethics in the profession

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     I was wondering what is the ethics of the dental board, when they have
a policy that if the board prevails in a hearing they get to charge for the
cost of the investigation, but if the dentist prevails, he can't recover
costs.

     I was also wondering about the ethics of this when it relates to the
board never losing cases, and overturning the judge in the hearing, because
they didn't like the result and can't collect for the investigation.

     Such bias goes to the heart of an ethical profession.

     Just wondering.

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