Ex-employee sues dentist over Medicaid billing dispute

The former office manager for a Texas dentist has filed a wrongful termination lawsuit against the dentist, claiming she was fired for refusing to take part in "improper and illegal billing practices."

Shelly Hamnett, who had 19 years of experience in dental billing, worked for eight months for Sweeta Walia, DMD, and Premier Family Dentistry in Plano, TX, according to a press release from Kendall Law Group, the attorneys representing her in this case. She claims she was fired in October after raising concerns about Dr. Walia's billing practices.

Dr. Walia was not available for comment.

In the lawsuit, Hamnett details how she began receiving a "substantial" number of denial letters from insurance carriers who found that the services Dr. Walia provided were either medically unnecessary and/or were not supported by documentation.

Approximately 40% of Premier's patients are covered by Medicaid and the Children's Health Insurance Program.

After receiving the denial letters, Hamnett reviewed the office's billing records and found several alleged irregularities, including cases in which insurers would be billed for more expensive materials than patients received, billing for two-day procedures that took only one day, and billing for procedures that were never performed, according to Kendall Law Group. She also found instances in which the dentist performed procedures that were unnecessary or more expensive than necessary, the complaint states.

Hamnett claims she raised her concerns to Dr. Walia, who allegedly admitted to the fraudulent billing and ordered Hamnett to cooperate. She refused and was fired two days later, according to the lawsuit.

The lawsuit is Shelly Hamnett v. Dental Impressions, Inc. d/b/a Premier Family Dentistry and Sweeta Walia, DMD, in Collin County, TX.