WARNING: This dental office is actively committing Medicaid fraud and engaging in seriously unethical business practices.
Someone came into this dental office impersonating my sister and somehow obtained access to her insurance information. That individual received dental services and X-rays using my sister's Medicaid insurance.
We discovered this when my sister attempted to seek care at a dental office in Manhattan and was informed that she had already received the same services at another facility. This was false.
During a recorded three-way phone call between an insurance representative and an employee of this dental office, the office violated HIPAA and knowingly admitted they had the wrong patient on file.
When we went in person to obtain copies of "her" medical records, the office demanded identification to release the information. For clarity: this is not standard practice. At most medical offices statewide, patients can access records using identifying information such as name and date of birth; requiring a photocopy of an ID is uncommon and not mandatory.
At the time, there was an active Medicaid appeal pending for wrongful billing and services rendered without prior authorization. During this process, the office photocopied my sister's ID without her consent and used it to submit "proof" to Medicaid to justify fraudulent billing. We were told this was "office policy."
Taking and storing a copy of someone's government ID without consent, especially after admitting the patient was misidentified, is both a HIPAA violation and fraud.
Additionally, after my sister received new X-rays from a different dental office, that provider confirmed the X-rays supplied by this office do not belong to her. Her dental condition is not even remotely consistent with the records they submitted.
A police report has been filed to document the fraud. Despite this, the dental office is now amending medical records, which is illegal, particularly in the context of an active investigation.
You unlawfully obtained and retained a copy of my sister's ID, and you believed this would protect you. Instead, it has further implicated your office. Altering records, stealing patient information, and billing Medicaid under false pretenses are crimes.
We are actively pursuing every available avenue to report this conduct to the Department of Health, the State Dental Board, Medicaid, and all appropriate regulatory authorities.
Good Luck and Well Wishes, you guys fucked up royally. read more
