Billing irregularities may have led to the University of Nevada, Las Vegas (UNLV) School of Dental Medicine overbilling patients and insurance companies by thousands of dollars, according to a January 23 article in the Las Vegas Review-Journal.
The school paid $366,000 to have a law firm investigate its billing practices but has refused to make its findings public, as of press time.
Patients of Phillip Devore, DDS, who left the university to work at Image Dental in Las Vegas, were billed for costly surgical extractions three times more often than simple extractions, according to an analysis conducted by the Review-Journal. Medicaid data showed those figures were well above the average for Nevada.
From as far back as 2012, the review found questionable billing practices, such as billing patients for both surgical and simple extractions for the same teeth by other school dentists.
Former staff members have said officials, including former dental school dean Karen West, DMD, were aware of billing irregularities. Dr. West is now the president of the American Dental Education Association.
Data showed that Dr. Devore performed two surgical extractions and about 500 simple ones during his four years at the school. However, a closer look at detailed billing data showed that the university billed Dr. Devore's patients and insurance for a minimum of 790 surgical extractions and approximately 270 simple extractions from 2014 to 2017. The average price of a simple extraction is $42 whereas the average cost of a surgical removal of a tooth can range between about $110 and $300.
Records further show that about $400,000 of Dr. Devore's approximately $600,000 income in 2017 came from payments he accepted from patients, according to the report.
About two dozen patients of Dr. Devore were billed for a simple and surgical extraction on the same tooth. The review also revealed that Dr. Devore billed at least one patient for a procedure that was never performed. On at least three occasions, he billed for molar root canals on teeth that weren't molars.
Dr. Devore contended that he only billed for procedures he performed and provided charts to the school's billing department and left them to send appropriate bills to patients and their insurance companies.
Not the first time
The billing discrepancies are just the tip of the iceberg for Dr. Devore. Prior to the overcharging drama, Dr. Devore was found to have used single-use healing abutments, made unjustified payments to one of the university's top dentists, and failed to disclose the investigation into the school's billing practices to the public, according to the news report.
In 2017, the school announced that it was hiring a law firm to investigate Dr. Devore's reuse of abutments. However, it was later discovered that the firm was tasked with reviewing the billing practices at the faculty dental practice. A whistleblower at the school brought the billing irregularities to the administration's attention.
Issues with other faculty dental staff
Analysis of the data also showed that patients received bills, stating certain clinicians performed procedures when, in fact, others, such as dental assistants, completed them. The state dental board states that dental assistants can bill insurance under licensed dentists, but bills must reflect who performed the procedures.
The data provided by the school also showed that dentists other than Dr. Devore billed for different procedures on the same tooth in about 100 instances, according to the report.
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