More management and insurance knowledge in my newsletter: https://www.odysseymgmt.com/newsletter

Did you know that throwing away a simple "education letter" from an insurance company could be the first step toward an audit seven years later? Or that hiring a team member without checking the exclusion list could label your practice "radioactive" and cut you off from federal funding? Many dental practice owners don't realize that common habits, like billing under a selling doctor's name during a transition are actually considered False Claims fraud.

In this episode, I sit down with dental-specific attorney Justin Withrow to reveal the serious legal risks that often fly under the radar. He breaks down the three "buckets" of regulatory enforcement: insurance audits, board investigations, and criminal/civil inquiries. Then he explains how to organize your records before the investigators show up. This conversation is about protecting your livelihood.

An audit isn't just a request for money back, it is an investigation that can lead to referrals to the state board or attorney general. Don't wait until you receive a subpoena to organize your compliance protocols!

In this video, we cover:

• The "Education Letter" Trap: Why insurance companies track these for years and use them to prove you "knew better" during future audits.

• The Exclusion List: Why employing someone on the OIG list creates a "radioactive" situation for your practice and how to check it. https://oig.hhs.gov/exclusions/index.asp

• Billing Fraud vs. Mistakes: The dangerous reality of billing under a veteran doctor's name while a new associate waits for credentialing.

• Audit Survival: Why organized records and "audit-proof" documentation are your best defense when a payer demands 50 patient charts.

• Informed Consent: Why this must be a conversation process, not just a signature on a form, to protect you from board complaints.

Connect with Justin Withrow

Email [email protected]

Website https://flannerygeorgalis.com/team/justin-withrow/

Facebook https://www.facebook.com/justin.withrow.77

Linkedin https://www.linkedin.com/in/justin-withrow/

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Beyond the Operatory Career Workshop: Have you ever wondered what career opportunities in dentistry exist beyond clinical care? Whether you're a dentist, hygienist, assistant, or manager, this full-day, in-person workshop is your chance to explore new paths in speaking, coaching, consulting, and more.

Join Teresa and Angela on March 6th, 2026 in Northern Virginia. Limited to just 20 attendees. Registration is open. Secure your spot today:

🔗 https://www.beyondtheoperatory.com/

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I created Dental Revenue Network to foster collaboration and networking amongst RCM professionals. Billing company owners and billing professionals will have access to skill building sessions, current carrier news and insurance discussions beyond "what's the code?" Check it out - I hope you'll join! https://dentalrevenuenetwork.mn.co/

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Synergy Dental Partners offers lower prices for your dental supplies and services

https://www.odysseymgmt.com/synergy

NTMT listeners receive a 2 Month Free Trial + a 3rd Month if you buy anything from any vendor during the trial period. Also, new Darby customers receive a $200 Darby statement credit with a purchase.

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My insurance course Dental Insurance Design and Management is geared toward those who want to understand the how and why of insurance. As a loyal podcast listener, please use "NTMT" for a $75 courtesy toward your investment.

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Visit odysseymgmt.com to check out my book, webinars and courses.

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Don't forget to check out my other podcast Chew on This - A Dental Podcast!

**If you like the show then I'd appreciate a good rating. Tell your friends. Even podcasters ask for referrals!**

YouTube: https://youtube.com/@odysseymgmt

#DentalPractice #DentalLaw #InsuranceAudit #PracticeManagement #RiskManagement #DentalBilling #Compliance