Mayday for Identity Theft Provisions 2009
By Darrell K. Pruitt; DDS
On October 22, 2008, the FTC announced that it would delay the enforcement of the Red Flags Rule for healthcare providers for six months – until May 1, 2009. A handful of attentive dentists, as well as ADA Chief Legal Counsel, Tamara Kempf, released a sigh of relief. Ms. Kempf immediately went to work to persuade the FTC to delay enforcement “indefinitely.”
The FTC Delay
Four days later, Kempf caught the mood of the few who were paying attention in her quote for an article on DentalCompare.com:
“We are very pleased that the Federal Trade Commission has postponed for six months its implementation of the ‘Red Flags Rules.’”
http://www.dentalcompare.com/news.asp?newsid=250078
The DentalCompare article continues:
“If the FTC persists in its position that dentists are covered by the rule as creditors, the ADA will make available a sample compliance plan or program well in advance of the new enforcement date. Dentists will have sufficient time to consult with their personal attorneys and to put an appropriate identity theft prevention program into place, according to the ADA’s Legal Division.”
The ADA Legal Division
Did the ADA’s Legal Division follow through with its promise? If information about the Red Flags Rule is posted on the ADA News Online Website early tomorrow morning, is a 24 day warning considered by the ADA to be “well in advance”? (Emphasis mine) As reassuring as Kempf’s words sounded five months ago, it can be argued that the ADA’s intentions were misrepresented to DentalCompare. I checked the ADA Online Website and found nothing at all about preparation for the Red Flags Rule – at least not yet.
http://www.ada.org/prof/resources/pubs/adanews/index.asp
ADA Archives
When I searched the ADA archives for “Red Flags Rule,” I was provided seven links to the topic, but none included “a sample compliance plan or a program.” Three of the links are irrelevant, three are to articles about the delay of the FTC enforcement, and one is a link to a hopeful letter dated November 24, 2008 and addressed to William E. Kovacic, Chairman of the Federal Trade Commission. In other words, I found nothing that will help dentists become FTC compliant well ahead of time.
HIPAA
If the ADA’s help in preparing members for the 1996 HIPAA Rule is any indication of the help members can expect with Red Flags Rule, it will take the ADA at least 13 years to start on the Red Flags. The leaders of the otherwise conservative ADA seem to have bet a huge chunk of membership trust that Kempf and the Legal Affairs department would succeed in delaying Red Flags enforcement indefinitely, and that the Department of Dental Informatics would not have to admit that contrary to what they led members to believe, computers in dental offices are rapidly becoming too dangerous and too expensive for the profession. For many dentists, pegboards, carbon paper and ledger cards are looking better and better. You can forget about paperless practices. What happened, ADA?
The groveling November 24 letter to the FTC chairman that was signed by Kempf and cc’d to ADA President Dr. Johns S. Findley and President-elect Dr. Ronald L. Tankersley, officially begs for forgiveness and appeals for bureaucratic mercy to allow dentists to be excluded from becoming Red Flags-covered entities.
http://www.ada.org/prof/advocacy/let_081124_redflags.pdf
Since the fines for non-compliance of both HIPAA and the Red Flags Rule are obscene, and since the leaders of the ADA continue to fail to inform members what they should do to prepare for unannounced inspections from either HHS or the FTC, I will once again do the Department of Dental Informatics job for them, and let readers in on the secret.
An Economic Threat
If you wish to continue to accept assignment from insurance companies, and/or otherwise extend credit to your patients, the FTC recently posted a helpful pdf document titled “Fighting Fraud with the Red Flags Rule – A How to Guide for Business.”
http://www.ftc.gov/bcp/edu/pubs/business/idtheft/bus23.pdf
Dentists have become the nation’s unpaid fraud inspectors. And if a dentist’s practice is computerized, the more will be expected, or rather, demanded of the dentist, by law.
Here is a brief description of dentists’ Red Flags obligations lifted from the FTC document:
An Overview
The Red Flags Rule sets out how certain businesses and organizations must develop, implement, and administer their Identity Theft Prevention Programs. Your Program must include four basic elements, which together create a framework to address the threat of identity theft:
First: Your Program must include reasonable policies and procedures to identify the “red flags” of identity theft you may run across in the day-to-day operation of your business. Red flags are suspicious patterns or practices, or specific activities that indicate the possibility of identity theft. For example, if a customer has to provide some form of identification to open an account with your company, an ID that looks like it might be fake would be a “red flag” for your business.
Second: Your Program must be designed to detect the red flags you’ve identified. For example, if you’ve identified fake IDs as a red flag, you must have procedures in place to detect possible fake, forged, or altered identification.
Third: Your Program must spell out appropriate actions you’ll take when you detect red flags.
Fourth: Because identity theft is an ever-changing threat, you must address how you will re-evaluate your Program periodically to reflect new risks from this crime.
Note: More “red-flag” information may be obtained from the 2 volume, 1,200 pages, premium print guide: Healthcare Organizations [Financial Management Strategies].
Assessment
Since my business office still uses the pegboard, and no patients’ identifiers are on any computer, my official Red Flags policy is simple:
“Staff; if you notice anything unusual in relation to our patients’ accounts; or if you are handed an unusual-looking drivers license, notify me immediately”.
-The Management
My official notice will be fastened with thumb tacks to my wall of safety posters by May 1, 2008, and I will be in full compliance with not only HIPAA, but the Red Flags Rule as well. If the government continues its reckless, heavy-handed, one-size-fits-all laws, it won’t be long before I’ll be able to further undercut the fees charged by all computerized dental offices, and still make more profit. I say bring out the Department of Agriculture.
Conclusion
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Filed under: Alerts Sign-Up, Book Reviews, Breaking News, Career Development, Healh Law & Policy, Healthcare Finance, Information Technology, Managed Care, Practice Management, Professional Liability, Risk Management, iMBA, Inc. | Tagged: accounting ledger cards, ADA, AMA, American Dental Association, carbon paper, DDI, DentalCompare.com, Department of Dental Informatics, Dr. Ronald L. Tankersley, fake IDs, FTC, HIPAA, HSS, ID, identity theft prevention, Johns S. Findley, pegboards, red flag rules, Tamara Kempf, William E. Kovacic
I would like to note that the above comment was written twenty-three days ago, and twenty-two days ago, the ADA posted information about the Red Flags Rule.
Good thing they didn’t wait until less than three weeks.
Darrell
We have been covering the red flag rules for the last year.
Ann Miller; RN, MHA
http://www.HealthcareFinancials.com
Red Flag Rules delayed again. That was fun. Let’s do it again in July.
Darrell
Not Just for Dentists
There is no dispute: Red Flag Rules apply to health-care providers
The Fair and Accurate Credit Transactions Act of 2003 directed the FTC to promulgate rules requiring “creditors” with “covered accounts” to implement identity theft programs to identify, detect, and mitigate medical and personal identity theft. The FTC and the American Medical Association (AMA), joined with other related professional associations, have been in discussions regarding whether the Red Flag Rules apply to health-care providers. On February 4, 2009, the FTC, in a letter addressed to the AMA, declared that the Red Flag Rules apply to physicians and health-care providers.
The FTC has postponed the compliance date of the Red Flag Rules as a result of the uncertainty surrounding whether health-care providers were covered under the Red Flag Rules, which caused some providers not to implement policies.
And, on April 30, 2009, the Federal Trade Commission (FTC) agreed to delay enforcement of the new “Red Flag Rules” from May 1, 2009, to August 1, 2009, to give creditors, including health-care providers, more time to develop and implement written identity theft prevention programs.
Sandy Berkowitz
It’s now July 2nd, 2009. Just weeks before the Red Flag Rule Compliance deadline of August 1, 2009.
In a quick ‘n dirty survey our company just completed, over 70% of physicians, dentists and chiropractors we spoke to 1) still haven’t heard of the rule, or 2) believe that if they download a sample policy and file it away that they are compliant and 3) verfiying IDs constitutes compliance.
Nobody’s talking about the fact that over 70% of medical identity theft is from insiders, like employees, family and friends (of the patient). (See the World Privacy Forum’s 2006 report on Identity and Medical Identity theft).
Verifying patient IDs is closing the barn door long after the horse is gone, doesn’t prevent most of the theft that actually occurs and so is never going to protect doctors from the fallout of a theft.
We’re also now hearing that staff are turning patients away unnecessarily while verifying IDs, because they aren’t properly trained on what the Rule actually mandates. Sheesh.
Private practices are EASY targets for theft. A social security number sells for $1 on the street. Patient financial information sells for $50. It costs a doctor about $200 per record to repair a breach. Over 7 MILLION records were stolen in 2008. Small practices are sitting ducks.
The financial and public relations cost of a breach in a practice has shown to be in the many thousands of dollars without considering any fines due to non-compliance.
Our company has a website with lots of information on medical identity theft that might help doctors understand the implications, on our FAQ page (www.physicianredflagrule.com).
We’re hoping that whatever docs do to comply, that they do it for real.
Pamela Thompson
A blond, walking down the sidewalk, noticed a banana peel a few yards ahead of her. She pressed her hands against the sides of her face and exclaimed, “Oh no! Here I go again!”
10 days until Red Flags Rule – Again
Even though ADA leadership celebrated the second delay in the FTC’s Red Flags Rule deadline even heartier than the first, I think it is unlikely that our lobbyists can manage to delay the burden of compliance a third time. Suppose worse comes to worse, and instead of a most spectacular celebration yet, the August 1 deadline stands, and the Red Flags Rule becomes law for ADA membership:
- Have our leaders adequately prepared members for the liabilities of FTC oversight? Look around. I think most will agree they have not. The ADA is suspiciously silent, but no more than usual.
- If ADA members have questions to ask about how the Rule will impact their practices, can they depend on ADA resources for fast and accurate information? I have yet to find such responsiveness. My success for obtaining answers from the ADA is about 25%.
http://community.pennwelldentalgroup.com/forum/topics/transparency-and-the-ada-a
- And finally, if a dentist wished to avoid the FTC’s intrusion into his or her business, will it make a difference if CareCredit is offered through the practice? Good question. I’ve been working on it for a few weeks already, and yesterday I finally received tangible evidence that this question can be answered online by Cindy Hearn. I just don’t know if she will answer it in time.
Timely treatment is preventive treatment – but at what cost and risk to the dentist?
This continuing thread began on July 9 as my sincere question to CareCredit. “If the Red Flags Rule is not delayed for the third time in three weeks, how will it affect those who offer Care Credit?” I submitted it on the same day that DentalBlogs.com posted the article, “Press Release: CareCredit Adds 24-Month, No-Interst [sic] Payment Plan” (no byline).
http://www.dentalblogs.com/archives/administrator/press-release-carecredit-adds-24-month-no-interst-payment-plan/#more-3060
Since then, I followed up my time-sensitive question with four additional messages to CareCredit, ADA Business Enterprises Inc (ADABEI) and an anonymous DentalBlogs.com editor whom I named “Nancy” by default. Even though she allowed three anonymous sweet comments to be posted, all of my signed ones were censored. It is now July 22, 10 days before the Red Flags Rule deadline. Precious time has already been squandered because of DentalBlogs.com’s unethical reporting that is clearly biased by advertising clients’ interests. So will I get an answer from CareCredit before August 1?
Hello, Ms.Cindy Hearn, Vice-President of Marketing for CareCredit/GE
It turns out that the CareCredit vice president has been reading my censored comments about CareCredit. Even though she should have noticed my request from two days ago not to be called at my office, yesterday afternoon, she tried anyway.
I cannot help but suspect that Hearn called my office instead of responding online because she preferred to keep bad news about CareCredit quiet and private. On the other hand, it could have been an honest mistake that she skipped the very last thing I said in Monday’s message. Like Ms. Hearn, sometimes when I speed-read, I too misread important pieces of information.
Before Cindy Hearn was convinced that I will neither accept nor return her phone call, she told my office manager two important pieces of information: CareCredit is owned by GE (not the ADA as I had assumed), and that she can answer my questions over the telephone.
When I carefully re-read the CareCredit article, I figured out how I made the mistake about the ownership of CareCredit. I assumed that the wholly-owned ADABEI owned CareCredit because they are linked so often – not only in ADA publications, but also in the CareCredit article. In addition, “GE” was not mentioned anywhere.
As for her admission that she can answer my questions over the phone, I welcome the tangible evidence of progress at last. Hearn’s information urgently needs to be broadcast for the benefit of dentists who are considering signing CareCredit contracts. And it is far too important to be told second-hand by me. It is up to Cindy Hearn, VP of CareCredit to share her answers with everyone online. She is the person who should be held accountable now. Widespread marketplace communication has never been easier, and she really has no excuse to remain quiet about this. After all, she already admitted that she can answer my questions.
We could all win if GE’s leaders of CareCredit cooperate with transparency. Dentists could find out if providing CareCredit indeed increases their FTC liability before entering into a contractual relationship with GE. GE can be properly recognized as the source of the CareCredit ad posted on DentalBogs.com, and Cindy Hearn can gain Internet presence. She’s weak, like Trajan King was.
The revelation of GE’s quiet involvement with CareCredit reminds me of another obscure, revenue-promising ADA business venture with Intelligent Dental Marketing – a Utah-based dental marketing firm. Until he quit the job a few months ago, IDM was led by CEO Trajan King. On November 15, 2008, I emailed King some hard questions about the business relationship between my ADA and his IDM. Like CareCredit VP Cindy Hearn, CEO King also tried to privately answer my questions by calling me at work. However, he regrettably succeeded in gaining my reluctant attention.
Trajan King quit his job in May, and the ADABEI – IDM profit-center is no more. In hindsight, one can easily recognize signs of ground-level problems with the intra-business relationship other than institutional reticence. Even now, as the mistake is being painfully swallowed by the ADA, ADABEI and IDM still can’t agree on a name for the stinker. It is called “ADA/idm” by the proud ADA and “ADA/IDM” by equally proud IDM. American business is blessed with incredibly stoic egos, even when facing utter failure.
So here is my first question for Cindy Hearn, VP of Marketing for CareCredit/GE: Say a dentist does not otherwise offer financing for patients. If he or she signs a contract with GE, will he or she become a FTC covered entity – possibly on Aug 1?
CareCredit Vice-President Cindy Hearn has 10 days.
D. Kellus Pruitt; DDS
9 Days to Red Flags Deadline
I think Nancy grew tired of providing free moderation on company time.
I submitted the following comment to DentalBlogs.com a few minutes ago. Like the last half-dozen comments I’ve fruitlessly submitted, I expected this one to also require the routine moderation for a few minutes before being discarded without explanation. But this time, something different happened when I pushed “submit.” Instead of seeing my comment appear with the promise “Your comment is awaiting moderation,” my comment, “9 Days to Red Flags Rule,” disappeared completely. It was as if suddenly, today’s visit would have been completely erased from dental history if I hadn’t made a back up copy. Less than a day ago, I promised Nancy that I would be back for more moderation. What do you think happened?
I also noticed that Nancy is sure turning out lots of articles recently. Together, these two responses remind me of someone plugging their chubby fingers deep into their ears, while loudly singing “LA – LA – LA …”
So DentalBlogs.com prefers not to have its hate mail delivered to its mailbox where it can be conveniently read before warning Cindy Hearn about what is coming. That’s interesting. I think it is transparently foolish myself, and it’s not real fair to others that are becoming more and more involved in DentalBlogs’ mess.
Since DentalBlogs no longer wants to hear about it, Cindy is likely to discover the bad news herself through colleagues. That could easily drive a wedge between DentalBlogs and CareCredit. It certainly won’t make the officers any fonder of one another. I’m still trying to figure out – without going to too much trouble – how ADABEI fits into this dysfunctional family. Even though the ADA doesn’t’ own CareCredit like I thought, at the very least, our ADA is an enabler.
I find it fascinating how once a sharp stick gains purchase in a weak spot, the undermining is as easy as encouraging a run in a stocking. Its progress cannot be resisted any more than the inappropriate giggles, and squirming only makes the damage spread faster.
As yet, this adventure is still under the table. Is it just me, or do you also find this exciting in an ornery way?
http://www.dentalblogs.com/archives/administrator/press-release-carecredit-adds-24-month-no-interst-payment-plan/comment-page-1/#comment-35270
9 Days to Red Flags Rule deadline
Cindy, when are you going to come back down to Earth and face your market? We both know that as an officer of CareCredit, it is your ethical responsibility to properly inform dentists if there is indeed a Red Flags Rule liability from signing up for your bosses’ product. Transparency in business dealings is almost always the best thing, and you really need to come down and mix with us common folk before your tower is completely undermined.
We can either build from here, or you can expect me to entertain a bloodthirsty segment of my followers by publicly tinkering with CareCredit’s brand and your reputation. Do you really want to take such hits for the team? Ask Nancy, the anonymous editor of DentalBlogs.com, how it feels to be trapped between one’s boss and honesty. I’m not through with her either.
I promise you respect that I don’t have for Nancy. Nancy does not sign her work like you and I do. I think she proves that anonymity encourages poor behavior from employees because it rewards unaccountability. These days, faults in human nature can easily lead to bad PR on the Internet that starts out as a rumor. It appears to me that DentalBlogs.com is a biased blog that hasn’t enough pride to defend itself. I think that’s pathetic, and in my rule book, it makes DentalBlogs.com fair game for anything I might want to try out – perhaps involving contributors like Dr. John Cranham, Dr. Larry Emmott and Dr. Rhonda Savage.
I actually think CareCredit is a good product. Even though it is more expensive than most credit cards, it obviously helps patients obtain dental care they need, while at the same time, filling dentists’ chairs. I actually offered it for a while, and it worked out nicely. I enjoyed higher production for minimal investment. However, I quit offering the financing because it seemed that those who needed the help were not credit-worthy anywhere. Also, those who could get financing from CareCredit could find it elsewhere at a much better rate. So we stopped pushing it. Eventually, we shut it down because we found that we were paying a monthly fee for something we hardly used.
Cindy, I want you to let your bosses know that when I saw CareCredit’s generous response to the downturn in the economy it attracted my attention. Things are noticeably slow right now. I was actually looking into joining CareCredit again. That is why I properly asked the cogent question about the Red Flags Rule. Assure them I was polite at first, and tell them if someone had simply told me that CareCredit does not increase a dentist’s liability and administration costs, CareCredit would have signed up a new customer in Fort Worth, Texas.
As everyone can see, there was simply no excuse not to answer my question. It was only after I was insulted by unresponsiveness that it became clear to me that I just cannot allow such unchallenged disrespect to happen in my neighborhood, or it will happen again and again. People depend on me to help protect them from harm because there is simply nobody else around to do so. It is not my desire to see CareCredit go out of business like ADA/IDM did. I think CareCredit has redeemable qualities that ADA/IDM never approached, even if the bad manners are similar.
Cindy, it is my opinion that you are simply afraid of your market. Think about it. How can one be an effective VP of Marketing these days while harboring such fear? You also need to be more involved on the Internet. You are getting left behind, in my opinion.
As I am sure you know, I’ve raised audiences on several venues concerning the Red Flags Rule, and they are ready to hear what you preferred to tell me privately. I shouldn’t have to tell you that this will not end well for you or CareCredit/GE if you don’t cooperate.
Until tomorrow – day 8.
D. Kellus Pruitt; DDS
A neighborly ME-P Welcome to DentalBlogs.com
Wow. This has become an exciting day, sports fans. I’m having trouble keeping you abreast of fast-breaking niche news between seeing patients that my office manager has said I must see today. At this pace, there’s no telling what’s going to happen by August 1.
Immediately before I posted “9 Days to Red Flags Deadline” - in which I question why DentalBlogs.com (DB) refuses to post even my polite comments – I noticed that DB posted what passers by might mistake as an article on the PennWell blog titled “Growth and Expansion of Your Dental Practice” (no byline).
http://community.pennwelldentalgroup.com/profiles/blogs/growth-and-expansion-of-your
Since PennWell is the center of my neighborhood, the anonymous comment naturally attracted my attention – especially considering my recent history with DentalBlogs.com Here is their entire PennWell post:
“Check out the post by Linda Miles and Dr. Rhonda Savage on DentalBlogs today! These seasoned experts discuss dental practice expansion, growth, and investing in new technology in their monthly column, Two Sides of the Management Coin.”
As PennWell readers can see, this is more like an ad for DentalBlogs.com than an article, and the hyperlink that DB provided that was supposed to lead readers to Miles’ and Savage’s article, actually is a link to a garden-variety DB press release promoting Dr. Paul Homoly’s “Homoly Communications Institute.” Like Miles and Savage, he’s another DentalBlogs’ paying customer.
http://www.dentalblogs.com/archives/administrator/a-dental-blogs-exclusive-interview-with-dr-paul-homoly/
Like me, I’m sure the editor at DentalBlogs.com appreciates being informed as soon as possible so that she can correct mistakes like this. Indeed, because of the wrong link, DentalBlogs’ first venture into my neighborhood is meaningless and sort of frustrating for readers. Mistakes happen.
Why just recently, I mistakenly posted that CareCredit was a wholly-owned subsidiary of the ADA. I am thankful that CareCredit’s vice president of marketing Cindy Hearn noticed my error and brought it to my attention so I could make the correction yesterday (CareCredit is owned by GE).
Here is the correct link to “Two Sides to the Management Coin: Investing and Expanding Your Dental Practice” by Linda Miles and Dr. Rhonda Savage.
http://www.dentalblogs.com/archives/administrator/two-sides-to-the-management-coin-investing-and-expanding-your-dental-practice/
As expected from these two successful and respected veterans of the lecture circuit, theirs is an insightful article with lots of good points for struggling dentists contemplating investing in changes. Linda is one of my all time favorites. It’s too bad the link to their article is bad.
As a good neighbor, I informed DB about their bad link and welcomed them to the community a second time today.
Dear DentalBlogs.com: You accidentally provided a bad link for the article by Miles and Savage you promoted. I found the correct link for you.
http://www.dentalblogs.com/archives/administrator/two-sides-to-the-management-coin-investing-and-expanding-your-dental-practice/
Sincerely,
D. Kellus Pruitt; DDS
[Your new neighbor in the PennWell community. Welcome].
Here is the response I received from DentalBlogs: “Your comment must be approved before everyone can see it.”
Over the last several months, I’ve posted hundreds of responses following others’ articles on PennWell, and I have never before seen that message come up. Why is it that it’s the anonymous authors who seem to not respect others’ comments, even when signed? That, I guess, is one of those quirky things about human nature and accountability.
The unprecedented approval message was same response I was also given following my first welcome to DentalBlogs.com, just before it was rejected without explanation: “Good to see you here. Sincerely, D. Kellus Pruitt; DDS.”
Even if my second friendly gesture doesn’t attain approval to be seen by everyone, maybe the editor of DentalBlogs.com (whatever the name) will at least take my advice and repair their bad link. I actually didn’t have to bother to tell them about their error, but deep down, I’m really a nice guy.
D. Kellus Pruitt; DDS
8 Days to Red Flags Rule Deadline
Dear Cindy Hearn, Senior Vice President of Marketing for CareCredit/GE:
Please look at your credenza, Cindy. If you see a fat marketing textbook from a college course, recycle it with prejudice. The dental marketplace is changing faster than ink can dry. You are lucky that we collided because I have chosen you to accompany other fortunate healthcare stakeholders as we explore the boundaries of the new frontier together. To put it simply – you, CareCredit and even GE no longer have a choice in this adventure. You are my guests along for a ride you cannot refuse. And if you pull lame, prideful stunts – including silence – you could double as entertainment for sports fans that hang around. Sure, I’m a smart-ass bully. Why shouldn’t I be confident? I’m from inside the profession, representing only my patients’ interests. There are many reasons that I enjoy a better bargaining position than you, and I want everyone to know it.
Don’t allow yourself to get angry because of a cheap marketing trick. Strive to maintain professionalism because you’ll need it in the long run – regardless what happens here over the next week or so. You have suddenly found yourself in a strange, weakened position and you simply must make the best of it. We are establishing precedent. Play this right (or abysmally wrong, for that matter) and you could be mentioned in a future fat textbook on someone’s credenza.
I have claimed for years that slow-moving dinosaurs like CareCredit can no longer control information in what once was a soft, profitable and unnoticed niche industry. Since I started bringing transparency to my profession a couple of years ago, I have proven time and again that dentistry is no longer a tightly guarded secret part of healthcare – so traditionally dysfunctional that nobody dares to discuss it in public, other than me. Taking apart proud, huge businesses that have silently fed off my patients for decades is like dissecting a freshly killed business model that most thought became extinct for environmental reasons in the 1960s.
This thread discusses the Red Flags Rule deadline and CareCredit’s refusal to acknowledge an alleged liability of their product. I think this is the most flagrant example of institutional unaccountability I’ve yet come across. CareCredit’s deception by omission is only one reason why there is so much waste in healthcare these days. It is easy to imagine dentistry as a microcosm of the nation’s healthcare, and it is my opinion that too many healthcare dollars spent in dentistry never make it to patients’ mouths. And for once in history, dentists are not to blame.
I think in the short time we have been acquainted, Cindy, I have clearly shown that we are entering a time in dental history when there is no longer anywhere for healthcare stakeholders to hide from accountability to the principles – dentists and patients. Once this is pointed out, readers can easily recognize the warning sign that CareCredit’s liability is hidden as part of a marketing plan that includes pushing uninformed ADA members into signing contracts before August 1 – less than 8 days from now.
Even if you never agree to come to the table, Cindy, I’ll take you and your boss to the cutting edge of modern marketing and beyond. Together we can be the first in the nation to discover the challenges and pitfalls of the brand new pecking order in the dental industry. This is a truly historical victory for dentists and patients that will never make the evening news. I find the minor-league exciting.
Never before have dentists had a voice in negotiations on behalf of their patients. Now we do.
Until tomorrow – Day 7
D. Kellus Pruitt; DDS
Asking for a solid from DentalBlogs.com
I was curious whether DentalBlogs corrected their bad link to the Miles and Savage article featured on the DentalBlogs.com website, so I checked it out. The bad link has been fixed. That’s tangible progress for the community’s newest member. I think that shows good citizenship.
However, I ran into difficulty when I attempted to post a comment following the Miles and Savage article, so I explained it to the editor of DentalBlogs as a comment following her PennWell article.
I’m posting it here just in case. Sometimes my comments evaporate with no explanation.
Dear DentalBlogs:
I submitted the following comment to DentalBlogs.com to follow Miles’ and Savage’s article. I’m not certain that it was accepted, because I was not reassured that it was waiting to be moderated.
Could you do me a solid and see to it that it is posted? After all, I was the one who let you know of your error. I’m happy for you. Thanks a bunch, Nancy.
Oh yea. Welcome to the PennWell Blog.
http://www.dentalblogs.com/archives/administrator/two-sides-to-the-management-coin-investing-and-expanding-your-dental-practice/comment-page-1/#comment-35286
I’m pleased to see that DentalBlogs.com fixed their bad link that was posted on PennWell blogs. Miles and Savage put together a good article that will be appreciated PennWell readers.
D. Kellus Pruitt; DDS
7 Days to Red Flags Rule Deadline
Not much to write about today, so I’ll wing it.
As I piddle with undermining board meetings of Internet-clueless executives of very large entities on multiple fronts, I’m often reminded that the vulnerabilities I exploit were predicted almost a decade ago in the book “The Cluetrain Manifesto,” written by Rick Levine, Christopher Locke, Doc Searls and David Weinberger.
http://www.cluetrain.com/
What follows is a series of 5 Theses from their list of 95 that they defiantly nailed to the door of Big Business. Please, sit back and let me present documented prophecy of Reformation, 2000 AD.:
8. In both internetworked markets and among intranetworked employees, people are speaking to each other in a powerful new way.
9. These networked conversations are enabling powerful new forms of social organization and knowledge exchange to emerge.
10. As a result, markets are getting smarter, more informed, more organized. Participation in a networked market changes people fundamentally.
11. People in networked markets have figured out that they get far better information and support from one another than from vendors. So much for corporate rhetoric about adding value to commoditized products.
12. There are no secrets. The networked market knows more than companies do about their own products. And whether the news is good or bad, they tell everyone.
Maybe by tomorrow I’ll have more to offer than quotes from a dusty old manifesto. Maybe someone will stand tall and offer fresh news about CareCredit that can be shared with those who might chose to participate in their plan by the recommendation of the ADABEI.
Today, not much interesting happened. However, I did come across a shocking ad targeting healthcare providers who store patients’ identities in their office computers. That would be approximately 96% of the nation’s dentists.
http://www.physicianredflagrule.com/
Here is a paragraph in the ad that I found particularly disturbing about the Red Flags Rule:
“Your staff must be trained CORRECTLY, or they might turn patients away unnecessarily. We’ve already heard of this occurring. We have a thorough SELF TRAINING process, with step-by-step guides, materials, tests and certificates. Staff can study ON THEIR OWN, turn in the test, and now you have evidence in their personnel file. FTC Compliance? Done. Educated staff? Done. Contracts, forms, letters and reports. All in the Toolkit. You’re safely in compliance.”
“Staff can study on their own?” “Tests and certificates for employees’ files?” Haven’t we had enough of those games yet?
Not only is the Red Flags Rule as oppressive and unenforceable in dentistry as HIPAA, but if the FTC foolishly pursues the law any more aggressively than HHS, they could drive computerization smooth out of dentists’ business offices. Pegboards and ledger card boxes work satisfactorily for small offices, and they don’t have USB ports.
There is no telling how long it will be before the ADA utters a peep about the Red Flags Rule. What we are witnessing here is consistent with Thesis number 12, which I repeat for emphasis: “There are no secrets. The networked market knows more than companies do about their own products. And whether the news is good or bad, they tell everyone.”
Maybe I’ll say more about the return on investment of Red Flags Rule compliance tomorrow. If your office manager likes his or her computer, you should review the ad. It looks like you’ve got work to do, and only 6 days to do it.
Attention US Congress:
I can only guess at the reasons my ADA representatives are shopping to win a third 11th hour delay in enforcement of the Rule, but regardless whether they have you at a tipping point, I sincerely plead for you to please go along with a delay one last time in the interests of all Americans. As a concerned dentist with a unique view of my industry, I warn that it is clearly not in the interests of tax payers or dental patients for agents of the US government to intrude carelessly into our practices when we are so abysmally unprepared for your inspections, and quite frankly, your ambitious employees still scare us because we still respect your power.
I’ve been working my shtick on dentists for quite a while. It’s a tough crowd.
Please give us one more chance to repair our horrible security holes in a meaningful way. Those in the mouths of dentistry on a daily basis know exactly what I mean when I warn that a heavy hand, especially in this economy, will appear authoritarian, wasteful and foolish. I speak respectfully and honestly with you when I warn that my profession is so far from HIPAA and FTC compliancy that pressure hasn’t a chance of causing meaningful improvement in security. Inspections will only raise the cost of dentistry for people with toothaches, and drain the morale of the poor slobs in the FTC. I know some of the rascals your agents will be dealing with – one at a freakin’ time. Be warned that we fiercely protect our patients from everyone, including you. Yet some of us are admittedly ineffective in protecting their security, and that liability simply has to be all but eliminated in dentistry. Let’s not blow our chances for real solutions now by forcing the FTC to squander their fear factor. It takes far too long to rebuild respect with dentists.
Please give us to the end of the year. I have an idea and a decent audience. We can side-step this exploding identity theft problem in dentistry. Then again, maybe we can’t.
D. Kellus Pruitt; DDS
6 Days to Red Flags Rule Deadline
Tension builds in a boring, obscure niche market – even as we sleep.
As hinted by that excuse-me introduction, I’m out of ideas, friends. I winged it yesterday and my piece turned out to be an acceptable dud. I’m warning readers that if you want to turn away now, I’m really, really running low on material concerning the CareCredit drama. Please don’t expect much today. Maybe Monday morning will bring fresh news to chew on.
Since I’m not a union writer who gets paid for filler, I grow bored with describing the same scenes in different ways, from different angles, over and over. Regardless of whether I am paying attention or bored, this reality show I signed on to direct as well as to report, steadily evolves in undermining ways that cause panic that we can only imagine. Wouldn’t you just love to know what’s being said between CareCredit vice president Cindy Hearn and her boss at GE as they discuss the FTC’s rules? Perhaps GE will some day allow the priceless, action-filled transcript to be shared in a textbook that describes modern business errors – with illustrations. That chunk of dark comedy has enough juicy elements for an episode in a prime time sitcom.
In my boredom, I imagine that Cindy’s boss is a nervous, jittery type of executive who came up the ranks through accounting and with a lot of help from an uncle. In his 17 years with “GY” (often called “Gee. Why?” by the financial company’s detractors), everyone on the 4th floor assumed Hank had people skills that his colleagues on the 3rd floor knew he lacked big time – but were very quiet about. The 4th floor rumor stopped abruptly about 15 minutes into the last company picnic around the horse shoe throwing-as-hard-as-you-can pit. Now Hank not only finds himself in a job he hates and doesn’t understand with tactless, west Oklahoma emotion, but he always eats alone. I have to say I would choose Louis Black for the part of Hank.
I’m not yet sure whom I would prefer for the part of the struggling vice president under Hank. Right now, I’m thinking Sarah Palin… no. I’m sorry. I meant to say Tina Fey.
… What? Does it make anyone other than Hank, and perhaps Sarah, uncomfortable for me to creatively fill in the personalities of those who knowingly sit on important, time-sensitive information while still making money from those they deceive? Does GE’s business plan remind anyone else of Bernie Madoff’s?
Even though I still seem to be gaining more readers from this countdown than I’m losing, today I sensed it was time for a change of pace. In addition to the boredom-inspired screenwriting fantasies that you trudged through, I sent a strident message addressed to Cindy Hearn on Twitter. I told her it was my part of the private telephone conversation she sought but will not have. If one is interested in what I shared with her today, I was quite uninhibited. They call me “@Proots.”
Sorry I didn’t have anything more interesting to share. Maybe tomorrow – 5 days before the Red Flags deadline – news will break from somewhere, and I won’t bore you with sitcom drivel.
D. Kellus Pruitt; DDS
DentalBlogs sees the light
Good news for the neighborhood, everyone. DentalBlogs.com is overcoming its shyness and is on its way to becoming a model citizen in the community. Today, I discovered that Nancy changed her mind about me and decided to post two of my comments on the DentalBlogs.com Website. She posted my compliment to Linda Miles and Dr. Rhonda Savage concerning their dentalblogs.com article “Two Sides to the Management Coin: Investing and Expanding Your Dental Practice” They wrote a good piece.
http://www.dentalblogs.com/archives/administrator/two-sides-to-the-management-coin-investing-and-expanding-your-dental-practice/#comments
She also posted my comment about Facebook from yesterday following the article “Why Dentists Should Hook Up with Social Media” (no byline).
Do you recognize her rehabilitation? Do you think I should let up on Nancy now – even before she provides us her real name? I don’t think that is in the best interest of Nancy or the community.
I submitted this to be posted following DentalBlogs.com’s only article on PennWell forum, “Growth and Expansion of Your Dental Practice” (no byline). As usual for DentalBlogs.com but for nobody else on the PennWell blog, I was told the following comment would have to be approved before it will be allowed to be seen by everyone.
Wanna bet?
Dear DentalBlogs.com:
Today I noticed that you started posting selected pieces of what I’ve sent you. Though we are making progress, I’m sure you know that I expect you to post everything I’ve sent – including this piece – or explain why not to everyone. We work hard to keep our neighborhood clean. We like it that way.
Keep going. Nancy. We’re almost friends.
D. Kellus Pruitt; DDS
Even if by some miracle the Rule’s deadline is delayed one more time, the Red Flag Rules are only the beginning.
The security breach notification provision of the HITECH law goes into effect somewhere around mid-September. This is part of the updated HIPAA and HITECH regulations passed within the 2009 ARRA.
If you have a breach of 500 or more records (any electronic breach), you must submit your name to the HHS website and in major media in your region, unless you have encrypted all hard drives, portable media, etc., for data at rest (that stored on your system) and data in motion (i.e., transmitted, internally or externally).
So it looks like HHS will out-bully the FTC after all. Whew! That was close!
The good news is it is not difficult to encrypt hard drives to federal standards (found in FIPS 140-2). Windows 2000, XP Pro and Server 2003 and up have encryption capability built-in that so far, looks to be FIPS-140-2 qualified. I am awaiting confirmation from the government, which I would be happy to pass on.
May I add to Dr. Pruitt’s advice?
Insurance reimbursement isn’t a necessity for dentistry. Get out of it while you still can (and pray you are not part of healthcare reform). Go cash all the way. It’s the best medical model out there. By the way, patients paying with credit cards does not make you obligated to the Red Flag Rule.
Most docs won’t go back to pegboard, but it is a lovely thought. So unfortunately 2009 HIPAA / HITECH will apply. Actually, that might make you go back to pegboard.
HITECH is a month or so out. I expect that there will not be any HITECH delay, as people know less about HITECH than they do about Red Flag, if that’s physically possible. So stink-making is probably not occurring with gusto. Or at all.
I digress. Back to Red Flag.
As Dr. Pruitt said, lots to do. Red Flag Rule compliance is a few days away.
If it makes you feel any better, 78% of the physicians (not dentists) we have surveyed nation-wide (granted, only a few hundred so far this week), have no idea what the Red Flag Rule is, nor do their Office Managers. So their associations aren’t getting through either. We didn’t have the heart to ask them if they’d heard of the new HITECH law.
1996 HIPAA was never enforced, cost untold millions to implement, and I don’t know how much actual protection was provided. And really, from a patient’s perspective,who cares about the guy’s polyps who’s sitting next to you in the waiting room?
But the new Red Flag Rule law might be something that patients actually care about. Financial and medical identity theft is expensive to fix for patients and doctors. Regulatory penalties aren’t the half of it.
I don’t know any doctor who wants to comply to it and I sympathize. However, Red Flag Rule compliance isn’t that onerous a matter (OK, relative to HIPAA /HITECH) if you understand the law and its requirements.
Problem is, the FTC document (or association document, which is just as bad) is given to staff to execute, who have a hard time discerning what the law’s crafters meant after the title. So compliance doesn’t really happen, and if it does, it is with a fair apportionment of pain all around, with more doctor time spent than anyone wants to invest (which is none, I know).
If a government is going to insist that we do something they ought to write it so we can understand the darn thing. You practically have to be an attorney to get through anything in the Federal Register.
And while I’m ranting about that, let me just add that the Red Flag Rule crafters OMIT the most vital information a doctor needs to provide some tangible protection for the practice, so that they might actually receive some benefit from all the hoop-jumping.
“Checking patient IDs”, which is what the 3 people who’ve heard of the Red Flag Rule believe IS the totality of the Rule (because the FTC led them to believe it), is like closing the door of the barn after the horse has gone, found a mare and had a paddock-full of frolicking fillies.
13% of identity theft is attempted by falsifying IDs at the front desk. 80% of breaches are committed by employees, who often sell it to pros, who scam insurers for big money. You don’t see anyone talking about that.
The good news is there doesn’t seem to be much chance of that with dentists, at least from the pros. You guys don’t get paid enough for a professional thief to bother with. And you thought your low (or no) insurance reimbursement was a bad thing … maybe not so much.
P. Thompson
4 Days to Red Flags Rule Deadline
B. F. Skinner, electrified grids and modern business
I skipped bothering you yesterday because there is still no word from Cindy Hearn, vice president of CareCredit/GE, concerning the Red Flags question which she assured my office manager that she could answer. I didn’t want you to wake the kids over nothing.
In the meantime, DentalBlogs editor Nancy (a default name) finally posted a couple of my “innocent” comments because she could tell that I made it clear to everyone that not doing so would make her look soo foolish, soo early in this game we’re playing. (See “DentalBlogs.com hates D. Kellus Pruitt DDS)
http://community.pennwelldentalgroup.com/profiles/blogs/dentalblogscom-hates-d-kellus
Unfortunately, Nancy is still trying to hold out on me – hoping against hope that I’ll just leave her alone before she has to betray those who pay her salary – like CareCredit and/or the ADA. Her type is easy to spot because anonymity gives them away immediately. It really shouldn’t surprise any of those who have been following my adventure to hear me suggest that Nancy requires additional instruction in manners before she can take that next step to becoming a better citizen with a real name. She is still stuck in the fantasy that as anonymous editor of a major dental blog, she somehow still wields the command and control right to censor troublemakers without having to explain why. That’s so 1990s.
For economic reasons, Nancy still thinks it is in her interest to protect her advertisers – forget the audience, and say bye-bye to truth. Nevertheless, I’m a big fan of operant conditioning because I’ve seen what it does for teaching manners to lab mice. So I publicly let Nancy know that I welcome progress (See “DentalBlogs sees the light” on this Medical Executive-Post)
http://healthcarefinancials.wordpress.com/2009/05/01/red-flag-rules-in-dentistry/#comment-4867
It is easy to see that we are indeed making progress. Not that long ago, Nancy was censoring everything I submitted, and now she is allowing nicer ones through, but is still blocking others that could damage advertisers’ reputations. Where do you think her threshold level of acceptable stands? As you can probably guess, I will progressively challenge Nancy to have to decide what is acceptable for her readers to see and what is not. Her reaction to the comment I submitted today will tell us just a little more about her values. Isn’t this fun?
With each day that passes, it will become more and more tedious for Nancy. Let’s watch her slowly fail – if that is the way she prefers.
Nancy’s challenge for today happens to be my second comment following the DentalBlogs.com article “Why Dentists Should Hook Up with Social Media” (no byline). The article also attracted 5 other comments, including one from “Administrator.” If you recall, a week ago, Administrator was the one who posted the third acceptable comment following the CareCredit article in which he (?) pleaded that he was on vacation the week when all hell broke loose on DentalBlogs.com concerning CareCredit’s article – and that it wasn’t his fault. Or something like that. There is no longer any record of his comment because it was deleted a short time after it appeared without explanation, leaving two really nice comments from anonymous fans of DentalBlogs.com and CareCredit.
Here’s something interesting. In one of the comments posted today following “Why Dentists Should Hook Up with Social Media,” Dr. Helaine Smith asked Administrator for DentalBlogs’ Twitter address. Administrator misunderstood the question and provided what turns out to be a bad link to DentalBlogs’ Facebook account.
http://www.facebook.com/debtalblogs
What? A second bad link provided by a representative of DentalBlogs in a week? Do you see a pattern developing?
Think back about a week. Who else posted a bad link? Remember the link provided in a DentalBlogs article that was posted on PennWell blogs to connect PennWell readers with an article by Linda Miles and Dr. Rhonda Savage? Instead, it led to Dr. Paul Homoly’s “Homoly Communications Institute,” another advertiser on DentalBlogs.com. If you recall, I did the neighborly thing and helped Nancy finally correct that error. Now here is the question for those of you who are really getting into this: Do you now suspect that Administrator and Nancy might be the same person? In that case, do you think there might be a really big, pissed off dude with tattoos working for DentalBlogs who is damned tired of being called “Nancy”? (Gasp!)
(Should I offer my help to Administrator with his bad link too or should I just leave it alone this time?)
Want to witness me determine where Nancy, who may or may not be big and hairy, draws the line for acceptable posts? Here is the comment I submitted to her blog following “Why Dentists Should Hook Up with Social Media.” It is still awaiting moderation. Will it pass or fail? No wagering please.
http://www.dentalblogs.com/archives/administrator/why-dentists-should-hook-up-with-social-media/#comments
Dr. Robert L. Smith, Zoe Tsoraklidis and Dr. Helaine Smith are all respected and successful dental marketing consultants who back their opinions with marketplace knowledge about how social networks can be used to attract new patients while keeping existing patients actively engaged in thinking about dental work.
Like almost all dentists, I must compete for new patients even harder during slow times. Though I have yet to start my own Website, I have to admit that Facebook and even Twitter are gaining my consideration as marketing tools. Like the earlier guests, I think the potential is untapped.
As I inferred in my earlier post about how Facebook helps reacquaint dental school classmates, the Internet is truly like the “Flat Earth” that author Thomas Friedman predicted over five years ago. Without a doubt, transparency – whether we invite it or not – must be respected. But don’t forget that transparency gives as much agony as it causes. Through conversations much like this, as guests of DentalBlogs.com, our individual contributions make each other more aware of our surroundings than ever before in the history of dentistry, and less vulnerable to biased information from healthcare stakeholders who might otherwise interfere with our practices.
For example, a few weeks ago, CareCredit attracted my attention with an ad for their 24 month no-interst loan offer for dental patients. I’ve known that the FTC’s Red Flags Rule deadline is approaching, so I sent Cindy Hearn, vice president of CareCredit/GE a question asking if signing up for CareCredit would make me an FTC-covered entity – subject to inspections and additional administrative work I don’t need. It’s been weeks now and unfortunately, I haven’t yet received an answer that I can share, but with the Red Flags Rule compliance deadline in 4 days, I repeat, 4 days, Ms. Hearn, I would discourage dentists from signing a contract with CareCredit/GE until we see what happens. Why invite the FTC into your office if you don’t have to?
It is my hope that this helps other readers who might be wondering about how the Red Flags Rule affects CareCredit signees. That’s what transparency is all about, sports fans. It can spoil almost anyone’s day.
D. Kellus Pruitt; DDS
Fresh news: The Red Flags Rule compliance deadline is pushed back to November 1, 2009. Let’s do this again in October.
D. Kellus Pruitt; DDS
Red Flags Rule – Chemotherapy for systematic illness
How taxing is the Red Flags Rule? Imagine if HIPAA were actually enforced – plus more. If one’s practice is already 100% HIPAA compliant, which we know is very unlikely, arriving with the new Rule, there are more staff to train, paperwork to document and breaches to worry about. Barring a (possible) fourth delay of a compliance deadline – thus establishing a quarterly cadence for the deadlines over the last 12 months – after November 1, 2009, if a dentist reports his or her computer stolen in a burglary, he or she can expect inspections and fines from both the HHS and the FTC. And unlike the HHS, the FTC has no sense of humor. They are through-and-through unfunny.
For my colleagues who also suffered through OSHA’s learning curve twenty years ago, you should understand what I mean when I warn that when the FTC starts waiving Red Flags, it signals bad news for healthcare. Fortunately for our patients who would otherwise have to pay the increased costs of governmental bonehead mistakes, as dentists, we can escape the tentacles of FTC and HHS, whereas physicians cannot. And if worse comes to worse – which it will – by drinking just a little bit of poison, the principles in dentistry can shed parasites already weakened by the poor economy. Then the profession that emerges will be motivated to provide improved quality at lower the cost through free market competition for patients. As long as quality work is valued by consumers in the land of the free, the challenge to our system will monetarily reward dentists who work hard to satisfy the needs of their cash-paying patients who are free to go elsewhere for better service.
If you think the status quo in dentistry is serving principles swell, need I remind you that competition is coming from not only the traditional threats to our turf, such as more dentists and more effective pressure from denturists, but also in the form of dental therapists and expanded duty hygienists who will succeed in winning our patients by undercutting our fees if we do nothing at all, even if they cannot touch our level of quality. We must start providing our patients more than they pay for today, not tomorrow.
As dentists who are already mistakenly characterized as rich and greedy, if we don’t start catering to consumerism, we will be devoured by it. We either shed parasites or we will die in the cold of winter of 2010.
Even though ADA leaders, as well as the leaders of virtually all healthcare organizations, are frantically lobbying to avoid inclusion in the FTC’s oppressive new law, let’s not kid ourselves. It is coming and it is potent. From what I can tell, there are only two ways for dentists to avoid liability when the Red Flags Rule reaches dental office managers’ desks following only one or two additional delays. (Four more at the very most).
1. Do not extend credit.
That means not only does the ADA-approved dental care financing company CareCredit/GE/ADA have a questionable future once the Red Flags Rule inhibits rapid growth, but imagine the shock to the system when dentists are forced to cease accepting assignment of benefits from insurance companies.
“Payment is expected in full at time of service – We accept cash, check and most credit cards.”
This retro habit may cause some of us acute pain at first, but merely the threat of some of us slipping away from their grasp has already caused permanent damage to insurance executives who exert far too much unquestioned control in our practices. Transparency will show that it is an unfair business practice for insurers to hold for leverage in bargaining money we already earned – even going so far as to second-guess the quality of our work long after it leaves our offices attached to satisfied patients.
A while back I wondered what it would take to force dentists to shift toward simple cash basis of payment rather than accept assignment from insurance – as a favor to insurers, don’t forget. I assumed that if the insurers continue to remain unaccountable to dentists, they would eventually drop off like warts when their unfair business practices forced more and more dentist to cash – bypassing clever actuarial MBA-quality hoops. I also regretted that for this to happen, it was a long shot that could take a few years. And then came along ambitious bureaucrats in the FTC about the same time 20 Billion dollars in stimulus money was allocated to healthcare IT. Coincidence? I never imagined that the pressure against taking insurance assignment would come from a government agency with more ambition than HHS. The ARRA fuels ambition.
2. A dentist cannot store patient identifiers on office computers.
With more and more security talk turning away from encryption and towards de-identifying healthcare data – other than names and possibly birthdates (eliminating 16 of 18 points) – there is hope that computerization will not be priced out of dentistry. However, if de-identification is not adopted as a means to lessen the impact of both HIPAA and the Red Flags Rule, dentists could ditch computerization and return to pegboard and ledger cards. Long ago, that was a funny joke I told again and again. I wore a hole in its funny.
When dentists can no longer afford to wait to be paid for even harsher reasons than merely the loss of the float, it hurts insurers much more than dentists. Too many times we forget that waiting to be paid is a favor, not a requirement. I think everyone knows that those who pay the premiums will be even less forgiving than dentists are with slow payments from insurance companies. Furthermore, they won’t want to hear anything about a dental consultant’s need for an x-ray before the claim can be processed and the check mailed. For most in the dental insurance these days, accountability removes unearned profits radically, but completely.
I find the implications of these two effects on dentistry real-time interesting. Some day someone other than me will be struck with the irony that our nation’s chronic identity theft problem has finally caused our lawmakers to inadvertently dissect insurers from dentists using their newest one-size-fits-all solution. And here is what makes the bolus of humor dark and rich: The poor slobs have no choice.
As dentists, we could sooner rather than later witness the painful end of a cancer that started in 2003 when the Bush administration quietly amended the 1996 HIPAA Rule – enhancing stakeholders’ powers over principles’ in the healthcare industry – using digitalization as a blunt tool while calling it a cornerstone.
Inadequate laws amended by political favors predictably yielded unsatisfactory results. Now those responsible must take control of our identity theft problem even if it coincidentally drastically changes the fiscal appearance of dentistry – as if anyone would notice.
For decades the dental industry has been traditionally and incredibly uninteresting to those watching healthcare, yet I find the microcosm fascinating and educational precisely because of the tricks that were just good enough were quietly nurtured by stakeholders’ greed and laziness that developed for natural reasons in an environment devoid of accountability. Since this obscure reality show I’m describing continues to play itself out unscripted and under the radar – and since there are very rich CEOs of very large companies who are stoically fighting to keep the disfiguring disease quiet all the way to its dramatic conclusion, I find this adventure ornery in a visceral way.
Just wait until the fun starts in a week or two when the FTC tries to explain to dentists their compliancy requirements that lawmakers are now demanding from them. That is when the Red Flags Rule will impact dentistry harder than 99% of the dentists who know about the rule can imagine – and possibly even harder than I imagine. If you like to observe stuff shrivel up and fall off, keep an eye out for the FTC’s help in increasing security in dentistry. Then listen for signs of sluffing as slimy adnexa hit the floor.
Wear old shoes.
D. Kellus Pruitt; DDS
Hey, dentalblogs.com … I’m back.
“If a dentist participates in your financing program, will that cause him or her to become an FTC-covered entity according to the Red Flags Rule?” – D. Kellus Pruitt
I submitted that question to be posted on dentalblogs.com today following an advertisement (no byline) purchased by a financing company called “American Benefit Credit, Inc. a California based Corporation, which works with hospitals and medical providers to build and deploy financial solutions for their patients.”
http://www.dentalblogs.com/archives/administrator/press-release-new-patient-financing-company/
It’s been several hours now, and my comment is still “awaiting moderation.” That doesn’t look good for “Nancy” (default name), the anonymous editor of dentalblogs.com. She should try to persuade ABCI to respond, or I will take my frustration out on her as well.
“This product was needed in today’s financial crunch for medical providers and patients alike,” said Philip McClendon – ABCI Vice President of Operations. A response from Mr. McClendon could be the start of a warm relationship.
I could be wrong, but I think ABCI is just like the ADA-approved CareCredit in the eyes of the FTC. If you recall, Cindy Hearn, Vice President of CareCredit/GE delayed accountability for her product’s bankrupt-level liability caused by the Red Flags Rule. She simply refused to answer my question, and now I give her hell whenever the opportunity arises … Such as just now. Is that rude of me?
Do you think ABCI treats consumers with any more respect than CareCredit/GE? I promise you this, sports fans. Philip McClendon will regret it again and again if his behavior in my neighborhood turns out to be no better than Cindy Hearn’s. Since it looks like he has a weak presence on the Internet, I think I can help his search engine optimization, while simultaneously branding him according to how happily he welcomes transparency. Philip McClendon has the opportunity to be a hero or a heel.
D. Kellus Pruitt; DDS
Net Fishing
I hope you’re enjoying the hunt, sports fans. A few days ago, I asked Philip McClendon, VP of American Benefit Credit Inc. a simple question: “If a dentist participates in your financing program, will that cause him or her to become an FTC-covered entity according to the Red Flags Rule?”
This morning I discovered that instead of hearing from VP McClendon, ABCI representative Jason Glavin pulled an old school evasive trick on me. It’s called, “I’ll give you a link to the FTC’s home page and you can look it up your own damn self.” He began his reply by thanking the two anonymous cheerleaders, Heather W. and Cosmetic Dentistry, for their support.
http://www.dentalblogs.com/archives/administrator/press-release-new-patient-financing-company/comment-page-1/#comment-35599
Jason Glavin // Aug 25, 2009 at 12:59 pm
Thank you as the program is receiving rave reviews from the medical community, we appreciate your support!
As far as red flag rules I would direct your attention to the following link which should offer you further insight, as the Dr. is not the lender in this program.
http://www.ftc.gov/bcp/edu/pubs/business/alerts/alt050.shtm
Also for clarification the patient financing program has fully launched thus completing it’s initial pilot program earlier this year.
—————————————–
Is Jason Glavin correct? It sounds like the ABCI representative would have naïve dentists believe that unless the provider personally loans his or her patients money, they will not be covered by the Red Flags Rule. Maybe he is right. I intend to run him down to find out.
I attempted to post the following comment in response to Jason Glavin’s reply, but DentalBlogs editor Nancy is pulling her disingenuous censoring tricks again. Just yesterday I made a comment that she was a smart editor. She also censored yesterday’s comment that was addressed to ABCI Vice President Philip McClendon, Heather W., and Cosmetic Dentistry. No explanation was given. That irritates me.
————————————–
Thank you for responding, Jason Glavin.
Can I interpret that to mean no, the American Benefit Credit program will not cause a dentist to become a Red Flags Rule covered entity because the dentist is not lending the patient the money?
D. Kellus Pruitt; DDS
—————————————–
With the Internet at our disposal to reveal misleading statements by sleazy businesses, why do we still put up with bozos like Jason Glavin, Philip McClendon and Nancy? Here is what I sent Nancy this morning as a comment following her only entry onto PennWell blogs, “Growth and Expansion of Your Dental Practice.” I was told that it would have to be reviewed before everyone is allowed to see it.
http://community.pennwelldentalgroup.com/profiles/blogs/growth-and-expansion-of-your
Nancy, I see you’re playing games with me again.
I see you failed to post my last comment, and now you block me from commenting at all. I thought you and I had our differences all straightened out. I see I was wrong.
As you know, Nancy. You cannot escape me. Watch for this to appear soon.
—————————————-
I just went back to Nancy’s “Growth and Expansion of Your Dental Practice,” and the notice that my comment must be reviewed has been taken down. This means that even though Nancy won’t come to the door, she is still picking up her mail. Please send her your best wishes if you want to warm up her day. Tell her D. Kellus sent you.
As for Jason Glavin, if indeed that is his real name, I know where you live. I will soon put together an email for you and will send it to the American Benefit Credit Website.
http://www.abfcredit.com/
I’ll share my email with friends here as well, even Nancy. This will be fun.
D. Kellus Pruitt; DDS
CareCredit responds to D. Kellus Pruitt DDS
Less than a month before the third delay of the deadline for Red Flags Rule compliance for covered dentists, on July 9, DentalBlogs.com posted the ad, “Press Release: CareCredit Adds 24-Month, No-Interst [sic] Payment Plan.”
http://www.dentalblogs.com/archives/administrator/press-release-carecredit-adds-24-month-no-interst-payment-plan/#more-3060
On the same day that CareCredit’s press release was posted, I submitted a simple question to the anonymous author, and later to CareCredit/GE Senior Vice President Cindy Hearn. My question turned out to be too difficult for them to even acknowledge, much less answer: “If the Red Flags Rule is not delayed for the third time in three weeks, how will it affect those who offer CareCredit?”
On the DentalBlogs Website, I was given the automatic response “Your comment is awaiting moderation.” But days later, it was obvious that CareCredit, which paid DentalBlogs to post their advertisement, was not about to allow my question to crater their sales. However, CareCredit is an ADA-approved vendor. So what gives Cindy Hearn the right to conceal important information about her product from ADA members? Is CareCredit the best the ADA can do? If you are an ADA member, Hearn’s deceit should make you furious now that you know about it.
I persistently challenged the anonymous editor of DentalBlogs, whom I named “Nancy” by default, and VP Hearn to answer my question before the Aug 1 compliance deadline. I’m fairly certain I had CareCredit/GE leaders running for cover before their almost unexpected reprieve. With only a day or so to spare, the FTC announced the third delay. Now the compliance deadline is November 1. Naturally, the delay cut the increasing momentum of my attacks.
Even though I kept CareCredit in mind and lobbed grenades their way every now and then just to aggravate them, I had little luck making tangible progress until today. Only a few days ago, CareCredit opened a new Website to assist clients and providers with their questions. Right or wrong, I assumed that meant me. It took me a few minutes to find an email address among phone numbers which CareCredit’s slick good ol’ boys prefer, but I finally discovered the sales department’s address, I immediately probed their lines, not expecting a return.
Dear Sales Department, CareCredit:
I am a dentist who practices in Fort Worth, Texas, and I am trying to determine if by signing up for CareCredit, it will make me a covered entity under the FTC’s Red Flags Rule.
A prompt reply would be appreciated.
Sincerely,
D. Kellus Pruitt; DDS
To my surprise, a sales consultant who I’m certain was clueless about my history with CareCredit and Cindy Hearn, attempted to answer my question which she must have misread.
CareCredit Sales Consultant: Hello Dr Pruitt,
CareCredit had to go through compliance some time ago to satisfy the Red Flag Rules. You can be assured that CareCredit is compliant with this new act.
Her carelessness and short answer signal to me that she was probably in a hurry and hardly took notice of my email. This is a common, casual mistake in traditional businesses. For those who depend on the Internet, emails must be taken seriously. On the other end could be a special bastard just waiting for someone to slip up.
Here’s something else her hasty reply tells me. I must be the only dentist in the nation pursuing CareCredit’s deceit.
I responded:
Thanks for your response. However, you still did not answer my question. As a dentist, if I sign up patients for CareCredit, does that bring my practice under the Red Flags Rule?
It is as simple as yes or no.
Thanks again,
D. Kellus Pruitt; DDS
CareCredit: To answer your question, YES. Anyone who is accepting credit cards or doing credit checks on customers at their place of business, falls under the Red Flag Rules. Please follow the link below from the ADA and read about the rules. We are endorsed by the ADA.
http://ada.org/prof/index.asp#rule
“To answer your question, YES.”
The siege took six weeks, but as you witnessed, if one keeps probing for weak spots, and chances upon a naïve salesperson who is overworked and otherwise not paying attention, one can sometimes capture a secret answer without a fight.
So there you have it, fellow health care providers. If one is otherwise not a Red Flags Rule-covered entity, signing up for CareCredit will change that. As far as accepting credit cards, don’t believe her. I think it is clear that the CareCredit sales consultant over-reached her knowledge of the Rule. Sales consultants often interpret federal mandates in ways that favor sales consultants.
Expression forensics and rumors.
If you have a minute or two, let me share with you a niche interest of mine. As you may have noticed from this comment today, I enjoy analyzing not only what is said and what is not, but also subtle things like sentence structure, style and mistakes. If a reader is alert and not in a hurry, within a few sentences into a document, one can begin to build an increasingly accurate image of the author – almost subconsciously. Later in the document, often one’s early suspicions are confirmed by consistency.
Sometimes it is the little things that tell me the most. When the sales consultant closed with “We are endorsed by the ADA,” that told me several things. First of all, it confirmed that she was “naïve.” If she knew who I was, she would have never pointed that out to me. And since she failed to recognize me, the salesperson simply has not been watching her market in the last few months.
Cindy Hearn, as well as ADA leaders stay silent because they obviously are aware that when dentists are provided the truth about the Red Flags Rule, such as right about now, it will hurt CareCredit sales. Yet CareCredit’s sales consultant seemed to be unaware of the Rule’s liability. This tells me that their sales force is disconnected from the top. So what’s new?
The sin of wasted time. The lack of transparency in traditional corporations reminds me of “The Cluetrain Manifesto’s” 85th Thesis which warns leaders like Cindy Hearn. “When we have questions we turn to each other for answers. If you didn’t have such a tight rein on ‘your people’ maybe they’d be among the people we’d turn to.” What a loss, Cindy. It is easy for me to see why you cannot afford to be transparent with your employees. Your business ethics aren’t wired for that.
Now, sports fans, you also get an idea how much fun it can be to be the origin of office rumors.
Thanks for your readership. I had some mischievous fun with this one – a cheap, fire and forget missive.
D. Kellus Pruitt; DDS
D. Kellus Pruitt tells Jason Glavin, “Keep smiling”
It appears that because of a clever, mysterious business plan, American Benefits Credit Inc. enjoys a tremendous advantage over the ADA-approved Care Credit in the dental care financing industry.
I posted a congratulatory note to ABCI representative Jason Glavin today.
http://www.dentalblogs.com/archives/administrator/press-release-new-patient-financing-company/comment-page-1/#comment-35609
Dear Jason Glavin, American Benefits Credit Inc. representative:
I appreciate your help in clearing up what appears to be my misconception about the Red Flags Rule and your company. When I asked if participating in your dental care financing plan would cause a dentist to become a Red Flags Rule covered entity, you promptly replied, “With the use of this [ABCI] product the Practice would not fall under the association of a creditor nor lending institution that is dealing with coverd [sic] accounts and/or transaction accounts that the Red Flag Rule applies.”
There must be something about your product that is vastly different than the ADA-approved CareCredit. Yesterday, one of their sales representatives told me “YES. Anyone who is accepting credit cards or doing credit checks on customers at their place of business, falls under the Red Flag Rules. Please follow the link below from the ADA and read about the rules. We are endorsed by the ADA.
http://ada.org/prof/index.asp#rule “
Because of the windfall immunity from the Red Flags Rule, American Benefits Credit Inc. definitely has a market advantage over CareCredit/GE. Your bosses’ business plan has put you in a very sweet position.
If I were in charge of your marketing department, I’d start pushing the immunity point subtly at first, and then increase the PR spending as the November 1 compliance deadline approaches. We both know that inevitably, dentists nationwide will start trying to dodge the liability of being FTC-covered. That means that they’ll abandon CareCredit for American Benefits Credit.
Good luck with that plan. You’re sitting pretty, Jason Glavin. Keep smiling.
D. Kellus Pruitt; DDS
American Benefit Credit retracts Red Flags Rule statement
A week and a half ago, I posted “D. Kellus Pruitt tells Jason Glavin, “Keep smiling”
http://community.pennwelldentalgroup.com/forum/topics/d-kellus-pruitt-tells-jason
The foil in the “Modest Proposal” satire, Jason Glavin, represents American Benefits Credit Inc – a competitor in the healthcare financing industry with ADA-approved CareCredit/GE.
I unintentionally misled readers when I wrote, “I posted a congratulatory note to ABCI representative Jason Glavin today.” It would have been less presumptuous if I had written “I submitted a congratulatory note to be posted if Jason Glavin so chooses.” Mr. Glavin elected not to post the comment. Of course, he had no choice. He easily saw right through the satire.
My rejected piece focuses on a claim made by Jason Glavin that his ABCI financing product successfully skirts the Red Flags Rule, contrary to the fact that CareCredit already quietly admitted the bad news. Even though Glavin’s family attorney had problems with interpreting the law, many experts long ago agreed that helping one’s patients with financing puts dentists in the middle of FTC turf, and staying there can be expensive. How could Jason Glavin possibly not know that?
As you may know by now, I had Glavin nailed all the way. As a matter of fact, in one of my aside comments, I more or less said that CareCredit/GE’s lawyers will eventually sort out the truth.
Life’s little victories
Here is what has happened since I bid farewell to Glavin on August 28 with the ominous salutation he moderated before refusing to post: “Good luck with that plan. You’re sitting pretty, Jason Glavin. Keep smiling.”
Have you ever seen a craw-fish scoot away? Crawfish are graceful.
http://www.dentalblogs.com/archives/administrator/press-release-new-patient-financing-company/comment-page-1/#comment-35609
Jason Glavin // Sep 4, 2009 at 12:30 pm
I must apologize as to my previous post in the area of the Red Flag Laws, as this law may indeed fall onto the front steps of your dental practice.
After my numerous attempts to call and write the FTC direct to gain further knowledge and insight for dental practices, it looks as though this law is broad at best for dentists and/or general businesses in that regard.
I was informed that “if you arrange for credit and/or bill customer for your services at a later time than you may fall under this law” no matter if your a credit facility.
In my attempts to gain further understanding into this law with the FTC, I was informed that if there is any area that I did no understand to call my attorney for further insight. In calling my families attorney I found it ironic that she had to research the law as she was vague on the subject matter at well. Her interpretation to me was that it looked to be most businesses in general that are using credit might fall under these current laws regardless if you are the creditor.
Here is some good information which I found to research and/or write the FTC to gain further understanding. Again this was my own interpretation and research to gain further understanding into the law for health care providers themselves, as I hope this helps in my feeble attempts to gain further insight and clarification.
Note: to write the FTC on Red Flag laws: redflags@ftc.gov
Website: http://www.ftc.gov/bcp/edu/pubs/business/idtheft/bus23.pdf
I SUBMITTED the following comment to Jason Glavin for consideration of posting:
D. Kellus Pruitt DDS // Sep 6, 2009 at 1:39 pm
Thank you for clearing that up, Mr. Glavin. I’ll spread the word.
D. Kellus Pruitt; DDS
Your comment is awaiting moderation.
Do you think it was a good idea for Glavin to use a family lawyer for this question? Gavin said, “Her interpretation to me was that it looked to be most businesses in general that are using credit might fall under these current laws regardless if you are the creditor.”
So let’s lay this out: American Benefits Credit Inc., a competitor with CareCredit, is hoping to finance millions (?) of dollars in dental care for patients across the nation, and a PR representative for the company has to ask his family attorney if their product intersects with the FTC’s Red Flags Rule.
Among other very important ones, one question that comes immediately to my mind is, just how well financed is American Benefits Credit Inc.?
D. Kellus. Pruitt; DDS
Darrell,
Many thanks for all your investigative reporting – but you work too hard on Labor Day weekend. Anyone with a lick of common sense can spot [smell] a [not too slick] salesman a mile away.
Ditto for the sell-outs at the AMA and ADA!
Hank the Cynic
Thanks for your concern, Hank. Don’t worry about me. This is sport.
Darrell
If we don’t hold misleading salespeople accountable then we deserve to be misled.
This morning, when American Benefits Credit Inc. PR rep Jason Glavin googled his own name, his first hit was “D. Kellus Pruitt tells Jason Glavin, “Keep smiling.”
http://community.pennwelldentalgroup.com/forum/topics/american-benefit-credit
I hope I’ve proven to you that we no longer have to put up with lies. Slick salesmen like Jason Glavin have no place to hide.
D. Kellus Pruitt; DDS