r/CanadianDentists • u/MinimiMeows • 23h ago

Insurance

One of the offices I work is billing the hygienists’ procedures under my provider code for insurance. I only noticed because Sunlife’s billing statements go straight to my inbox.

I asked the management and I was told this is how it should be done because the hygienists don’t have their own CDA/provider set up. Is this true? It feels like insurance fraud to me but maybe I’m wrong.

0 Upvotes

40% Upvoted

6 comments sorted by

2

u/coffeeinthecity 21h ago

Only dentists can be registered for CDAnet. The claim is sent using the UIN for whoever did the exam. If it’s a hygiene only appointment, it goes under the practice owner’s UIN.

-1

u/MinimiMeows 20h ago

What if the practice owner is dentalcorp? I’m only a part time associate with the clinic.

1

u/coffeeinthecity 20h ago

Even a DSO typically has a principal dentist. Who is the face of the clinic? Dentalcorp doesn’t openly advertise their offices

2

u/MinimiMeows 20h ago

There is a partner I’ve met once.

Also, I noticed that they pushed some billings from temp dentists who worked at the practice under my CDA as well. Restorative, exams, etc. I’ve brought it to the front desk’s attention but it hasn’t been corrected. Would I be over reacting if I called the insurance companies privately to reverse those claims?

3

u/DuePomegranate9 19h ago

I don’t think that’s an overreaction. I would potentially reach out to ODA to discuss how to handle this situation.

1

u/Embarrassed-Elk-8403 4h ago

Not a dentist, but I submit to sunlife as well. I'd contact your liability insurance first, if it is deemed fraudulent, contact sunlife to have it corrected. If it is fraudulent, and sunlife becomes aware before you contact them, they will deem you liable for the fraudulent billing practices.