The investigation of a complaint made by an insurance company against Dr. Allen Shen raised serious ethical concerns and identified instances of inappropriate billing including:
- date of service not documented
- services not documented or supported
- upcoding (billing for a more expensive procedure than provided)
- unbundling of codes (billing additional fees that would normally be included in a procedure)
- other issues with patient records and billing practices
- charting irregularities
- not collecting the co-payment (patient’s portion of the bill)
- discounts extended to patients but not the insurer.
A panel of the Inquiry Committee reviewed the investigation and had serious concerns about Dr. Shen’s recordkeeping, radiographic interpretation (as it relates to prescribing), and billing practices. The panel considered Dr. Shen’s sizeable repayment to the insurer and his cooperation with the investigation to be mitigating factors.
Dr. Shen signed a memorandum of agreement and understanding (MAU), agreeing to:
- a one-month suspension from practice beginning June 30, 2017
- pay a fine of $10,000
- take the College’s Dental Recordkeeping course (and encourage his staff to do the same)
- review and comply with the College’s Dental Recordkeeping Guidelines
- review the UBC Faculty of Dentistry recommendations for prescribing radiographs
- ensure billing practices accurately reflect the treatment provided (and instruct staff in this regard)
- achieve an unconditional pass in the PROBE Canada (Professional, Problem-Based Ethics) program
- a monitoring and inspection agreement that includes a review of his records.
View Dr. Shen’s signed MAU (Redacted; PDF)