Five employees of a dental management company were accused of fraud insurance l More than a million dollars Through dental clinics in Hialeah and Little Havana.
Linares Mercedes53 years old Kristi Olson47; Leonardo Ramos22; Lionel Ravelloand 34 y Rion VasquezThe 33-year-old was arrested Tuesday on charges that include making false insurance claims, organized scheme to defraud and criminal use of personal information, according to arrest reports, which he had access to. 10 local news.
the five –Four of them are of Cuban descentHe allegedly participated in a $1.3 million insurance fraud scheme at two dental clinics in South Florida.
The suspects reportedly used ID cards from out-of-office dentists at their clinics for insurance bills and added unnecessary procedures to collect additional rewards.
According to the police report, in 2020 a couple sold shares of their dental practice, with offices located in Hialeah and in the Little Havana neighborhood of Miami, to the management company of the five involved.
The company subsequently separated the couple and allegedly carried out operations in violation of Florida laws regarding ownership of dental practices by non-dentists.
Authorities said the company continued to bill insurance companies for ID procedures from dentists who had stopped working there.
The suspects also asked six associated dentists.It will accept a new billing process“Where procedures performed by dental assistants” would be signed off by current licensed physicians even though they were not administering or supervising the treatments. “
However, dentists disagreed with this process because they did not supervise it, and they will not be compensated, and they do not want to use their licenses without their direct management, according to the police report.
Authorities also revealed that Lionel Ravelo led the director of the Little Havana office to use something called a “behavior management code” on all children under the age of six “without the knowledge and consent of doctors, to increase production and meet your financial goals for a monetary reward.”
The report added that the six dentists discovered this fraud scheme including claims for services not provided and stopped billing, and conducted an audit of all claims by the Code of Conduct Department.
His audit revealed 50 fraudulent claims, four of which had already been filed, totaling $1,800 in fraud.
“Physical evidence, witness statements and financial records will show that Olson, Vasquez and Ravelo knew and colluded to correct and cover up this fraud after they (the dentists) confronted them,” the memo said.
The total amount of fraud was $1,350,246According to the authorities.
Investigators with the Florida Department of Financial Services’ Office of Insurance Fraud dubbed the case “The Tooth Fairy Robbery”.
The company is at the center of accusations, AC Pediatric Dentistry and Orthodonticsissued a statement to 10 local news denying the allegations and blaming “disgruntled former employees”.
“Unfortunately, the origin of this ugly debacle can be traced back to the disgruntled former employees who were fired in 2022, who are now obsessed with bringing down the company they worked for, no matter the human cost,” he said in a statement. a permit.
For the charges against them, the five people could spend up to 90 years in prison if found guilty.
Also in Florida, a man was sentenced to prison Buying and selling more than 2.6 million dollars Medicare Beneficiary Identification Number.
Charles William McCloy, 36, was sentenced to 41 months in prison after pleading guilty to one count of conspiracy to violate the 2015 Medicare and CHIP Reauthorization Act (MACRA).
Other Medicare scams have been reported in recent months in Florida. A Miami chiropractor and doctor has been convicted of defrauding the public health system for more than $31 million.
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