NH settles Medicaid billing dispute with orthodontist

Nov 23, 2010

Frederick Salvatoriello, DDS, who practices in Claremont, New London, and Hanover, NH, has agreed to repay the state $225,000 following an investigation of Medicaid billing in his offices, according to the New Hampshire Attorney General's Office.

The agreement resolves an audit of the Medicaid billing codes used by Dr. Salvatoriello's practice when treating more than 1,500 Medicaid beneficiaries between 2007 and 2009. The audit found that Medicaid reimbursed Dr. Salvatoriello for services related to preorthodontic visits, palliative treatment, and periodic oral evaluations that were already reimbursed under other codes, including the established rate for comprehensive orthodontic treatment.

The audit also disallowed certain claims for limited orthodontic treatment because of insufficient documentation that those services were distinct from the comprehensive orthodontic treatment provided. Dr. Salvatoriello also charged for functional appliances without obtaining Medicaid's prior approval, incorrectly believing the appliances qualified as space maintainers and were therefore exempt.

In addition, the audit determined that Dr. Salvatoriello was not entitled to certain evaluation fees for patient x-rays and models that were submitted to the state for prior approval of services.

There was no allegation of any intentional wrongdoing, and Dr. Salvatoriello fully cooperated with the audit, the attorney general noted.