In 2009, the National Health Care Anti-Fraud Association (NHCAA) estimated that 3-10% of the nation's annual benefits paid for health care were paid for fraudulent or abusive submissions. Estimations by fraud analysts indicate that there is a greater percentage of fraud in dentistry than there is in medicine. Because insurance fraud significantly impacts the cost of dental benefits, you can play a key role in identifying and reporting suspicious activity.
The NHCAA reports that the most common fraudulent acts include:
The close monitoring of processed claims via Superior Dental Care's (SDC's) secure web access (Superior Direct Connect: www.superiordental.com/directConnect.htm) is one easy way to monitor submitted and received claims. If you are aware of any false information submitted to SDC, please contact our Dentist and Member Services Team at 937.438.0283 or 800.762.3159 to report the activity. If preferred, a written complaint may be mailed to: Superior Dental Care Alliance Inc., Special Investigating Unit, 6683 Centerville Business Parkway, Centerville, OH 45459.
SDC's Special Investigating Unit handles all reports of suspected fraud expeditiously and with confidentiality. Reports are accepted anonymously; but, every report initiates an investigation. SDC takes necessary actions to report confirmed fraudulent activities to appropriate state agencies and to recover monies paid in association with misrepresented services.