Dentists, What Do You Do When TMHP Demands Money You Haven’t Billed For and They Haven’t Paid You?

moneyWell, the answer to that question is about to be answered shortly.

TDMR was contacted today by none other than Dr. Paul Dunn, the long-suffering dentist from Levelland who thought his troubles with Medicaid were over when he settled his case earlier this year with the Health and Human Services Commission Inspector General.

Dunn ended up doing the settlement for the amount of money that had been withheld from his Medicaid payments as he didn’t have the funds to go to court and fight.

Received demand letter for $10,412.50 but hadn’t billed anything like that

So he was unpleasantly surprised yesterday when he received a letter from the Texas Medicaid and Healthcare Partnership that they were demanding back a further $10,412.50.

Dunn checked his bank account because he had never billed TMHP for any such amount.  Yet the letter said he had to repay the amount within 15 days from the date of the letter.  The letter did inform him he had the right to an administrative hearing though.

TMHP trying to collect for funds it hasn’t paid!

Then he went back and read the letter closely.  The letter was written on March 11, 2016 but states that Dunn was paid the money on March 18, 2016, SEVEN days in the FUTURE!

When TMHP contacted, doesn’t know anything about it

So Dunn immediately gave TMHP a call and the functionary he spoke with told him that they had no record of the payment or letter.  But they were going to “escalate” the issue and he should get a call back in a few days.

Now that is great administration and should give every dental Medicaid provider confidence in the system.

Accenture is obviously doing a better job running TMHP than Xerox, the company they replaced when Xerox was terminated and sued by the state for its suspect orthodontic prior authorization process!

Dunn letter

 

2 Responses

  • I have been investigated by the AG office for almost 3 years. Only had one meeting like a year and half ago.
    They havent accussed me of anything but they keep interviewing ex employees without finding anything.
    I already admitted the billing errors at the meeting and the money was return even before that meeting took place.
    Is there anything that can be done since a lot of dentist are getting settlements and or fines.
    Why I cant get a due process and finish this.
    My lawyer keeps on sending email to them and they dont even have the ethics to answer back.
    I think this is an abuse and has to stop.
    Please is there something that can be done.

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