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Allen M., Esq.
Allen M., Esq., Attorney
Category: Legal
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Experience:  Lawyer and legal specialist.
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I am a dentist in NC. I fired my dental assistant 1 yr ago.

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I am a dentist in NC. I fired my dental assistant 1 yr ago. 2 weeks ago, she hired an attorney claiming mental anguish over the loss of her job. Her lawyer just sent me a letter stating that she claims I committed insurance fraud by using an incorrect insurance code related to prophy/cleanings this assistant performed in my office. This assistant claims that she on MANY occasions complained to me about this code and that I told her I didnt care and wanted to use this more expensive code. No such conversations ever occurred and I know my dental law and insurance codes. There are NO other codes, so how in the hell did she ever have these conversations with me. These same codes are used by every pediatric dental office in this state. The funny thing about it, her lawyer didn't even bother to verify NC Dental Law or Insurance Codes prior to sending this letter. No fraud has been committed by the billing code I use. The lawyer encourages me to settle out of court and pay her in excess of $10,000 and his fees so that these "fraud codes" are not brought out in court and the community. If this lawyer wanted to intimidate me into paying, shouldn't he at least have a valid lawful threat of criminal activity? Is this a form of blackmail???
Hello, my name is XXXXX XXXXX I look forward to assisting you today. I bring nearly 20 years of experience in various legal disciplines.

No, it is isn't legally a form of blackmail. It's just bad lawyering. I would send the lawyer the law concerning the codes, tell him/her to read the law before sending a demand letter claiming fraud and then let him/her know that you'll be sending a courtesy copy of your response to the state bar association disciplinary committee (and actually do this).

The attorney, while not strictly breaking any statutory or criminal laws, could be found to have violated the code of ethics and may be made to answer for it. The threat alone is enough to give the attorney pause before claiming fraud again.
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