DEALING WITH REFUND DEMANDS FROM DENTAL PLANS (CONT.)
overpaid claim (28 C.C.R.
§1300.71(a)(8)(D)). However, the 365-
day limit does not apply if the
overpayment was caused in whole or
part by provider fraud or
misrepresentation. Also, if a provider is
paid for services not provided, the
provider must refund the plan within 30
days of notice of overpayment.
It is increasingly common for dental
plans to use offsets on future claim
payments to recover alleged
overpayments, so simply opting to
ignore a refund demand from a plan
doesn’t resolve the issue. Use of offsets
to collect the amount of an owed refund
is legal if the provider fails to reimburse
the plan for an uncontested
overpayment within 30 working days
and the provider’s contract with the plan
authorizes the plan to offset an
uncontested overpayment from the
provider’s future claims. Plans do not
have legal authority to offset future
claims payments of providers who are
not contracted with the plan. Some
plans automatically recover an
overpayment 45 days from the time of
the notice of overpayment to the
provider, so if there is a dispute
regarding the alleged overpayment, it is
important to appeal the refund demand
within the 30-day period prescribed by
law. In instances when a plan has offset
the overpayment, the plan must provide
a written explanation identifying the
specific overpayment, or payments that
have been offset against the specific
current claim or claims.
Dentists are encouraged to become
familiar with the resources on cda.org
related to overpayments and refund
demands. Again, the law assumes that if
a provider has been overpaid, and the
overpayment doesn’t match the four
criteria mentioned above, the provider
is obligated to refund the amount. But
providers always have the right of
appeal on a refund demand.
Contact CDA Practice Support to
discuss the circumstances of the
overpayment and to get advice on filing
an appeal of the refund demand. 䡲
PROPER LABELING CHEMICAL CONTAINERS
– HAZCOM REGULATORY COMPLIANCE
Reprinted with permission from OSHA Review
OSHA requires every original chemical container to have a
primary shipping label from the manufacturer with a few
exceptions: Drugs for patient care, consumer chemicals, and
pesticides, including disinfectants and dental unit waterline
cleaners, are not subject to the labeling requirements. The
chemical manufacturer must ensure that primary label is
marked with the following information:
1. Product identifier – The name or number used for a
hazardous chemical on a label or in the safety data sheet
(SDS).
2. Signal word – A word used to indicate the relative level of
severity of hazard and alert the user to a potential hazard.
Examples: “Danger”, “Warning”
3. Hazard statement – A statement assigned to a hazard
class and category that describes the nature of the
chemical hazard.
4. Pictogram – A symbol plus other graphic elements
intended to convey specific hazard information.
5. Precautionary statement – A phrase that describes
recommended procedures to follow to minimize chemical
exposure.
Los Angeles Dental Society Explorer
6. Name, address, and telephone number of manufacturer or
other responsible party
If any of the information above is not on the original container
label, contact the manufacturer.
ALTERNATIVE WORKPLACE LABELING
If the chemical is transferred from the original manufacturer’s
container to a different container, the container must be labeled
with a secondary label. The secondary label must include
product identifier and words, pictures, symbols, or combination
thereof, which provide at least general information regarding
the hazards of the chemicals, and which will provide employees
with specific information regarding the hazards of the
chemicals.
Because the regulation is a bit vague as to what exactly must be
on a workplace label, to ensure compliance, a simple way to
label a secondary container is to photocopy or take a picture of
an original label and affix the copy to the secondary container.
Another method is to print the required information, laminate
it, and affix it to the secondary container. Handwritten legible
labels are acceptable. Employers have until June 1, 2016 to
ensure that their secondary chemical containers are properly
labeled. 䡲