What happens when a practice obtains EHR incentive money without the dentist’s knowledge

Having assisted practices with obtaining money through the EHR incentive program for the past few years, I regularly get calls from office managers and providers wanting more information about how to take advantage of the federal and state money available for using a certified EHR.

However, a recent call I received from a practice looking for assistance highlighted the possibility that some practices are obtaining incentive fund payments without their dentists’ knowledge or permission. During this call, I was made aware that this particular dentist started his own practice after having worked for another practice. After determining that he was eligible for $21,500 of year-one EHR incentive money ($63,750 total), he contacted the EHR incentive program to find out how he could obtain this money to help his new practice.

What he found out was that apparently the previous practice he had worked for had already obtained the first-year $21,500 based on an assignment of payment from the dentist. What was shocking was the fact that this particular dentist was not aware that his previous employer had applied for – and received – his incentive money with payment being assigned back to the practice, not the provider.

So, basically, since his first-year money had already been distributed to his previous employer, the dentist was now out of luck. He cannot get his $21,500 of first-year money. He is certainly eligible going forward to apply for and receive the additional $42,000 of incentive money, but his previous employer deceptively obtained the initial $21,500 that he could’ve had in his pocket.

So, how could this happen? How could a practice or group obtain EHR incentive monies on behalf of its providers without their knowledge or permission? Well, because of the complexity of determining provider eligibility, registering, applying for, attesting and following up with federal and state agencies, many practices choose to have a consulting firm do all the heavy lifting when it comes to obtaining EHR incentive money. This has been common practice in both the medical and dental world. However, it is important to understand that the practice itself does not register, apply and attest for the funds. This is done on an individual provider basis, and a provider has a choice during the process of either obtaining payment themselves or assigning the payment back to the practice or group.

A large amount of money is available through the EHR incentive program and, having been involved personally with this program since its inception, I have noticed that numerous “EHR incentive consulting” firms have sprung up out of the woodwork in the past four years. Because of the number of consulting firms trying to cash in on the program, there will obviously be some that try to cut corners or not necessarily have the long-term interests of their clients at heart. In fact, I get calls all the time from groups and practices asking about the legitimacy of companies that call them offering to help them get the EHR incentive money.

So, maybe the consulting firm hired by the practice just went about their business to get the practice the incentive funds without provider knowledge or permission. Alternatively, perhaps the practice itself just went ahead and used all provider information to register and attest and assign payment of the provider’s incentive funds back to the practice without knowledge or permission.

In any case, it is certainly normal for a practice or group to require assistance because of the complexity of the program and the dollars at stake. But not making the individual providers aware of what is being sent on their behalf, and getting their approval, including the assignment of payment back to the practice, is neither ethical nor an appropriate business practice.

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