2014 wsda news issue 7 july mzd

Issu

WSDA 014 ly 2 · ju e7

The voice of the Washington State Dental Association

MEDICAID AUDITS: Will your practice be next?

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news

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Dr. Sammy Pak with Russell Wilson

WSDA news Cover story by Emily Lovell A Tale of Two Audits by Rob Bahnsen Cover photos by Bruce Andre PNDC photos by Anita Nowacka

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editorial

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guest editorial

issue 7 · july 2014

33

wdia news

6-15

pndc in pictures

37 newsflash

17

wsda academy

39, 41

in memoriam

18-19

wohf news

20-21

legislative news

46

membership marketplace

22-29

cover story

50

parrish or perish

30-31

members giving back

32

45, 47, 49

classifieds

wdia news

Like us on Facebook: www.facebook.com/WashingtonStateDentalAssociation WSDA News Editor Dr. Mar y Jennings Editorial Advisor y Board Dr. Victor Barry Dr. Richard Mielke Dr. Jeffrey Parrish Dr. Rhonda Savage Dr. Robert Shaw Dr. Mary Krempasky Smith Dr. Timothy Wandell Washington State Dental Association Dr. David M. Minahan President Dr. Gregory Y. Ogata, President-elect Dr. Bryan C. Edgar, Vice President Dr. D. Michael Buehler, Secretary-Treasurer Dr. Danny G. Warner, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Dennis L. Bradshaw Dr. Ronald D. Dahl Dr. Christopher Delecki Dr. Christopher W. Herzog Dr. Gary E. Heyamoto

Dr. Dr. Dr. Dr. Dr. Dr.

Eric J. Kvinsland Bernard J. Larson Christopher Pickel Lorin D. Peterson James W. Reid Ashley L. Ulmer

Senior Vice President of Government Affairs Bracken Killpack

Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail: info@ wsda.org/w w w.wsda.org

Art Director/Managing Editor Robert Bahnsen

In the event of a natural disaster that takes down the WSDA web site and email accounts, the WSDA has established a separate email address.

Should an emergency occur, members can contact washstatedental@gmail.com.

WSDA Staff: Executive Director Stephen Hardymon

Manager of Continuing Education and Speaker Ser vices Craig Mathews

Senior Vice President/ Assistant Executive Director Amanda Tran

Government Affairs Coordinator Michael Walsh

Vice President/Chief Financial Officer Peter Aaron General Counsel Alan Wicks Vice President of Operations Brenda Berlin Vice President of Communications Kainoa Trotter

Public Policy Coordinator Emily Lovell Membership Manager Laura Rohlman Exhibits and Sponsorship Ser vices Coordinator Katie Olson Bookkeeper Joline Hartman Office Coordinator Gilda Snow

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The WSDA News is published 8 times yearly by the Washington State Dental Association. Copyright © 2014 by the Washington State Dental Association, all rights reserved. No part of this publication may be reproduced without permission of the editor.

Statements of fact or opinion are the responsibilit y of the authors alone and do not express the opinions of the WSDA, unless the Association has adopted such statements or opinions.

Subscription price is $65 plus sales tax per year for 8 issues of the News. Foreign rate is $97.92 per year.

Advertising is published as a service to readers; the editor reserves the right to accept, reject, discontinue or edit any advertising offered for publication. Publication of advertising materials is not an endorsement, qualification, approval or guarantee of either the advertiser or product. Communications intended for publication, business matters and advertising should be sent to the WSDA Office, 126 NW Canal Street, Seattle, Wash.

98107. ISSN 1064-0835

Member Publication American Association of Dental Editors. Winner: 2013: Journalism Award, Platinum Pencil, 2012: Journalism Award, Best Newsletter, Division 1, 2012: Platinum Pencil Award Honorable Mention (2), 2008: Best Newsletter, Division 1, 2007 Platinum Pen Award, 2006 Honorable Mention, 2005 Platinum Pencil Award, 2005 Publication Award; International College of Dentists

table of contents issue 7, july 2014

a day in the life

editorial dr. mar y jennings

Making my eyes twitch Every now and then a policy comes through that is so irritating that it makes my eyes twitch. The latest one comes from Medicare. Like most irritating policies, it was created with the best of intentions.

The Affordable Care Act (ACA) changed the healthcare playing field in many ways.

Several government agencies are struggling to write rules to fit this new act. One of the drivers for the creation of these new rules is cutting the costs created by fraud.

A few months ago, the Centers for Medicare and Medicaid Services (CMS) asked the American Dental Association (ADA) and others to comment on rules it was creating for Medicare. Included in the rules was a proposal that would require providers who write prescriptions covered under Medicare Part D be enrolled or have formally “Opted out” of Medicare. Heretofore, Medicare honored the prescriptions written by non-registered providers for their Medicare patients. The fact that the patient was enrolled and needed medication seemed to be justification enough. Evidently, there was abuse of this system.

So here we are. After the June 1, 2015 grace period, neither pharmacies nor patients will be reimbursed for any prescription a non-enrolled prescriber writes, unless the prescriber has opted out.

In real life, that means that if you have no Medicare patients, you have no worries. The rest of us have to decide if it is less painful and more ethical to enroll (or opt-out) and help our Medicare patients, or not act and suffer their wrath.

I understand what enrolling in Medicare is. If you look for the forms online it is overwhelming. While much of it may be explanatory information, the Medicare enrollment form is 29 pages long. On the other hand, the “Opt-Out Affidavit” option is only two pages, although it has to be resubmitted every two years. Opting out verifies us as legitimate practitioners and our prescriptions are covered. Enrolled practitioners can bill Medicare while practitioners who opt out cannot. Probably the best way to opt out for dentists is to fill out the “Ordering and Referring Form” since it is only thirteen pages and only has to be submitted once. The ADA, working with CMS, helped develop it several years ago as an alternative to the longer enrollment form.

These changes caused hell amongst the yearlings (i.e. those of us who were perfectly content with the old system. The system most of us never billed and never had to bother belonging to.) The ADA pointed out that it was insensible and burdensome for the roughly 194,000 dentists in the United States to register for Medicare. The ADA argued that registering dentists will not stop fraud and abuse because prescriptions written by dentists represent a tiny fraction of the Medicare prescription budget, administrative oversight would be costly, and it is simply not necessary. We all know that it would be problematic for Medicare patients who live on fixed incomes to pay out of pocket for prescriptions written by dentists.

At one point, CMS withdrew the rule and we felt relieved. It was short lived. The final rule was issued on May 23, 2014. Despite our best efforts, registration of dentists was included. The effective date for the rule is July 22, 2014 with a June 1, 2015 grace period.

In response to objections from the ADA and others, CMS responded by saying: “While we recognize the concern of these commenters, we do not believe dentists, psychiatrists, VA physicians, or eligible professionals should be granted special exemptions from 423.120.

The issue of primary concern to us is not the typical volume of drugs these individuals prescribe but the need to ensure and confirm that Medicare payments are only made for Part D drugs that are prescribed by qualified physicians and eligible professionals.”

I feel like an innocent bystander caught up in this fray. It is not about us. We are a small percentage of the prescription writers and probably even a smaller percent of fraudulent providers. This is just another irritating thing we have to keep up with. With the exception of feeling good about helping our Medicare patients in need, there is no incentive for us to bother to enroll or opt-out. This rule makes an expensive program more expensive.

Why do the good guys have to bear the burden instead of going after the creeps who forge prescriptions? What is that all about?

To the good, this rule is harsh enough that there are strong points to argue to legislators and budget watchers. The other professionals who are affected will be complaining too.

The ADA is putting their sharp, collective minds together to quash this rule. To the bad, government agencies are pedantic and justice rides a slow horse.

Looks like I am going to have to sharpen my #2 pencil and sign up next spring if we have not eliminated this irritating thing by then. Like most dentists, my patient’s needs come before my own. I still think we have a good chance at turning this around. I look forward to the fight.

Dr. Mary Jennings Editor, WSDA News

“ Heretofore, Medicare honored the prescriptions written by non-registered providers for their Medicare patients. The fact that the patient was enrolled and needed medication seemed to be justification enough.”

Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email address:mjenningsdds@gmail.com.

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I’m not a dental professional, and I don’t play one on TV, but due to my role in the Seattle/King County Clinic with Remote Area Medical® that will occur this October, I find myself learning more than I ever anticipated about dentistry. Dr. Jeffrey Parrish and Dr. Michael Karr, the clinic’s Dental Directors, suggested I share my perspective as the Project Director about why we’re turning KeyArena into a giant free clinic for dental, vision and medical care and why we want you to volunteer and join us.

As an event manager at Seattle Center, I’ve been involved with some amazing experiences, but when I visited one of these free clinics in California run by Dr. Russell Webb I realized that this project would take the cake. Quite simply, it was the most inspiring moment of my life to witness the generosity, humanity and dignity of everyone involved.

From my vantage point in the dental clinic I met professionals and patients alike and their stories continue to motivate me to this day.

Early on, I saw the x-ray of a man who needed to have most of his teeth extracted, it was obvious even to me. I expected at the end of his procedure that he would feel miserable if for no other reason than the realization he no longer had any teeth! Quite the contrary, he repeatedly hugged the dentist and dental assistant then went around mumbling thank you and giving thumbs up to everyone he encountered. I discovered this effusive expression of appreciation was a norm at the clinic.

On the receiving end of this thankfulness, dentists also told me how exhilarating it was to work in that environment. They not only had fun working with friends from other offices, but liked that they got to focus on providing care rather than all of the other responsibilities associated with a dental practice. One dentist said he tried to start a charity day at his office, but arranging it proved too complicated. He felt it was easier and more productive to bring his staff to work at the clinic for a couple of days.

My favorite story is about a little boy who came up to ask me for some tape. I could only find blue painter’s tape, but he was content with that. In the waiting area he sat ripping up scrap paper and tape, then when the time came for his mom to be treated he went up to the dentist, shyly said something and held out his creation. The dentist teared up and put a haphazard paper crown on her head, where it remained for the rest of the day.

Later the dentist said the mother had been in so much pain she was having a hard time functioning. The boy wanted to thank the dentist for helping her so he could “have his mommy back.”

On my last night is when it struck me. Staff at my hotel stopped to thank me for helping at the clinic which many of them attended because, even with access provided by the ACA, healthcare costs were still too steep to get all of the care they needed elsewhere.

That’s when I realized these people were just like my in-laws who worked in good jobs all of their lives, well into their seventies, until increasing health issues forced them to retire.

Even with help from their children and the benefits provided by Medicare they don’t have enough money to cover the mortgage, utilities, food, medications, medical, dental and vision care that they require. It is a horrible and helpless feeling to see someone you love have to choose between the most basic needs, but even more so to be in that position.

I know that dental professionals work day-in and day-out to provide care to people in need, they volunteer, take on charity cases and work to affect the system for the benefit of their patients. Yet despite all of these valiant efforts there are still many people in our community with unmet healthcare needs. I also recognize that a clinic like this is just one small piece of a very large puzzle. It’s not going to serve everyone, however, it will address pain and infection for hundreds of people so that maybe in that month they won’t have to choose between health and heat, or they can eat once again, or spend quality time with their children.

As the Project Director it has been an honor to meet and work with such a tremendous array of people and organizations. Seeing the community rally around this project truly does, as one participant described, “demonstrate the dedication of a caring community.”

We hope you’ll be a part of it too, October 23 – 26 at KeyArena! Information on how to volunteer is available at www.seattlecenter.org/volunteers or you can email me at julia. colson@seattle.gov

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Ms. Julia Colson Event Manager, Seattle Center

“As an event manager at Seattle Center, I’ve been involved with some amazing experiences, but when I visited one of these free clinics in California run by Dr. Russell Webb I realized that this project would take the cake. Quite simply, it was the most inspiring moment of my life to witness the generosity, humanity and dignity of everyone involved.”

guest editorial ms. julia colson

A different perspective

pndc news pndc in pictures

Another amazing educational experience!

For the second year, the Pacific Northwest Dental Conference was held in Bellevue, Wash., a short drive across the lake from Seattle.

Attendees continue to tell us that they not only like the educational offerings, but they’re enjoying our new host city as well. Monica Salver, a dental assistant, said, “Downtown Bellevue is beautiful and clean! I loved all the outdoor art. I also loved that my badge earned me $2 off at the Bellevue Art Museum. I really liked not fighting the traffic and construction in downtown Seattle. The Meydenbauer Center is a very nice location. I liked having lunch on Thursday outside on the terrace!”

Sip, Spend, Save!

Attendees flocked to the Meydenbauer Center on Thursday night for the second annual “Sip, Spend, Save” reception, featuring signature cocktails sponsored by Nakanishi Dental Lab and AmericanWest Bank, and tons of appetizers distributed throughout the Hall. Exhibitors like the event because it gives them additional face time with practice decision makers, and attendees go to party and play with colleagues and friends — it’s a great way to kick off the conference!

Complete the survey and be entered to win!

If you attended the PNDC this year, we want to hear about it! Your feedback is essential to the success of the conference, and we value your opinions. Take our short survey before July 31 and you’ll be entered to win a 2015 PNDC Full Conference Badge. Take the survey here: https://www.surveymonkey.com/s/N7N7NL6.

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A look in pictures

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Photos by Anita Nowacka

pndc news pndc in pictures

2014 PNDC

pndc news pndc in pictures

“Bellevue was a nice host city for PNDC. All the food I had was tasty and there were a lot of restaurant choices in the area which was convenient. The city was clean and the staff was very friendly.”

— Dr. Todd Garcia

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pndc news pndc in pictures Photos by Anita Nowacka

“I really enjoyed PNDC. The staff did a fantastic job. The Bellevue area is nice and modern. The shops and dining choices are amazing, especially for a “tourist” like myself. The free gourmet coffee bar welcomes you with great hospitality. The shuttle bus was very helpful and easy to access. The parking options are much better than downtown Seattle. I will highly recommend PNDC to my Canadian colleagues.”

— Dr. Jones Young

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pndc news pndc in pictures

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pndc news pndc in pictures The Crowd Goes Crazy For Russell Wilson!

The fans came dressed head to toe in Seahawks gear — brighteyed despite the early hour — ready to hear the Superbowl Quarterback answer a wide range of questions, even some from audience members. Wilson was funny, gracious, humble, and reverent — and served to further solidify the perception that he’s a talent who hasn’t been corrupted by his ego or the media.

Photos by Anita Nowacka

Mobbed by fans as he exited the hall, Wilson stopped to sign many autographs along the way to the Foundation fundraising event that followed immediately after.

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pndc news pndc in pictures

“I got to meet Dr. Gordon Christensen — amazing man! Even got my picture taken with him! Kevin Henry was a powerful speaker, really enjoyed his session.

Best convention ever!”

— Tracee Godfrey, RDA

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Photos by Anita Nowacka

pndc news pndc in pictures

“I appreciated the PNDC shuttles to and from each facility. The trips were very quick and easy.

The classes were great; and the shopping in Bellevue is always fun. I do appreciate Bellevue as the host city, as I always feel safe walking around the city at any hour.”

— Cindy Hedstrom, RDA

pndc news pndc in pictures Selfie fever at the PNDC

When not snapping selfies with a cutout of Russell Wilson (best PNDC prop, ever!) attendees were busy capturing lighter moments during the two days, which were then posted to the Photo Wall in the Exhibit Hall. Next year, we’re going to make the experience even more interactive, just wait!

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Photos by Anita Nowacka

pndc news pndc in pictures

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Why a Career at Willamette Dental Group?

As a Traveling Dentist, I always feel like, and am treated like, a Hero! My assignments take me to offices where there is a need, especially for a dentist with experience. Dentistry allows me to enjoy a genuine feeling of satisfaction for the good services I provide; as a Traveling Dentist, I can say that feeling is double.

Practice proactive dentistry.

Learn more about our dentist referral program or to apply:

David Skvorak, DDS Traveling Dentist | OR, WA, ID

Nathalie La Chance, nlachance@willamettedental.com, 503-952-2172

www.WillametteDental.com/careers WSDA NEWS JULY 2014

PROFESSIONAL RACTICE P SPECIALISTS,

INC.

1-800-645-7590

Aaron Pershall - Randy Harrison NEW! BELLEVUE, WA – Highly profitable G/P collecting $1.2M+ in 2013. 4 ops, digital x-rays, all in a stylish office space.

SW ALASKA – Great G/P situated in a sportsman’s paradise! Collecting $700K+ working only 37 weeks per year! Associateship also available.

NEW! FAIRBANKS, AK – Long established, profitable G/P collecting $700K in 2013. 3ops. Great staff ready to transition.

BELLEVUE, WA – Biological dental practice collecting $600K. Amalgam free/safe office features 7 ops (5 equipped) and digital x-rays.

KETCHIKAN, AK –G/P collecting $600K. 100% fee-for-service. Longestablished office has 4 ops, updated about 5 years ago.

FAIRBANKS, AK – Associate wanted for busy endodontic practice!

LEWIS COUNTY, WA - G/P collecting around $1.2M. Pano, 7 ops, ample parking, great access.

RURAL ALASKA – Collecting $350K+ working just 10 weeks per year! Includes SUV and small apartment. Perfect satellite practice!

HOMER, AK - G/P collecting around $550K in 2013. Wonderful, long established practice includes a great staff, digital x-rays, laser, and pano.

OR COAST – Several opportunities.

WESTERN OR OMS - Tremendous growth potential. Great, easy access building with good off-street parking.

ALASKA PROSTHODONTIC – Exceptionally productive practice collecting $1.5M+ in 2013. Seller willing to stay for transition.

JUNEAU, AK – G/P collecting $1M. 5 ops, digital x-rays and pano.

MAT-SU VALLEY, AK – Excellent G/P collecting almost $400K in 2013.

Newer equipment, 3 ops, pano and digital x-rays. Seller relocating.

www.PracticeSales.com Aaron@PracticeSales.com RandyH@PracticeSales.com

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www.wsdasource.org

Puget Sound

In association with Pierce County Dental Society, Seattle King County Dental Society, Snohomish County Dental Society 8/9

Achieving Anterior Esthetic Excellence · Dr. Don Jayne

9/5

Practice Management and Marketing for Practice Owners Dr. Rhonda Savage and Sesame Communications

10/15 Dental Materials 101: Understanding What to Use and

When for Direct and Indirect Restorations ·

Dr. Michael Johnson 11/13 Models of Dental Practice - How Dental Benefits Effect Your

Business · Dr. Michael Perry 12/3

An Interdisciplinary Approach: Utilizing Orthodontics to Enhance Restorative Outcomes · Dr. Rebecca Bockow

Spokane

In association with Benton-Franklin Counties Dental Society,

Spokane District Dental Society, Yakima Valley Dental Society 8/23

Introduction to Anterior Esthetics - Ceramic Veneers Dr. Ariel Raigrodski

9/25

An Interdisciplinary Approach: Utilizing Orthodontics to Enhance Restorative Outcomes · Dr. Duane Grummons

10/10 Practice Management and Marketing for Practice Owners

Dr. Rhonda Savage and Sesame Communications 11/19 Dental Materials 101: Understanding What to Use and

When for Direct and Indirect Restorations

Dr. Michael Johnson 12/17 Dental Insurance: What Practice Model Is Best For You?

Dr. Michael Perry Southwest Washington

In association with: Clark County Dental Society, Lewis

County Dental Society, Lower-Columbia District Dental

Society, Thurston-Mason Counties Dental Society 8/23

Introduction to Anterior Esthetics - Ceramic Veneers Dr. Ariel Raigrodski

9/17

Dental Materials 101: Understanding What to Use and When for Direct and Indirect Restorations · Dr. Scott Dyer

10/17 Practice Management and Marketing for Practice Owners

Dr. Rhonda Savage and Sesame Communications 11/20 An Interdisciplinary Approach: Utilizing Orthodontics to

Enhance Restorative Outcomes · Dr. Duane Grummons 12/11 Models of Dental Practice - How Dental Benefits Effect Your

Business · Dr. Michael Perry

FOR THE YOUNG DENTIST In the last issue of the WSDA News, we told you about the formation of the WSDA Academy, a statewide CE program directed to the needs of dentists out of dental school or their graduate/ specialty program for a decade or less. Held in conjunction with the state’s 17 component societies, The Academy will offer 16 courses presented at no cost to participants at three locations in the state — the greater Seattle area, as well as Clark and Spokane Counties.

The first event was held at the PNDC, and program coordinators were very pleased with the results of the sold-out event — “Everyone who took the survey following the workshop said they would attend another lecture by Dr. Little,” said Laura Rohlman, Membership Manager for the WSDA. One of the doctors in attendance, Dr. Kim Trieu, said, “I was so fortunate to be one of the attendees to the sold-out course offering from WSDA Academy. The first CE course available was provided by Dr. David Little. Having just graduated from dental school, it was great to learn along with the other dentists in the room, and it was motivating to hear about their experiences. I made a few contacts that I hope to build lasting friendships upon. The only catch is that you have to check your WSDA e-mails frequently and sign up early. The spaces really do fill up quickly!”

Registration for the cosmetic dentistry/smile design courses in August is now open. August 9: Salish Lodge, August 16: Great Wolf Lodge, August 23: Cour D’ Alene Resort. Register for the WSDA Academy here:www.wsdasource.org.

Questions about the WSDA Academy?

Please contact Laura Rohlman at (206) 973-5218 or email her at laura@wsda.org.

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membership news wsda academy

2014 WSDA Academy Schedule

wohf news 2014 wohf classic

Clark County Takes the Prize...AGAIN We swear it’s not rigged, but the team from Clark County walked away with the Component Cup for the third time in the WOHF Golf Classic’s four-year history.

Team regulars Drs. Dan Warner, Mike Warner and Mark Johnson were joined

by Kurt Olson this year (top right, opposite page) at The Golf Club Redmond Ridge on Saturday, June 13 for a fun day golf, food and prizes to support the work of the Foundation across the state. Special thanks go out to event sponsors: Constantine Builders, Inc, Stuart Silk Architects, and Max Technologies, who make the day possible.

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Clark County team takes the Cup…again!

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Photos by Bev Sparks

wohf news 2014 wohf classic

WOHF GOLF CLASSIC

legislative news andy hill fundraiser

SENATOR ANDY HILL

Fundraiser hits the mark during PNDC

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Photos by Rob Bahnsen

legislative news andy hill fundraiser

DentPAC would like to thank all of those who contributed to, and attended, the grassroots fundraiser for State Senator Andy Hill (R-Redmond).

More than 25 dentists and dental students attended the June 12th event in Bellevue which was hosted by WSDA President, Dr. Dave Minahan, WSDA President-elect, Greg Ogata, SKCDS Past-President, Dr. Patrick Taylor, SKCDS President, Dr. Audrey Tatt, and SKCDS President-Elect, Dr. Judson Werner. Grassroots dentists from across the state attended the reception and raised over $6,000 for Senator Hill's reelection campaign.

Senator Hill has been a friend of dentistry and small business throughout his career in public service. He is currently the Chair of the Senate Ways & Means Committee and was selected as the chief budget writer and negotiator in the Washington State Senate in 2013.

As the architect of the 2013-15 operating budget, Senator Hill was able to help keep tuition rates flat in Washington's public universities and colleges, reinstated the Adult Dental Medicaid program and invested an additional $1 billion into K-12 education.

If you were unable to attend the event and would like to show your support for Senator Hill's reelection, you can still contribute online at: https://www.completecampaigns.com/ public.asp?name=HillAndy&page=31

cover stor y medicaid audits: will your practice be next?

If you’re a general dentist or a specialist accepting Medicaid in the state of Washington, you may soon be the target of a federally mandated audit of your practice devised to ferret out fraud by providers in the system. And while as an Association we stand behind any effort to quash fraud perpetrated by dental professionals against the federal government, the results of two recent audits conducted on WSDA members seem to paint a more malevolent picture: with auditors alluding to prison time for non-compliance and querying staff about the personal spending habits of the doctors unrelated to the practice. And, as you will see, while initial claims well into the six figures have been disputed down to just a fraction of that amount (after lengthy procedures and wait times), neither dentist has received a final judgement — a year or more after the audits began.

— continued on page 24

MEDICAID AUDITS: Will your practice be next?

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Photo by Bruce Andre

cover stor y medicaid audits: will your practice be next?

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cover stor y medicaid audits: will your practice be next?

Here, we’ll walk you through two types of audits you’re most likely to encounter as a Medicaid provider, and tell you what you can do to prepare yourself for the process.

ers identified by Review MICs.

Editor’s note: These descriptions of the audit processes are in brief, summary form. They do not contain all details in the rules, and should not be relied upon as a substitute either for legal advice or review of the specific rules. Note that time periods may be treated as cutoffs for the provider (time to appeal, etc), but are probably guidelines as to the auditor’s process. Also, there are other, distinct forms of audits which are likely to be in use in the next few years, but are beyond the scope of this article.

MIC Audit Process:

• Education MICs — Auditors who educate providers and beneficiaries on program integrity issues.

Currently, MIC audits are being conducted in Washington state on dental providers and, according to the Health Care Authority (HCA), have been taking place since May of 2012. HMS Federal is the MIC in Washington state. When conducting audits, HMS is auditing claims from the past three years with a typical sample size of 250 claims.

1. Each month, CMS gives Review MICs a data analysis assignment in which CMS specifies the state, type of Medicaid claims data, and range of service dates to be reviewed. After a lengthy audit target selection process, CMS assigns audit targets to Audit MICs. 2. An Audit MIC will contact the provider and schedule entrance conferences which may be conducted in-person or by phone. Providers will receive ten business days’ notice of intent to audit.

Providers will also receive an initial notification letter and a records request which outlines the specific records which will be audited.

Medicaid Integrity Contractor (MIC) Audits Background: Federal legislation known as the Deficit Reduction Act (DRA) of 2005, established the Medicaid Integrity Program (MIP), a program directed at reducing Medicaid fraud.

Under the MIP, the Centers for Medicare & Medicaid Services (CMS) contracts and pays MICs for their activities in identifying fraud, waste and abuse. MICs are not paid on a contingency fee basis and their payments are unrelated to identified overpayments. There are three types of MICs:

3. Audit MIC conducts audit including documentation and records review. These audits may be desk audits or field audits and should be conducted according to Generally Accepted Government Auditing Standards.

• Review MICs — Auditors responsible for reviewing state Medicaid claims data to identify providers whom have received potential overpayments.

• Audit MICs — Auditors responsible for auditing specific provid-

4. Following the audit, the Audit MIC holds an exit conference in which the provider has the opportunity to comment on preliminary findings and provide any additional information as needed.

Providers have 30 days from receipt of the preliminary findings to submit an informal dispute.

GLOSSARY: Automated Audit

A review of claims data without a review of records that support the claim. Used for payment errors that do not require human review of records.

Claim

Each procedure or encounter billed by a provider.

A statistical measure of the reliability of an estimate.

Desk Audit

An audit in which those who are being audited send copies of requested records to the auditor’s office.

Extrapolation

CMS

The methodology of estimating an unknown value by projecting, with a calculated precision (i.e., margin of error), the results of an audited sample to the universe from which the sample was drawn (WAC 182-502A-0200).

Centers for Medicare & Medicaid Services

Complex Audit

Confidence Level

A review used to find improper payments on claims that cannot be determined by a simple review and requires a manual evaluation of records and supporting documentation.

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6. Within 28 days of receipt of the final audit report, a provider may appeal audit findings and is entitled to full appeal rights under state law.

Medicaid Recovery Audit Contractor (RAC) Audits *Please note that at this time the WSDA is unaware of any dental providers being audited by a Medicaid RAC in Washington state. However, Medicaid RAC audits have been conducted on dentists in other states.

Background: The Affordable Care Act (ACA), which was passed by Congress in 2010, requires states to partner with Medicaid RACs to identify both underpayments and overpayments by the state Medicaid agency. In September of 2011, CMS published final Federal regulations which required states to implement their respective RAC programs by January 1, 2012.

Medicaid RACs perform both automated and complex reviews. They are paid on a contingency fee basis, meaning they receive a percentage of identified overpayments. According to CMS, states may pay contingency fees up to 12.5 percent. When conducting a RAC audit, a Medicaid RAC must not review claims that are more than 3 years from the date the claim was filed unless it has received permission from the state, as is specified in CMS’s Final Rule.

In determining what area of a state’s Medicaid program to target, the states have full discretion in deciding the areas Medicaid RACs focus on. Therefore, any particular provider participating in a state’s Medicaid program could be subject to a RAC audit at some

Field Audit

An audit which is conducted on-site at a provider’s office.

Generally Accepted Government Auditing Standards

General standards used for auditing private companies. The standards cover qualifications to be an auditor, standards of work product, standards of fieldwork, and information that should be considered before issuing a final report.

Health Care Authority

A state organization responsible for overseeing various health care programs such as Medicaid and other medical assistance programs.

point in time. CMS does not require states to announce in advance the audit areas which their Medicaid RACs will focus on. CMS does not have national guidelines in place for how a state conducts their Medicaid RAC audits. Each state is responsible for determining guidelines for the audit process (such as how many records can be requested, the appeal process, etc.) for a Medicaid RAC audit.

RAC Audit Process: 1. Under WAC 388-502A-0600, providers receive 10 business days’ notice of intent to audit.

2. For desk audits, providers have 30 calendar days to submit records. For on-site reviews, a RAC should schedule a review 30 days in advance.

3. Under federal regulations, Medicaid RACs have 60 days to notify providers of overpayment findings and send Preliminary Review Results to the provider. Providers may request an Informal Dispute Review conference within 30 days of the receipt of their Preliminary Review Results, providing any additional information they wish to have considered.

4. Medicaid RACs will send Final Review Results within 45 days of Preliminary Results notification or within 60 days of completing Informal Dispute Reviews.

5. Providers may request a formal appeal within 28 days of receiving the Final Review Results.

Appeal process in Washington state: Under Washington state law, providers who have been audited have two opportunities to dispute audit findings: an informal dispute process and a formal appeal.

Overpayment

Any payment or benefit to a client or to a vendor in excess of what is entitled by law, rule or contract, including amounts in dispute, as defined in RCW 43.20B.010 (WAC 182-502A-0200).

Sample

A selection of claims reviewed under a defined audit process (WAC 182-502A-0200).

Universe

A defined population of claims submitted by a provider for payment during a specific time period (WAC 182-502A-0200).

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cover stor y medicaid audits: will your practice be next?

5. An Audit MIC will prepare a Draft Audit Report if there is a potential overpayment. This report is reviewed by both the state and CMS. CMS determines the final overpayment amount and submits a final audit report to the state. The state then issues a final audit report to the provider and is responsible for collecting overpayment from providers and returning the federal share to CMS within one year.

cover stor y medicaid audits: will your practice be next?

Provider Audit-Dispute Process (WAC-182-502A-1100): • Providers may dispute draft audit findings by submitting a written request within 30 calendar days of receipt of the draft report.

• The provider must specify which findings they are contesting, supply documentation to support their position, and indicate whether a dispute conference is requested.

• The HCA/contractor may decline a provider’s dispute request.

• A provider must schedule a dispute conference within 60 days of receiving a written acceptance of the request for a dispute conference.

• If during the dispute conference an agreement is reached, the HCA/contactor will issue a final audit report. If an agreement between the provider and HCA/contractor cannot be reached during the dispute conference, and the provider has had the opportunity to raise all concerns, the HCA/contractor will close the dispute process and issue a final audit report.

Provider Audit-Final Report/Appeal (WAC 182-502A-1200):

of paid claims for a specific time period (claim-by-claim audit), and random sampling and extrapolation. According to recent documentation from the HCA’s Office of Program Integrity, auditors often use random sampling and extrapolation.

WAC 182-502A-0900 lays out the following requirements when conducting audit sampling, extrapolation and claim-by-claim review: • When conducting an audit, a sample size must be sufficient to ensure at least a ninety five percent confidence level.

• When calculating the amount to be recovered, the department totals all overpayments and underpayments reflected in the sample and may extrapolate to the universe from which the sample was drawn.

• When the department uses the results of an audit sample to extrapolate the amount to be recovered, the provider may request a description of all of the following: (i) The universe from which the department drew the sample; (ii) The sample size and method that the department used to select the sample; and (iii) The formulas and calculation procedures the department used to determine the amount of the overpayment.

• Upon receiving a final audit report, a provider has 28 calendar days from the date of the report to appeal the overpayment.

• When a claim-by-claim audit is conducted, specific claims are selected from the universe and audit overpayments are not extrapolated.

• A request for an audit appeal must be in writing, state the basis for contesting the final audit report and be served on the HCA within 28 calendar days in a manner which provides proof of receipt.

• During an audit appeal hearing, the provider will carry the burden of proving compliance with applicable federal and state statutes and regulations, billing instructions, fee schedules, and published memoranda.

Audit Methodologies:

• The department recovers overpayments identified in the final audit report.

• The department does not consider nonbilled or zero paid services or supplies when calculating underpayments or overpayments.

• The department considers undocumented services to be program overpayments.

There are several methods in which audits may be conducted.

These methods include the use of algorithms, 100 percent review

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How will I know if I am being audited?

What types of records may be requested during an audit?

How can I prepare for an on-site (field) audit?

• Prescription records

You will be notified by the contractor conducting the audit via correspondence, a telephone call or both.

The Health Care Authority’s Office of Program Integrity has provided the following recommendations in preparing for an onsite audit: • Provide a workspace or room, with table and chairs and adequate electrical outlets for audit equipment.

• Have key office staff available during the audit for the audit team to interview.

• If medical records are requested in advance, please have records in alphabetical order placed in the designated workspace for the auditors.

According to the Health Care Authority’s Office of Program Integrity, the following is a list of potential requested documents. Please note this is not an all-inclusive listing.

• Office visit notes • Patient care plans • Diagnostic test results • Dental x-ray films • Treatment records • Durable and non-durable equipment/product delivery documents

• Have copies of current business license(s) and professional healthcare licenses of all pertinent staff available for the auditors.

• Transfer records/referral documents • Medication administration records • Financial report/accounting/billing records

Should I have an attorney present during the audit?

“Not everyone will choose to have an attorney present during the early stages of an audit,” says Alan Wicks, General Counsel for the WSDA, “But engaging your attorney early can be very helpful later on, especially if there is a chance that you will need to contest the audit.”

Generally, Wicks advises engagement of an attorney early on, and consultation about the degree of involvement in the early stages of the audit.

Will I be reimbursed for costs incurred during an audit?

Under WAC 388-502A-0800, providers are not reimbursed for administrative fees such as copying fees for records requested during an audit.

• Third party insurance documents • Credit balance reports • Appointment books • Ownership agreement/business license and professional staff licenses/certificates • Office/facility policies/employment records • Complete hospital medical records

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cover stor y q & a

AUDIT Q & A: Information you’ll need in case of an audit

Editor’s Note: For this sidebar we spoke with two dentists who were audited in the past year, both were MIC Audits, and both audits were conducted by HMS Federal, an independent contractor hired by CMS to carry out the audits on their behalf. We cannot speculate or extrapolate to general populations based upon these two cases, they are simply presented as cautionary tales to allow you to prepare your practice for an audit. The dentists have asked to remain anonymous, and in this article they will be referred to as Dr. A and Dr. B.

small, rural community in eastern Washington. With more than 50 employees and hundreds of pediatric Medicaid patients a day, Dr. A’s practice epitomizes the type of practice that is likely to become the target of an audit. In fact, they had already gone through an educational audit, a process they said was instructional and beneficial to the practice, “They made recommendations for positive change,” he relates, “We were very open, and already looking to how we could work with our staff and retrain them. We were given constructive direction to do better and help more children.

In contrast, this audit was not at all like the first. These second auditors said they worked for the federal government (in fact, they were contractors working for a corporation on behalf of the government) and informed us they would find mistakes and we would be fined because of them. Our feeling was that they could do anything they wanted, and they didn’t care if we improved our services or not – in fact, they didn’t want us to do better. They only wanted us to return income that was erroneously taken from the government. The difference in these two audits was in their intent.

The first audit was to help our clinic improve and treat children better; the intent of the second audit was simply to find errors and generate fines to take money back from our clinic.”

Prison time

During the second audit, the two auditors were in the practice for a week, and prefaced their visit by informing the partners that if they did not cooperate with them they could face additional fines,

Photo by Bruce Andre

A TALE OF TWO AUDITS

Dr. A “Dr. A” is one member of a large, multi-dentist practice in a

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penalties, or even prison time. The auditors privately interviewed many staff members, asking if they knew if the partners were ethical, and if they suspected the doctors of committing fraud in any way. Fortunately, Dr. A’s office manager was able to sit in on all interviews. When interviewing the dentists, they asked each doctor if they knew of any other doctors within the practice or elsewhere making false claims or mistakes.

The auditors initially asked for 200 specific files, and when they arrived they requested 50 more that they had supposedly chosen at random. Dr. A’s office manager felt that they were looking for specific, targeted problems. “Things like fluoride applications, limited exams, and chart verbiage were all red flags,” said Dr. A, “The auditors explained that they would take the deficiencies and extrapolate these mistakes to the general population of the practice to arrive at a fine, and bill us for that amount.” The news came as a shock to the partners: with 100,000 patient records in the practice, the potential fines were enormous. “We were instructed that we needed to devote staff members to the auditors for the entire week. This was probably less than $10,000 in lost salaries to the company. We were infinitely more concerned with the possible fines, given that the auditors were extrapolating errors from the files they pulled to the general population of the practice. If five errors were found in 200 charts — that would be 2.5 or 2,500 theoretical errors. If each error was only $5, the amount owed back would be $12,500. However, if there was a fine of $100 and a penalty for $300 per error, it would then become a $1 million slap on the wrist.”

But fines and penalties aren’t Dr. A’s only concern — attorney fees could easily top that amount. He has learned of a dentist in Washington with initial errors/penalties/fines of $6 million — which were later whittled down to $750,000 in court — but the dentist still had to pay his lawyers in excess of $1 million dollars for his defense.

But how did Dr. A arrive at the $10,000 salary loss figure? His office manager and other employees had to put all work on hold while the auditors were there, but worse than that, the auditor charged with scanning the records discovered that she hadn’t saved them in the right format. Dr. A had to pay his staff overtime to get everything scanned properly — they stayed all night to get it done. “This was a huge cost accrued to the practice which doesn’t help children at all — and that’s what we’re here to do.” he said.

In hindsight, Dr. A says there are several things he would have done differently — including engaging an attorney from the very beginning. “We contacted attorneys after the audit, but they told us that there is little we could do at that point. They told us that it was inappropriate for the auditors to meet with staff privately, for instance. The problem is, the auditors made us feel that if we didn’t do everything they demanded, that we would be in violation of the law.” Additionally, Dr. A did not realize that he was able to save an identical copy of the records the auditors took — something the WSDA says can help your case (Dr. B did, and it helped tremendously when it came time to dispute the auditor’s findings).

And while he knows it won’t make a difference in the outcome of his audit, one thing still rankles Dr. A — “I would really love to see what the purpose of the audit is – if it is to make money because Obamacare is failing that’s one reason to do it, but if it is to make dental offices better so that we can treat more high-risk children in the program that’s a completely different reason.”

Dr. B

Dr. B has a small practice in an urban setting. He’s been highly active in the state’s ABCD program, so when the auditors first contacted him from HMS Federal, he felt confident about his practice’s billing procedures — after all, he had been trained by the state (and had even trained other dentists in the proper billing procedures). He was blind-sided by the outcome of the audit, saying, “Although they were polite,” Dr. B relates, “They asserted their authority on behalf of the federal government, and told us that not being in compliance could endanger our contract. As a flagship office we were happy to have them come in, we simply were not worried. Once we got the initial findings we were embarrassed, and since we didn’t know

other offices going through the same thing we didn’t reach out, but we should have.”

While the auditors declined to name an exact fine based on the discrepancies they found in the audit process, by working with a consultant Dr. B was able to estimate that the initial figure was approaching $1 million, though that has never been confirmed.

The problem was that more than 70 of the files the auditors had requested were not Dr. B’s patients — and proving that to the auditors was vexing. “Somewhere, our provider number was being used by a different practice, and there were problems on those files. We were associated with other offices at one time, and those offices had used our provider number.”

While the auditor assured Dr. B that she could handle tracing the error, he wasn’t convinced. He explains, “They would come in at 8 or 9 and often take a two hour lunch, and then they would want to work until 3:00 or 4:00.” He continues, “And even though we knew the records in question were not ours, the auditor was adamant that we find and include them in the sample.” Ultimately, they were able to prove the patients weren’t theirs, but it took 46 hours of staff time to get it straightened out — working with the state to establish a tracer on the checks, and then working closely with the bank, which wrote a letter stating that they were not associated with the patients. Dr. B, his wife, and their finance coordinator were also careful to make identical copies of every file requested and used in the sample by the auditors — something that was tremendously helpful in the dispute process.

A long process

The process has been a long one and is still not complete more than a year after it began. Dr. B explains, “They first contacted us in March of 2013, and they conducted the interview and audits that April. My wife kept after them quite a bit, but we didn’t receive the draft report until a year later, in March of 2014, and we were given 30 days to provide a rebuttal. One of the excuses for the time lapse was the government furlough. We still have not seen a final report, but we assume that it is being reviewed by the state at this time.” While it is possible that the fine could inch into six figures, he’s hopeful that with the help of a consultant hired to verify the auditor’s findings, that figure will be greatly reduced.

Dr. B estimates paying 70 hours of staff time before the audit, 50 hours of his time after the audit, plus attorney and consultant fees of roughly $7,000 total.

Still, Dr. B says he would not have gotten the attorney involved earlier. “I know our attorney, and he would have just told us to proceed. I don’t think getting a consultant involved any earlier would have helped us, but it’s hard to say if it would be helpful for another office.” He would, however, advise dentists being audited to bring in extra help during the audit procedure — his wife is not an integral part of his staff and was able to devote many hours to the audit, and his finance coordinator was involved from start to finish. Having another person there to help direct the day-to-day operations of the practice would have been helpful.

But even though the audit process isn’t finished, Dr. B and his staff have used the experience as a teachable one, saying “We have been actively retraining our staff – each time something would come up in the audit, we would meet with staff and redirect them.

We’ve looked at our billing procedures to clear up potential problems. It’s been hard on the staff to go through this with us, we have to imagine that they have worried about the future. We’ll be grateful when it’s all over.”

In conclusion

Review procedures often, and make a point to do random checks of your staff’s work. Clerical errors and fraud — though vastly different — are treated identically in an audit. And if you do get audited, don’t take it personally, says Dr. B “We’re passionate, emotional type A people. We want to come out swinging because we’re so offended, but we need to take two steps back and look at it objectively.”

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members giving back dr. nordberg in guatemala

Making a difference in Guatemala For the past 12 years WSDA Member and Loma Linda

Dental School Adjunct Professor Dr. Kim Nordberg has been making short term dental mission trips to Guatemala and El Salvador with a group that has included his sons Peder and Eric; students from dental schools at Loma Linda, USC and UCLA; and fellow dentists from the Christian Medical Dental Association of Southern California.

While there, they see as many as 400 patients a week, working with 20 or more students and other volunteers including church members, local Christian dentists, interpreters, and even mechanics and electricians, providing care in 15 ops with nomad x-ray and digital laptop sensors, among other high-tech equipment.

Dentists interested in participating in trips with the group can contact Dr. Mike Roberts, CMDA Southern California Area Director at drmiker@sbcglobal.net.

Dr. Nordberg and his son, Peder

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Dr. Kim Nordberg

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Photos courtesy of Dr. Nordberg

members giving back dr. nordberg in guatemala

MEMBERS GIVE BACK:

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As you build your financial portfolio both for your financial security now and in anticipation of enjoying a long retirement, you need to factor in the cost of care for when you need assistance in your home or become a resident of a nursing home or assisted living facility. The average length of stay at a nursing home is 2.5 years, which in Washington State could cost you over $250,000. You can designate money in your portfolio to cover the costs or you can purchase Long Term Care Insurance.

For 2014, the average annual cost of a nursing home in Washington is $102,000; an assisted living facility is $51,000 and in-home care with a health aide is $52,500.

Long Term Care Insurance will help you meet the cost of your spouse’s and your care should you need assistance with daily living. It gives you the flexibility to choose when and where you receive care and to provide emotional and financial support for your family.

70% of people over the age of 65 will require long term care services at some point in their lives.

Long Term Care Insurance is similar to Disability or Life Insurance in that you are paying a monthly premium to have a pool of money available to you when you need it. Unfortunately, “Long Term Care” is not an accurate description of the benefits provided on a Long Term Care Insurance policy: “Family Freedom Coverage” may be a bit more accurate. This type of insurance frees you from the substantial financial burden of paying for care while it frees your family from the burden of caring for you at the detriment of their time, finances and physical and emotional well being.

41% of people receiving long term care are between the ages of 18 and 64.

Since the need for assistance, not age, is the trigger for receiving long term care benefits, this insurance will cover you should the unexpected happen at any age.

For example, if at age 47 an illness or accident leaves you needing care, you would be eligible to receive benefits. This would allow your spouse to continue working or caring for your children while a professional caregiver came to your home to help you with your daily needs such as bathing, dressing or getting in and out of bed.

Washington Dentists’ Insurance Agency strongly encourages you to add Long Term Care Insurance to your insurance portfolio. Along with Disability and Life Insurance, Long Term Care Insurance will protect your family and you from the large financial burden that an accident or illness may cause. Purchasing coverage will relieve your family of having to center their lives around your personal care while giving you the freedom to choose where you would your care to take place.

To learn more about Long Term Care Insurance and to receive quotes, please contact WDIA at 206-441-6824 or 1-800-282-9342 or at info@wdiains.com.

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Matthew French Director of Insurance Services WDIA

“Long Term Care Insurance will help you meet the cost of your spouse’s and your care should you need assistance with daily living.

It gives you the flexibility to choose when and where you receive care and to provide emotional and financial support for your family.”

wdia news long term care

Why you need Long Term Care Insurance

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CHALLENGE?

THE SUITE CONTEST IS BACK, AND IT’S MORE

SUPER THAN BEFORE!

Winners celebrate at last year’s event

The Goal: To draft as many non-member dentists to join organized dentistry with a grassroots approach that centers around you — the active WSDA member.

The Game: Have all 17 component societies compete for the largest increase in membership based on the recruitment efforts of the component’s members.

The Prizes: WSDA recruiters from the top three components will win pairs of tickets to a

suite at a Superbowl Champions Seahawks game for the upcoming season, and everyone who recruits a new member can win cash and free badges to the PNDC.

Want to learn more? Visit www.wsda.org/suitechallenge Proudly sponsored by:

www.nordicins.com

th e wsda ne w s · issue 7, july · 2014 · www.wsda.org · 35

www.wdiains.com

membership suite contest returns

ARE YOU UP TO THE

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Complimentary Webinar:

Stumped With Your Student Loans?

What you need to know about advanced refinancing techniques

Daniel Shefer, Director of Business Development, SoFi Tuesday, Sept 30 · noon (PDT) · Space is limited Reserve your Webinar seat here:

https://attendee.gotowebinar.com/register/1256027467384349442

The webinar will cover:

• An introduction to student loan debt • A few comments on credit and financial wellness.

• Review government repayment programs.

• Introduction to SoFi and our joint program, cover the application process and discuss advanced debt reduction techniques applicable to dentists.

SoFi, WSDA’s newest endorsed company, consolidates and refinances student loan debt from both federal and private sources at markedly lower rates than those paid today, without charging the fees typically associated with loans — including application, origination or prepayment penalties — to its applicants and borrowers.

Questions about the webinar? Contact Craig Mathews at 800-448-3368 or by email at craig@wsda.org.

News from the Alliance of the Washington State Dental Association

The Alliance of the Washington State Dental Association (AWSDA) has created two funds to support the dental community of Washington State.

Grant Guidelines: • There is approximately $5500.00 in each fund.

• Fund #1 is to supply toothbrushes to those in need – up to 500 per project.

It may be for a free dental clinic, a safe house program, or other not-for-profit organization.

• Fund #2 is to be used for grants of $500 to $1000 to support community dental health projects. Projects might be educating children about good oral hygiene or educating youth about the dangers of smoking and meth mouth.

• All toothbrushes and project grants must be used for dental health in Washington State.

The Alliance believes in supporting our dental communities and looks forward to hearing from you. You can request a copy of the grant by writing to theminahan@ aol.com.

Koday named to post

WSDA member Dr. Mark Koday was recently nominated and selected for membership on the Prevention Measures Technical Workgroup of the Washington Health Alliance. The group is charged with recommending standard statewide measures of health performance by January 1, 2015.

The measures will inform public and private health care purchasers, and will enable identification of benchmarks to track costs and improve health care in the state.

Congratulations to Dr. Koday!

Open Enrollment Period for Adding Adult Dental to Certain Individual Medical Plans

The next Open Enrollment Period will be concurrent with the Affordable Care Act Open Enrollment Period of November 15, 2014- February 15, 2015. If would like to add dental coverage to your existing Premera or Lifewise Individual coverage, WDIA highly encourages you to sign up this month, or you will not be eligible for coverage until the next Open Enrollment Period.

For more information or to add dental coverage to your individual medical plan, please contact WDIA at: 206-441-6824 or 1-800-282-9342 or info@wdiains.com.

IRS Clarifies Rules on Employers paying Employees’ Individual Medical Insurance Premiums

Recently, the IRS clarified how employers are allowed to pay for employees’

th e wsda ne w s · issue 7, july · 2014 · www.wsda.org · 37

individual medical insurance premiums under the Affordable Care Act (ACA). In previous years, employers could pay an employee’s individual medical insurance premium with pre-tax dollars through an HRA (Health Reimbursement Account), but that is no longer legal in the majority of cases. While employers are still allowed to pay for an employee’s individual medical premium, those funds must be taxed.

Dentists who choose to pay an employee’s medical premium can do so by giving them a raise or a stipend that will go toward their medical premiums. But these funds will be subject to payroll taxes for the employer and is considered taxable income for the employee. If you continue to pay your employee’s individual medical premiums with pre-tax dollars you may be subject to a tax penalty of $100 per day, per employee. For more information, please see the following New York Times article as well as the IRS question and answer document on this ruling: http://www.nytimes.com/2014/05/26/ us/irs-bars-employers-from-dumpingworkers-into-health-exchanges.html, and http://www.irs.gov/pub/irs-drop/n-13-54. pdf Washington Dentists’ Insurance Agency recommends that you contact your accountant for clarification on how this IRS ruling affects you.

If you are interested in group or individual medical coverage, please contact WDIA at 1-800-282-9342 or info@wdiains.com.

newsflash issue 6, may 2014

newsflash

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Dr. Russell Paul “Russ” Esposito

Professional Management Associates, Inc

CURRENT LISTINGS Lake City Office

Great beginner office, three operatories, 20 new patients a month, three days a week

Olympia

General practice in Olympia, three operatories, recently remodeled, state of the art facility, a unique practice with some of its patients.

Kitsap Peninsula Office Four days a week, great location, state of the art facility, four operatories.

Redmond

Shared space in a beautiful office.

Space that is shared is reception room and staff lounge.

Completely ready to use.

Associate positions available at once!

Concerned About Fraud?

We can help review your records in a discrete manner. Call for a free list of items to help thwart embezzlement in your office.

Linnell Isoshima Steven Kanzaki 1206 Olympic Avenue Edmonds, WA 98020 Pager: (206) 399-0242 Fax: (425) 712-1859

Esposito was born March 26, 1920 in Spokane, Washington. He was the son of Pasquale (Charles) and Angelina Esposito, both deceased. He was raised in the Gonzaga University/St. Aloysius neighborhood, attending both St. Aloysius grade school and Gonzaga Prep before entering Gonzaga University. He enrolled in pre-medicine and played at an end position during Gonzaga University’s final era of college football. After college he attended medical school in Portland, Oregon attaining a degree in dentistry. While there, he met his future wife Peggy Tallman.

Upon completing his degree, they married on 11 November 1944 and he then joined the Army as a dentist during WWII. Later he transferred to the Navy and was stationed in San Diego. Following the war he returned to Spokane to open his practice but was forced to close it when he was recalled to active duty by the Navy during the Korean conflict. He was stationed in Oakland California Naval Base where he operated out of a mobile medical van serving the Naval Bay Area.

After Oakland he returned to Washington to attend the University of Washington where he completed a degree in Orthodontics specializing in maxillofacial surgery. His PhD thesis was photo-Elastic stress analysis.

He practiced orthodontics in Spokane with Peggy as his medical assistant. The couple retired at age 65 and began to travel. Russ enjoyed his immediate family, the Migliuri clan on his mother’s side in Spokane and the Scarcello side belonging to his father’s sister near Rathdrum, Idaho.

Esposito was an avid fisherman and hunter, traveling to Alaska with his brother, Joe. He loved his yard and garden and spent time relaxing with family and doing work on the family lake cabin at Twin Lakes, Idaho. He and Peggy traveled throughout the world visiting Europe, Australia, China, Canada as well as Africa and other locations, often to meet up with his uncle George Migliuri. He and Peggy took trips in their motor home around the county. He participated in charitable organizations, including services to reconstruct cleft palate deformities in children. He and his father initiated the annual Gonzaga Prep spaghetti dinner. Following the death of his wife, Verna Felice, a long-time family friend, became his constant companion.

He was preceded in death by his parents, wife Peggy and brother Joseph Anthony.

He is survived by his brother Charles, sister Gloria and her husband Richard Poole, sister-in-law Joyce Esposito, and close companion Verna Felice. Nieces and nephews; Charles’ children; Angela, Charles, Gina, Sarina and Anthony. Joe and Joyce’s

th e wsda ne w s · issue 7, july · 2014 · www.wsda.org · 39

daughters; Kate, Molly, Jill, Sara and Amy. Gloria’s children; Richard, Brian and Kristina. He was blessed with numerous great nieces and nephews.

Dr. Charles O. Evans

Dr. Charles “Chuck” O. Evans, was born in Dryden, Wash., September 13, 1931 to Gordon and Marjorie Evans. He graduated from Dryden High School in 1949. He earned his DDS from the UWSoD where he was a member of the Sigma Phi Epsilon fraternity. After college he was commissioned in the Army as a Captain at Fort Lewis. He enjoyed working with his hands and was a gifted craftsman.

In the 1960’s, he parlayed his talent into a successful and respected dental practice, where he was known for his skill and his artistry. Evans practiced for over 30 years in Parkland, Wash., providing service to his community and beyond, including state senators and congressmen who sought him out for his reputation. Upon retirement, he fully transferred his skill from tooth work to woodwork and felt most comfortable with a tool belt on and a hammer in his hand. He became “Mr. Fix It.” In 1954, he married Velma Meister. They were married 24 years. After Velma’s death, Evans married his beloved Josie, spending 35 full years with her exploring all that life has to offer. He competed nationally in downhill ski races. He piloted small planes, he biked with his friends, and nearly every day he got up early and went to work on his properties. His first love was golf. He was one of the oldest members still playing golf at the Tacoma Golf & Country Club, where he was known for his golf game and his vibrant clothing style.

Evans is survived by his wife, Josie; his brother, Richard (Gail); his children, Mike (Laura), Marsha, Dan, Susan (Joe); his stepdaughter, Jill (Sam); his grandchildren, Natalie, Trisha, Luke, John, and Iain; his nieces, Tammy, Hannah and Cindy; and nephews, Mark, David, Rick, Ryan, Robert, Murray, Jessie and Mark.

Dr. M. L.“Westy” Westerberg

Milton Leon Westerberg died peacefully on April 25, 2014. He was 91. Affectionately known as Westy, he was born in Sioux City, Iowa on January 2, 1923. The family moved to Everett, Wash, where he graduated from Everett High School. He served in the Navy during World War II and in the Army during the Korean conflict.

He attended the University of Washington, and obtained his dental degree from Washington University in St. Louis, where he met and married the love of his life, Jeanne continued on page 41

in memoriam drs. esposito, evans, westerberg

In memoriam

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4 0 · th e wsda ne w s · issue 7, july · 2014 · www.wsda.org

O F

W A S H I N G T O N

SCHOOL OF DENTISTRY

CONTINUING DENTAL EDUCATION FALL 2014

SEPTEMBER

NOVEMBER

6

1

Morning lecture: Management and Prevention of Gingival Recession: The Interactive Seminar George K. Merijohn, DDS Afternoon workshop: Autogenous Gingival Grafting: The KIWImethod™ Minimally Invasive Non-palatal Approach – a hands-on course George K. Merijohn, DDS

7

Save the Day with Emergency Preparedness!

Bart Johnson, DDS, MS

Hollender Symposium – Oral Radiology, The Evolution Goes On. Where Are We Now? Robert Langlais, DDS; John Ludlow, DDS, MS, FDS RCSED; Alan Lurie, DDS, PhD; Axel Ruprecht, DDS, MScD, FRCD(C); and Gerard Sanderink, DDS, PhD

12 Restorative Update 2014 Richard G. Stevenson III, DDS 22 Oral Pathology Evening Course: HPV-Induced Benign & Malignant Oral Lesions Dolphine Oda, BDS, MS

OCTOBER 3

An Update on Implant Options for the Partially Dentated and Edentulous Patient Including Fixed Removable Prosthetics Keith Phillips, DMD, MSD This course is offered in partnership with the Seattle King County and Pierce County Dental Societies, and will be presented in Auburn.

14 Oral Cancer Eric Statler, RDH and Dolphine Oda, BDS, MS This course is presented in partnership with the Washington State Dental Hygienists’ Association.

15 Provisionalization of Single Implants in the Esthetic Zone – a hands on course Yen-Wei Chen, DDS, MSD and Sul Ki Hong, DDS 21 Perio Topics for Today’s Dental Practice Morning: Perio Patient Information Management Afternoon: Nutrition, Lifestyle and Perio: An approach that can change lives Timothy Donley, DDS, MSD This course will be presented in Tacoma, Washington.

17 Sixth Annual Washington Dental Service Practice Management CDE Oral Health to Total Wellness: Discover the Links and Learn Practical Application Susan Maples, DDS 27 Oral Pathology Evening Course: Oral Ulcers and Sloughing Epithelium: An InDepth Evaluation of the Causes Dolphine Oda, BDS, MS 31 Clues to Your Patients’ Health: The Most Common Physician-Prescribed Medications Hal Crossley, DDS, PhD

Plan Ahead for Sunshine and Oral Pathology in 2015!

February 14-15, 2015 To Biopsy or Not to Biopsy: Soft tissue and Bone Pathology for all Dental Practitioners Dolphine Oda, BDS, MS This course will be presented in Lahaina, Hawaii

Online Courses at www.uwcde.com including Bloodborne Pathogens!

Registration Information: REGISTER Telephone: (206) 543-5448 Toll Free: (866) 791-1278 NOW! For more detailed course information and to register online visit www.uwcde.com

SCHOOL OF DENTISTRY UNIVERSITY of WASHINGTON

UNIVERSITY OF WASHINGTON IS AN ADA CERP RECOGNIZED PROVIDER ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

th e wsda ne w s · issue 7, july · 2014 · www.wsda.org · 41

In memoriam

continued from page 39

Rowenhorst in 1946. He attended the University of Minnesota, where he obtained his Oral and Maxillofacial Surgery and Medical degrees. He practiced at the Eye and Ear Hospital, as well as teaching at the University of Washington for 34 years. He was a member of the American Dental Association, International College of Dentists, President of Washington Dental Service and North Central Washington Dental Society.

He was an entrepreneur, as well as an oral surgeon, and owned orchards. With three partners, he purchased the town of George.

He started an equipment leasing company, eventually blossoming into the largest in the state and built the nine-story hotel next to the Wenatchee Convention Center.

He loved Wenatchee. He was president of Wenatchee Chamber of Commerce, president of Wenatchee Little League, president of the Wenatchee Chiefs and a member of many Wenatchee organizations. One of his other interests was travelling and he and Jeanne traveled extensively around the world, seeing every state in the union, all provinces of Canada, throughout Europe and Asia, as well as the Arctic Circle and the North Pole.

After retiring from his oral surgery practice in 1989, he and Jeanne moved to Arizona. He was active in the Desert Palms Presbyterian Church as an elder, a deacon and chairman of the scholarship and mission committees.

He is survived by his best friend and wife of 67 years, Jeanne; his children, Susan Baker (Gary) of Portland, Ore., Steve Westerberg of Wenatchee/Goodyear, Ariz. and Sheri Smith (Mark) of Wenatchee/Sun City West, Ariz; his six grandchildren, Justin, Marit, Jeff, Malia, Camille, and Garrison; his great-grandchild, Zora; and his sisters, Anne Marie Lorentz and Bernice Martin. He was preceded in death by an infant grandson, Cameron Smith.

in memoriam drs. esposito, evans, westerberg

U N I V E R S I T Y

4 2 路 th e wsda ne w s 路 issue 7, july 路 2014 路 www.wsda.org

2015 DENTAL ACTION DAY

SAVE THE DATE FEBRUARY 20,2015

th e wsda ne w s 路 issue 7, july 路 2014 路 www.wsda.org 路 43

Stuart Silk Architects is WSDA’S Endorsed Provider for Architectural Services •

Architecture

•

Interior Design

•

Planning

Exclusive complimentary benefit for WSDA members!

Finding a new location for your practice is rarely as simple as it seems and it is important to engage a qualified architect. We are pleased to offer a preliminary land use or tenant space code analysis exclusively to Washington State Dental Association’s members without charge or obligation. For more information, please contact Andrew Patterson at 206.728.9500. To read more about us and this special offer, go to www.stuartsilk.com/commercial/wsda.html.

206.728.9500 2014 WSDA AD-1.indd 5

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Stuart Silk Architects the commercial studio 5/28/2014 1:53:15 PM

4 4 · th e wsda ne w s · issue 7, july · 2014 · www.wsda.org

OPPORTUNITIES AVAILABLE

OPPORTUNITIES AVAILABLE

ENDODONTIST SEATTLE — Gentle Dental is currently has multiple openings for Endodontist for the Seattle area. As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits. You will also have plenty of dental professionals supporting you to confer and collaborate with as you continue to grow in your career. We seek high-caliber professionals possessing degrees or certificates from accredited colleges or technical schools/programs (as well as valid/current state license) with at least 1 year of dental experience. We aim to provide our network of affiliated doctors and staff with a competitive benefits package. Contact: Ron Brush, phone: 971-295-9914 or email: brushr@ interdent.com APPLY: http://interdent.force. com/careers/apex/ts2__JobDetails?jobId=a0xi 0000001YWwcAAG

SEEKING ASSOCIATE/PARTNER DENTIST — Port Angeles, Wash. We are a small group of private practices in Western Washington dedicated to providing dentistry at the highest level. We are seeking a long term associateship/partnership with someone who is passionate about providing excellent care and has the ability to relate to each and every patient.

The facility is modern, digital, and most importantly has an experienced caring staff to support you. Please email resume and CV to adam@cramerdentistry.com.

DENTISTS NEEDED — Light Dental Studios is a multi-practice dental company in South Puget Sound. We are a very special company with long-standing patients, doctors, and staff. We are seeking dentists for part-time and full-time positions in our existing 4 locations as well as expanding locations. We are looking for people with backgrounds of proven success in academics and/or work life. Upward corporate mobility, potential ownership, and other streams of compensation exist for individuals interested in being a greater part of our amazing company. Discover us at www. lightdentalstudios.com and check out our reviews online. Please email your resume with personal and professional references to Angie Dunn at adunndds@gmail.com.

PEDIATRIC DENTIST — Seattle South. To provide the most comprehensive dental care in the industry means having the best dental specialists working at our Gentle Dental affiliated offices. That’s why we take pride in working with Pedodontists nothing short of exceptional.

As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits. You will also have plenty of dental professionals supporting you to confer and collaborate with as you continue to grow in your career. We seek high-caliber professionals possessing degrees or certificates from accredited colleges or technical schools/programs (as well as valid/current state license). Gentle Dental has delivered high quality care with a personal touch for over 30 years. We have the resources you need to achieve true personal and career success. We aim to provide our network of affiliated doctors and staff with a competitive benefits package.

Contact: Ron Brush, phone: 971-295-9914, email: brushr@interdent.com. APPLY:http:// interdent.force.com/careers/apex/ts2__JobDet ails?jobId=a0xi0000001YvdqAAC. ASSOCIATE DENTIST (Tri-Cities/Yakima/ Spokane/Seattle Areas)Smiles Dental (www. welovesmiles.com) is an award-winning group dental practice located throughout the Pacific Northwest. Smiles currently owns and operates fifteen practices and is aggressively growing throughout Washington, Oregon and Alaska.

We are looking for a passionate, quality-focused dentist with exceptional interpersonal skills and leadership ability to join our team.

The position requires a minimum of 1-2 years of experience and the ability to provide a broad scope of dental care. Applicant must have a current license in Washington or be immediately eligible for a Washington dental license. Please send a cover letter and resume via email to sholmes@welovesmiles.com, No phone calls.

GENERAL DENTIST — Seeking an experienced general dentist to join established group practice approximately 32 hours per week in Vancouver Washington. Please send CV to jennifers@wendeldental.com.

DENTIST NEEDED — As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits to help our affiliated dentists and employees grow in their careers. Are you a Dentist just wanting to focus on building relationships with your patients and providing quality care? With Gentle Dental, you can count on us to manage the nitty gritty of your office so that you can focus on dentistry. You will also have plenty of dental professionals supporting you to confer and collaborate with as you continue to grow in your career. **This position will be full time split between our Lakewood and Puyallup office. Gentle Dental has delivered high quality care with a personal touch for over 30 years. We have the resources you need to achieve true personal and career success. We aim to provide our network of affiliated doctors and staff with a competitive benefits package, which include: medical, dental, vision, life insurance, 401K plan, PTO, CE credits, and career opportunities to advance with the company. We’ll handle the details, you focus on your patients, let’s practice together. Submit resumes to: vuh@interdent.com.

PERIODONTIST/ORAL SURGEON — Do you possess outstanding clinical skills and a heart for people? Our highly successful and growing practice In beautiful Colville Washington is seeking an Associate General Dentist. Applicants must have great people skills and always put the needs and desires of the patient first. We provide an extremely high standard of care and offer a wide array of dental services including. Our incredible support team is dedicated to providing thoughtful care in a warm and friendly environment. Please e-mail a cover letter and resume immediately to: Dentalnow1@aol.com.

DENTIST NEEDED — Growing general dental offices are seeking caring, competent dentist with great people skills to join our team at greater seattle area. Excellent opportunity for potential partnership.Please email resume to dentalresumeneeded@gmail.com

th e wsda ne w s · issue 7, july · 2014 · www.wsda.org · 45

GENERAL DENTIST NEEDED — Do you possess outstanding clinical skills and a heart for people? Our highly successful and growing practice In beautiful Colville Washington is seeking a Periodontist / Oral Surgeon who specializes in implants for 1-2 days per month.

Applicants must have great people skills and always put the needs and desires of the patient first. We provide an extremely high standard of care and offer a wide array of dental services including. Our incredible support team is dedicated to providing thoughtful care in a warm and friendly environment. Please e-mail a cover letter and resume immediately to: Dentalnow1@aol.com GENERAL DENTIST (.75) — Peninsula Community Health Services (PCHS) is a non-profit, Federally Qualified Health Center dedicated to providing our patients with quality, compassionate and affordable health care services.

Our busy general dentistry clinic is in need of a part-time (.75) dentist to join our team of caring professionals. Applicants must have graduated from an accredited dental school, licensed in the state of Washington, possess a DEA certification and be comfortable working with young children. Prefer applicants with at least a year post-graduate experience in a dental clinic. This position offers a competitive salary with excellent benefits including health coverage, fully paid malpractice insurance, relocation assistance, continuing education stipend, and generous PTO. Site is eligible for NHSC loan repayment. Submit CV to: Susan Chesbrough at sechesbrough@pchsweb.org/ Fax: (360) 373-2096. www.pchsweb.org.

ASSOCIATE DENTIST — Downtown Seattle.

Experienced associate dentist needed for a busy, well established, fee-for-service practice in downtown Seattle. Long term, highly capable staff. 3-5 days a week. Great income opportunity. Please email CV campheathern@ gmail.com.

classifieds issue 7, july 2014

OPPORTUNITIES AVAILABLE

membership membership marketplace

membership

MARKETPLACE GENERAL DENTIST — General dentist seeking associate position in private practice. Focused on providing conservative dental care with the patient’s best interest at heart. Confidence with providing dental care to children. Fluent in Mandarin. Email maoj@uw.edu.

GENERAL DENTIST — Confident and personable student (graduation 6/2014) seeking associateship with path to ownership. Interested in practices north of downtown Seattle. Six months’ experience as provider in CHC. Email matt1485@uw.edu for resume.

GENERAL DENTIST — Seeking associate position in private practice. Responsible, patient, compassionate, enthusiastic. Interested in Seattle&Eastside area position. USA and EU license. View my CV at http://chalakov.net/yankach.pdf Email: yanka@chalakov.net GENERAL DENTIST — Seeking associate position in private practice. Confident, friendly and patientfocused. Interested in Puget Sound area but all opportunities welcomed. View CV at http://tinyurl. com/ny28pts. Email me at deaster5@uw.edu.

GENERAL DENTIST — Seeking long-term associate position in private practice. Interested in greater Seattle area. Compassionate, dynamic, patient-focused. CV available at http://tinyurl.com/ mxg25ng. Email me at estherradds@gmail.com. 206-972-3374.

MOTIVATED, PERSONABLE — Very motivated and personable graduate seeking associate position on the East Side. Comfortable doing OS, Endo, Pedo, Perio surgery, and Pros. Willing to work extra days and great addition to any staff. Email: alexwardian@gmail.com

Each issue, the WSDA News will run up to 30 free classifieds for dental students and new graduates of dental schools who are seeking employment. To qualify, you must be a member of ASDA or the WSDA. Restrictions apply. Please contact Laura Rohlman at laura@wsda.org for more information.

ENDODONTIST — seeking long term associateship or buy-in/out in Washington State. I am also interested in providing care for an organization or multi-specialty center. E-mail me at: waendo@ yahoo.com DENTIST ANESTHESIOLOGIST — 10,000+ hours experience in sedation and anesthesia. Nationally-recognized author. Safe and effective techniques. Comprehensive services in your office.

Responsible for malpractice and DEA. www.northwestdentalanesthesia.com info@northwestdentalanesthesia.com GENERAL DENTIST — UW Graduate ‘14 — Seeking associateship in private general practice.

Keen to develop business skill. Oral medicine interest. Considering positions w/i 50 mi. of Seattle.

CV available at http://tinyurl.com/kdn5e98. t.duffman@gmail.com 425.890.7205 GENERAL DENTIST — Seeking long-term associate position in private practice in King/Pierce County. Personable, people-oriented, skilled, and motivated to learn more about advanced dentistry.

Graduation June 2014. For resume please email szolfa@gmail.com AEGD EXPERIENCED DENTIST — Welcome both full/part time associateship opportunities in South King and Pierce County. Strong fundamentals in general dentistry, including surgical extractions and endo. Contact amy.y.hua@gmail.com for CV

4 6 · th e wsda ne w s · issue 7, july · 2014 · www.wsda.org

OPPORTUNITIES AVAILABLE

OFFICES FOR SALE OR LEASE

PART TIME OPPORTUNITY FOR RESTORATIVE DENTIST – High quality solo practice with top staff, facility and equipment seeks an experienced dentist to work at least one day a week routinely and willing to fill in for occasional vacation time coverage. Perfect for retired dentist or one with young children who may not desire a full time commitment. Easy to reach location, just north of Seattle. Please fax resumes to (425) 775-9615.

WASHINGTON GENERAL DENTISTS — Our goal is to partner with our patients and practice proactive dentistry. We have excellent opportunities for skilled dentists and specialists throughout Washington. For current practice openings please contact Nathalie La Chance: (503) 952-2172 or nlachance@willamettedental.com and visit www.willamettedental.com/careers. See our ad on page 22!

FOR LEASE —Vancouver, Wash. Next to Vancouver Mall. Brand new remodel 2,000 sq. ft., just move in equipment. Built-in cabinets, Pano room, private office. Very nice! neilgray@comcast.net.

OLYMPIA, WASH — Seeking Associate/Partner Dentist. We are a well established practice with a large, growing patient base seeking a practitioner with exceptional interpersonal skills that is willing to commit to the potential of a long term partnership. Candidates must be comfortable and competent with all facets of general dentistry and share our passion for excellent patient care and superior dentistry.

Our modern and attractive eight operatory facility is home to a dedicated, skilled, long term team. We take great pride in providing an amazing patient experience and would require the same of any candidate. Experience is a must due to the pace we maintain and level of care we deliver. Please e-mail resume and CV to john@smileolympia.com.

PORTLAND, ORE. — Dentist opportunity.

Do the clinical dentistry you want to do. We offer paths in which you can manage or open your own practice with profit sharing. Pdxdentist@yahoo.com.

CLINICAL DIRECTOR NEEDED — As an industry leader, Gentle Dental provides a large network of resources, including an experienced practice management staff, cutting edge technology, and outstanding benefits to help our affiliated dentists and employees grow in their careers. We’re looking for a Clinical Director to help lead our region.

Must have an active state dental license, a DDS or DMD degree from an ADA accredited dental school, 5-7 years clinical experience working chairside, 1-3 years’ experience managing a team in a multi-location environment. For a complete job description and to apply, visit: http://interdent.force.com/careers/apex/ts2__ JobDetails?jobId=a0xi0000 001Z8RvAAK. GENERAL OR PEDIATRIC DENTIST — Great opportunity on the east side of the cascades.

Established and very busy group practice looking for an energetic and motivated general or pediatric dentist. We’ve got the patients, the chairs, and the best support staff possible ready to make your transition easy from the start. Great earnings potential if you are experienced and efficient. We are also a great place to learn if you are a recent grad or just need a little brushing up on children’s dentistry. Our experienced dentists and orthodontists can help get you up to speed. Contact us today if you’re ready for a new adventure! Please contact Jolene Babka at jbabka@applesmiles.com for further information.

DENTISTS NEEDED — Dental Professionals is recruiting dentists for temporary and permanent positions throughout western Washington – Vancouver to Bellingham and the Olympic Peninsula. No fee to you and you pick the days and geographic locations that you are available to work. This is a great opportunity to earn supplemental income or find a permanent position. If interested please call Bob at (206) 767-4851.

ASSOCIATE DENTIST — Prosthodontic/IV Sedation. Practice seeks experienced dentist to practice in the Woodinville area, state of the art equipment and facility. Please fax resumes to (425) 485-0764.

PART-TIME GP IN BELLEVUE — We are looking for an associate in Bellevue to work 2.5 days Wed-Fri. More days possible. We are a top office in our area. Beautiful modern office with state of the art technology. Fantastic patients and team. Fully digital. Must be highly skilled and experienced. Please email resume to bellevuedentists@gmail.com.

DENTIST OPPORTUNITY IN WESTERN WASH. — Seeking experienced dentist for busy, well established, successful, fee for service, group dental practice. Full-time position available. Excellent immediate income opportunity ($180,000 to $375,000 + per year) depending on productive ability and hours worked. Secure, long-term position. You can concentrate on optimum patient treatment without practice management duties. Modern well-equipped office with excellent staff, and lab services provided. If you are bright, energetic with a desire to be productive, very personable, and people oriented, and have great general and specialty clinical skills, Fax resume to Dr. Hanssen at (425) 484-2110.

GENERAL DENTISTS — Seeking FT and PT experienced general dentists for our offices in Lynnwood and North Seattle. Guaranteed salary plus additional benefits. Please email your CV to dentalcareers2014@gmail.com or call 206-407-6804 for more information.

OFFICES FOR SALE OR LEASE FOR LEASE — North Seattle multi-tenant dental building for lease. 1,646 SF. $23.80/SF, NNN. Available June 1st. Three operatories, private restrooms, lab, central compressed air and vacuum. Two offices, reception. Contact Tom (425) 455-1777.

th e wsda ne w s · issue 7, july · 2014 · www.wsda.org · 47

FOR LEASE – Turn key, fully equipped dental office located in North Spokane. Physical asset ownership. Immediate occupancy available. Excellent location close to north south freeway. Beautiful office with four fully equipped operatories. Two additional operatories for clinical or business use. Suite is 1800+ sq. ft. Great view of landscaping.

Email: Rundleperio102@gmail.com FOR SALE OR LEASE — Dental office for sale or lease in North Bend, an easy freeway drive from Seattle. Available for immediate occupancy. Ideal for auxiliary office or specialist. Four operatories. (425) 495-2635.

FOR SALE — Unique opportunity. General practice. Semi-startup with four ops. 1,280 sq. ft in a growing community and busy traffic area of Renton. Please email to lotusbalance@aol.com or call (206) 229-2125.

FOR LEASE — Vancouver, Wash. high end dental office in densely populated area next to Wallmart, Winco. 2,500 sq. ft., five ops, private office, break room. Ready for immediate use. Call Angela 808-203-4134.

PRACTICE SALE OPPORTUNITIES — Everett general practice: four ops/collecting $435K; South Seattle general practice: four ops/collecting $560k; Snohomish County General Practice: four ops/prosthetic emphasis. For more details and information please contact: Jennifer Paine at (425) 216.1612.

DOWNTOWN SEATTLE — Dental practice for sale. Long-established, small boutique practice with 3 operatories, Dentrix, Dexis, and Kavo handpieces. The office is nicely appointed with Stelty cabinets, and monitors and computers in the operatories. Asking $225,000, send all inquiries to: downtownseattledds@gmail.com.

FOR SALE - General practice in Tacoma.

Established (13 years) Satellite practice near JBLM in Lakewood. Associate relocated recently. Three chairs. Lots of parking spaces.

185K. Call (206) 779-5742.

FOR LEASE — Turn key and fully equipped dental office in greater Olympia area. Located with close proximity to I-5; great visibility and easy access. Suite is 2,000+ sq.ft., five operatories, great natural light, ample parking, staff lounge, and private office. Ready for immediate use, space available February 2014. Email: Hannajack@comcast.net or call (360) 789-4841.

classifieds issue 7, july 2014

OPPORTUNITIES AVAILABLE

Please Join The Executive Council of the Seattle-King County Dental Society (SKCDS)

Dr. Caldier is a WSDA Member and Delegate representing Kitsap County and a former Executive Council member of SKCDS who is running for the State Legislature.

at a fundraiser to benefit the campaign of Dr. Michelle Caldier

Your financial support will help send Dr. Caldier to Olympia to become a strong voice in support of our profession!

Tuesday, August 26, 2014 6:00 – 7:00pm

If you are unable to attend, please consider donating to Dr. Caldier’s campaign by going to www.michellecaldier.com.

SKCDS Offices 2201 Sixth Avenue, Suite 1210 Seattle, WA 98121

Please RSVP by emailing skcds@skcds.com or by calling 206.448.6620.

Call 1-800-232-3826 for a free practice appraisal, a $5,000 value!

AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are there to serve you through all stages of your career.

Robert J. Uhde, D.D.S. & Gurpreet S. Khurana, D.M.D. have merged their practices

- Bellevue, Washington

Matthew D. Richards, D.D.S. has acquired the practice of Randal S. Rigler, D.D.S. - Woodinville, Washington AFTCO is pleased to have represented all parties in these transitions.

Helping dentists buy & sell practices for over 40 years.

WWW.AFTCO.NET

4 8 · th e wsda ne w s · issue 7, july · 2014 · www.wsda.org

EQUIPMENT FOR SALE

SERVICES

FOR SALE — Prosthodontic practice in the greater Seattle area. An outstanding practice with lo overhead and hi net collecting over $2 million annually. Building is in a great location with plenty of parking and visibility.

Building would eventually be for sale to prospective buyer. Experienced staff will stay on with the practice. Owner also would stay on 1-2 days per week for up to a year to ensure a smooth and complete transition. Practice also has two full-time removable lab personnel on staff. Ideal practice for someone with implant surgery experience who could take this practice to a whole new level. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, Cell: (503) 680-4366, Fax: (888) 317-7231.

Email: reasorprofessionaldental@gmail.com.

NEXT/ANNIE MILLER & ASSOCIATES — New dental practice listings and sites for sale in Bellevue, Kirkland, Federal Way, Renton and Tukwila. Call today for tours and info.

Annie Miller, Re Max Eastside Broker’s Inc. (206) 715-1444 or email at annie@nextnw. com.

UNIQUE DENTAL OFFICE DESIGN — Not only will your design be uniquely yours through our exclusive space allocation we will also guarantee that your plans will go through plan check. We have successfully designed over 2,000 dental offices. Please visit our website to see our latest dental office which is in the Seattle area and give us a call. http://www.uniqueinteriordesigns.com/

SPACE SHARING OPPORTUNITY — Presently working three days/ week and have ample room to share space in our five chair downtown Seattle general practice office with in-house lab and technician. Bring your patients and staff and share the rent, utilities and supplies. Contact Rick Nicolini, DDS at (206) 310-5709 or drnicolini@hotmail.com.

FOR LEASE — Burien, Wash. Brand new, 2,700 ft, six op dental office with pano room, lab, break room, two restrooms and private offices. Completely wired and plumbed for state of the art digital dental office. $10/ft NNN or $2,200/mo. Must see to believe and appreciate. Great opportunity for start up or relocation. Contact (206) 909-3863.

ROSEBURG OREGON PRACTICE — Very visible location on one of Roseburg’s east-west arterials. Practice uses Eaglesoft and is digital throughout. Digital sensors by Schick. Collections have averaged in approximately $750,000’s for the past five years. Contact Rob (503) 7817311 Green Sail Transitions, Portland, Ore. NEXT/ANNIE MILLER & ASSOCIATES — Providing consulting services to the dental community for the past 35 years. New practice start-ups, practice transitions, sales and valuations. Dental space planning and architecture; real estate leasing and acquisitions, employment benefits; staffing resources and training; financing. Call today for your free consultation…we can’t mint money for you, but we can sure save what you have now! Annie Miller (206) 715-1444. Email: annie@nextnw.com.

FOR LEASE — Great location, over 2000 square feet, five operating suites in beautiful Olympia, conveniently located on Martin Way close to St. Peter Hospital. Over 30 years of quality dental care provided here. Contact Don at uncledgh@aol.com.

OFFICE SPACE TO SHARE — Excellent opportunity for specialist who wants to work one or two days a week or a start-up practice for any practitioner. Front office support. Contact Breezy at (425) 481-1038 or email office@ gentletouchdental.com.

FOR LEASE — Available for immediate occupancy. A fully plumbed dental office. 1,350 sq ft , three operatories, air, water, vacuum, nitrous oxide and oxygen, private office, lab, staff lounge, separate staff entrance. This office has exceptional exposure to the Southcenter Mall traffic. Call Diana at Medical Centers Management (253) 508-1293.

OPPORTUNITY — Dental office for sale in Burien. 15+ years in the same location. Grosses over $350,000 a year, six operators and laboratory. Owner is retiring but will stay for transition. Some financial available. Call JD at (206) 992-8771.

FOR LEASE — New construction. Professional Building in Lynnwood by Alderwood Mall.

2,000-6,000 sq ft available. Ample parking.

Private entry. High visibility and high traffic count. Each unit has up to 40 sq ft of signage on main-street. Ideal for specialist and/or group practice. Call Dr. Nguyen at 206-2503282 or email datman1@mac.com.

FOR LEASE — 300 Pelly Ave N. Dental suite available in Renton, walking distance to the prestigious Landing, as well as Boeing. 1,361 sq. ft. on 2nd floor, with only two other dentists in building. Three operatories, open configuration, plumbed with electrical, air, vacuum, and plumbing. Corner lot with heavy traffic flow. Rate is $23.26/SF/Y NNN, Triple Net is $5.60 (including utilities). Contact Dennis Schmuland (425) 417-1206.

USED/REFURBISHED EQUIPMENT — Adec, Gendex, Pelton Crane, Dentalez, Porter, Air Tech, Midwest, Midmark and etc. Lab equipment. Parts are also available for almost all equipment. Call Dental Warehouse at 800488-2446 or http://cascade-dental.net.

FOR SALE — Brand new never been used Vista Therma – Flow composite warming kit for sale. Including two composite syringes, 20 2X step downs and 20 4X step down tips. $595 or OBO. Please contact jung@implants123.com.

EQUIPMENT WANTED EQUIPMENT WANTED — Looking for wide range of used equipment. Adec, Kavo, Midmark, Pelton Crane, Midwest, Gendex, Air Techniques, Apollo, Porter, Cerec, Sirona. If you want to sell equipment, call (206) 260-3563.

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DESIGN SERVICES — Slater Interior Design uses a unique interactive and collaborative process to create a design that expresses your story, personality, and brand.

By exploring your likes, desires, and use of space, we will bridge the gap between functionality and design in your home or office space. Call today for complimentary consultation! 206-795-3245, or email us at slaterdesign@frontier.com.

HAVE SEDATION, WILL TRAVEL — Make fearful patients comfortable with IV Conscious Sedation. I am set up to come to your office and sedate your patients so that you can perform needed treatments the patients avoid due to fear. I have over 19 years experience providing safe IV Conscious Sedation. Serving Washington and Oregon. Richard Garay, DDS. (360) 281-0204, garaydds@gmail.com GUEST DENTIST — Will fill in at your practice for maternity leave, injury, illness, family emergency, etc. 35 years of general dental practice experience. Personable and patient oriented. Dr. Ed Kardong (206) 842-6300.

OFFICE CONSTRUCTION CONSTANTINE BUILDERS INC. (CBI) — WSDA endorses CBI as their preferred builder of Dental facilities with over 25 years of experience from ground up buildings, renovations, remodels, and interior tenant improvement projects. All projects are completed on time and within budget. CBI provides the highest level of quality service with integrity that exceeds our client’s expectation. Please see our display ad on page two and website at www. constantinebuilders.com for additional information and how you can become another satisfied client. Telephone (206) 957-4400, O. George Constantine.

classifieds issue 7, july 2014

OFFICES FOR SALE OR LEASE

parrish or perish

Take one, just one!

Dr. Jeffrey Parrish “If everyone is thinking alike, then somebody isn’t thinking.”

— George Patton

Last month I asked—no pleaded—with you to sign up for the RAM Clinic at Key Arena, October 23-26. Many of you have; thank you. But we are not anywhere near having the 300 dentists and 300 assistants we need to make the clinic a success. So again I plead: go to www.RAMvolunteers.org and then onto our local link and sign up with your staff. Everyone needs to sign up individually. If you have no idea what I’m talking about because your assistant took last month’s WSDA News home to read her favorite author on the back page and left it there, go to http://seattlecenter.org/ram/ and find out.

But many of you have pleaded, “I’d love to, Parrish, but I’ll be in [fill in the blank—preferably somewhere warm] in October and can’t make it. Sorry.” Hey, don’t feel guilty that you are going to be somewhere lovely while we are slaving away here in the drizzle and cold. Enjoy your trip; have fun; don’t get sunburned.

A few weeks ago, Dr. Mike Karr and I had the opportunity to take a trip of our own to the hills of Tennessee for participate in a RAM clinic there. The dental needs were horrendous due to lifestyle, Mountain Dew by the gallon and probably drugs in more than a few. But what also stood out to us was there was one dental office and one public dental clinic for this entire area of Tennessee; in other words, there was little possibility for any follow-up.

So therefore I am making another plea to those of you who can’t make the clinic: can you volunteer to TAKE ONE…JUST ONE. By that I mean, will you allow us to give your name just once to a RAM clinic patient. One of our goals is to provide every one of the 2000 patients we will see with a potential dental home. I don’t expect you to complete a full mouth reconstruction or provide any care for free; I am just asking that you volunteer to see one of our patients in the hope that they will eventually follow up with care and get on the road to better, more complete oral health. We will provide them with the Code: “RAM” so you might alert your receptionist if someone calls and says, “RAM”, it’s a referral from us.

Now we all know that this population does not have a great track record following up.

Probably less than half will ever contact a dental office. So the odds that you will ever hear from the patient we refer are less than 50/50. So there’s a pretty good chance that you won’t ever have to see our RAM patients so you are not at great risk. But I have no way of knowing which group a particular patient falls in [Go or No Go] so I need 2000 potential referrals.

We need dental offices from all around the state. While we expect the majority of our patients to be from the Puget Sound area, we will have folks show up from all over the state. So you folks in Bellingham, Spokane, Yakima, Omak, Vancouver and everywhere in between can contribute as well by agreeing to Take One…Just One. WSDA, Seattle-King County Dental Society, WSDHA, WSSOMS, UW School of Dentistry, WAGD and many others have all committed to make this event a big success. It is a chance to shine in the eyes of the community as there will be lots of media and public officials present. We need to present ourselves as a willing profession trying to deal with a huge deficit in our health care system: affordable dental care adequately paid for. But without adequate numbers of providers to provide follow-up care, we are going to look foolish and uncaring.

Can we count on you please? All you merely need to do is email your office name, address and phone number to SKCClinic@seattle.gov with the subject line “TAKE ONE”.

We will provide it to a patient who, hopefully, lives somewhere in your geographic area.

I promise we will give out your name only once unless you offer otherwise. I thank you, and the patients that do show up will thank you.

The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the WSDA.

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LIFE INSURANCE: For the ones you love.

Washington Dentists’ Insurance Agency sells the protection you need.

Life insurance policies ensure that your family will have the financial support it needs in the wake of your death.

The money is provided directly to your beneficiaries to use as they see fit, for things like making up lost income, paying off household debt, funding your children’s education and paying for funeral expenses.

Life Disability Long Term Care Professional Liability Practice Loan Protection Health Savings Accounts Business Owner Coverage Group and Individual Medical Risk Management Consultation Medicare Supplements and MedAdvantage

Matt French · Kerri Seims 206.441.6824 · 800.282.9342 www.wdiains.com

th eWashington wsda Dentists’ ne w sInsurance · issue 7, july · 2014 · www.wsda.org · 51 Agency: LIFE INSURANCE

Employment Practice Liability CyberSecurity Protection ERISA Surety Bonds

Sole broker for:

Washington State Dental Association 126 NW Canal Street Seattle, WA 98107

PRESORTED STANDARD U.S. POSTAGE PA ID SEATTLE, WA PERMIT NO. 8115

CHANGE SERVICE REQUESTED

How much is good customer service worth?

You may never really know how good your insurance company is until a claim is filed against you.

At NORDIC, we’re invested in you and the business ofinsuring you and your practice. When you call with a question, you’ll speak directly with the person handling that aspect of your policy, not a random operator. In fact, you’ll always speak with a live person unless you call after hours. We think that’s important.

Those big companies? Not so much.

NORDIC prides itself in excellent customer service before, during, and after a claim is filed against our customers.

800-662-4075 · www.nordicins.com 206-343-7800 · 206-441-6824

sole broker for NORDIC

5 2 · th e wsda ne w s · issue 7, july · 2014 · www.wsda.org