“Maneuvering the Coding Minefield. Do Dentistry, Not Time"With Dr. Roy Shelburne
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“Maneuvering the Coding Minefield. Do Dentistry, Not Time"With Dr. Roy Shelburne

“Maneuvering the Coding Minefield. Do Dentistry, Not Time"With Dr. Roy Shel...

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Bonadent Dental Labs

2495 BonaDent Drive

Seneca Falls, NY

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Come join us on October 14th 2016, at 9am. 

Audience: Dentist, Hygienist, Assistants and Front Office

4 CE AGD PACE

Guest Speaker: Dr. Roy Shelburne

When the practice is paid rapidly and appropriately, things are good; however, when there are delays, denials, and requests for additional information, thing are not quite so good.  Mistakes can be devastating to the practice. 

During the investigation as well as in the preparation for and during my trial it became apparent that my billing and coding systems were faulty.  I now educate others so that they can bill and code appropriately. My message is; it is possible to implement systems that can form a proactive defensive systemic approach that will result in maximum legitimate reimbursement.  To be prepared for this challenge the team must be careful, concise, complete, and diligent.  Learning and implementing my approach will result in higher reimbursement while reducing the risk associated with the coding piece of the practice.  If the deficiencies in your systems are ignored both doctor and staff are at risk.

Objectives:

·         To recognize the dangers in coding improperly and benefits of coding properly

·         To know the most commonly misused codes and how to avoid the “usual” errors

·         To be able to develop systems that get your services paid and prevent coding errors



About Roy S. Shelburne, DDS


Born in Pennington Gap, VA, I was "raised" on a farm in rural southwest Virginia. Growing up there I learned to love the people and the scenery of the Appalachian Mountains. The second of 4 boys born to a High School agriculture teacher and a registered nurse, working on the farm instilled the importance of hard work. I'm deeply thankful to my parents for the example they set for me. I graduated from Pennington High School in 1973, with honors, and was accepted and enrolled at the University of Virginia, Charlottesville the fall semester of that same year. I was a 1977 graduate of the University of Virginia with a double major in Biology and Religious Studies.  I applied, was accepted to, and enrolled in the dental school at Virginia Commonwealth University and graduated with honors in 1981, 5th of 115. I returned home in 1981 to start my new practice in my grandfather's hardware store building.

Serving organized dentistry as a former Secretary/Treasurer and President of the southwest Virginia, Component 6, Virginia Dental Association I learned the importance of giving back to the profession. I was honored to be been made a delegate to the Virginia Dental Association's Annual Meeting. I also learned the importance of volunteerism....giving back to my community, state, and world as I had been so richly blessed.  I have served for over 7 years with the various Mission of Mercy projects in Virginia and have been a member of a team of short term missionaries with the Baptist Medical Dental Missions International to Honduras, CA for 10 years. All this happened prior to the voluntary surrender of my dental license for revocation after the conviction and prior to sentencing. 

The criminal action began as an investigation by the Commonwealth of Virginia and the FBI in 2003 of the dental practice and myself. To this day, we still do not know what or who initiated the action. I was indicted in October of 2006 after evidence was presented twice to the Grand Jury in the western district of Virginia. I was tried in United States District Court for the Western District of Virginia, Roanoke Division in Abingdon. I was found guilty after a 9 day jury trial on March 6, 2008, of Health Care Fraud, Racketeering, Money Laundering, and Structuring. The money laundering convictions were set aside on July 1, 2008. On July 10, 2008, I was sentenced by the Honorable James P. Jones, of the Western District of Virginia to serve 24 months in Federal Prison with an additional 36 months of supervised probation. I am now serving the 36 month of supervised probation. During the sentencing, the prosecution presented witnesses and evidence to establish, support, and "demonstrate the amount of loss sustained by the victims as result of the offense”. Of the payments that I received during the six and a half years reviewed (payments in excess of three and a half million dollars) that loss was determined to be $17,889.57. In addition, I was ordered on March 6, 2008 to forfeit $200,000 as a result of the RICO and Structuring conviction. A penalty of $75,000 were ordered on July 10, 2008. The restitution represents "restitution to each victim in the full amount of each victim’s losses”. The Government began an appeal of the decision in the criminal case; however, has since abandoned that appeal. The criminal case is now final as a matter law.  The government continued their attempts to again prosecute me and the practice via a civil complaint filed on November 6th, 2009.  That action was settled without going  to trial in February 2013.  The civil complaint was based on the same alleged course of action and claims as in the criminal action.  For the time being, there are no pending actions against me, but who knows how long that will continue to be the case?

It is my honor to speak, write, and consult on the subject in the hope that what happened to me will not happen to anyone else.
Visit:http://www.royshelburne.com/
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Date and Time
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Bonadent Dental Labs

2495 BonaDent Drive

Seneca Falls, NY

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