The dentist is under audit by a dental plan due to issues with claims, but inattention or mistakes do not necessarily constitute fraud. For fraud to be established, specific conditions must be proven, including knowledge, intent, and damage to the dental plan. The burden of proof is high for criminal fraud, making it unlikely in this situation. The dentist's main concern should be a breach of their participation agreement and the need for better billing practices.
Schulte, Daniel JD
"Dentistry and the Law: Did I Commit Fraud?,"
The Journal of the Michigan Dental Association: Vol. 105:
7, Article 2.
Available at: https://commons.ada.org/journalmichigandentalassociation/vol105/iss7/2
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