More than I bargained for

I didn’t really want to work for anyone else when I graduated, I just liked the idea of being my own boss and so I found my own premises to set up in. I’m happy still with the decisions and choices I made, although it came with challenges.

Employing staff was a lot harder than I thought it would be but I ended with a mix of experienced staff and brand new people who wanted to learn. My practice manager was a great find. She was local, knew everyone and had recently left a practice when it had changed owners. I should have checked her references, but I was more worried about all the red tape of practice and she was nice, and seemed to know what she was doing.

I had prepared myself for a slow start but my first day was busy and I got busier and busier, with a lot of prosthodontic work. I like making partial dentures and doing crown preps and so I was happy with the way my business was developing. In my heart, I knew that people were only coming to me because I was cheaper than my competitors, but I hoped that with good quality work, I could grow by referral and then gradually increase my fees – see fewer people but charge a bit more.

The pace continued, and I began to rely on my staff more and more to do their job without being overseen. I employed extra support staff to enable me to work two surgeries simultaneously.

Then I received a health fund audit. I thought this was just routine and sent the records as requested. I didn’t check who they were. I didn’t check their HICAPS receipts. I didn’t think about it again, I was too busy.

The worst day of my life was the day a letter arrived suspending my provider privileges and telling me I needed to pay back a huge amount of money for incorrect billing. Incorrect billing? What was that? I had done all of the work. I contacted Dental Protection and they talked me through what to do. I got the patient records and compared with the health fund records – they didn’t match. For example, if I had done a crown for 26, the patient had paid not for a crown, but for 5 fillings instead – same money to me, but not the same to the health fund, not at all.

I spoke to my practice manager to get an explanation. I thought she would be upset or apologetic, but she wasn’t. She said it was ‘standard practice’ and told me not to worry. I asked her to leave. She threatened to destroy my business by bad mouthing me but it didn’t matter, I felt she had already destroyed it through dishonesty.

I couldn’t believe that Dental Protection helped me, but they did. They helped me with a letter to the health fund to explain and they came to a meeting with the health fund and me. As a result of this, I got my provider recognition back, but I did have to pay back an amount for the dodgy billing. That was tough, particularly as it wasn’t me, but I do understand it is my provider number, and so my responsibility.

I now check all of the billings that go through HICAPS, because I can never ever be in this situation again, it’s an extra job, but it’s worth it. My practice has continued to grow as the patients liked me and the work I did. It’s a relief. I would advise anyone to keep an eye on their provider number!