I am a receptionist at my dentists office and we are under investigation for health care fraud, what will the consequences be?

If the Dentist Office you work at is under investigation of Health Care Fraud, there must be a long pattern of sketchy insurance claims. Health Care Fraud is considered very serious in the US and costs the country nearly over $100B in damage each year. Common violations of Health Care Fraud include over billing for misrepresented service, billing for services not provided, misrepresentation of a patients condition, and basically anything which is clearly misrepresented or fradulent in the scheme of obtaining added compensation from the insurance carrier. The fradulent act can be committed by either by the group provider, patient, or even a Health Insurance agent.

If your Dentist is convicted, some penalties include the possibility of improsenment for up to a few years, massive fines (each false claim has the penalty of $10,000 + the amount of the claim, so if there were hundreds upon hundreds of claims even at small values, the amount can add up to $5-20million easily which has already happened to many small practioners of health care around the counry), and having revoked priviledges of rendering health care services through insurance carriers for up to 5 years or longer. Depending on the circumstances, he may be offered an opportunity to repay the fradulent compensation plus a much lower surcharge of fines (given he can pay that amount immediately).

However, it is not clear whether you will be convicted as partaking in the Fraud or not. My personal opinion, I think you should be okay considering you are creating these bills under full instruction of your Dentist. You would not be aware of what service he is actually providing as your job requires you to sit in the front office, and not observe the rooms where the health care is being provided. However this is just my personal speculation. You would more than likely be cross examined in the court trial so there may be a possibility that you can face some of the consequences if convicted.

You should consult with a Criminal Defense Lawyer immediately to be aware of your rights and defenses for a Health Care Fraud charge. It is imperative to be very careful what statements you provide to the investigators as they may be held against you in court and self incriminate yourself. Speak to a Lawyer first, immediately.