A Calgary dentist has pleaded guilty to fraud charges for falsely billing two insurance companies for phony dental work.
Background
Dr. Alena Smadych, who purchased the All About Family Dental clinic on Elbow Drive S.W. on June 13, 2013, made more claims for root canals than any other general clinic in Canada. Her actions resulted in over $126,000 being bilked from Sun Life Insurance and Blue Cross Insurance.
Details of the Fraud
According to a statement of agreed facts read by Crown prosecutor Greg Whiteside and signed by Smadych and defense lawyer Alain Hepner:
- Staff at the clinic made direct claims to both Sun Life and Blue Cross based on information provided by Smadych about work she had done.
- Sun Life investigators began documenting strange billing practices in September 2021 after discovering false claims against several patients who did not receive treatment at the time claimed.
- One patient was billed $19,144 for a series of treatments that did not occur.
An audit conducted by Sun Life revealed:
- Fraudulent claims related to 51 patients between June 29, 2015, and June 15, 2021.
- No records were kept as required under Alberta law showing what treatments were actually done during appointments listed as having received endodontic therapy (root canal).
Expert Review
Two expert dental consultants reviewed the files from each patient identified and confirmed the fraudulent nature of the claims:
- Some procedures weren’t documented, let alone carried out.
- Others showed incomplete documentation, such as missing radiographs prior to performing certain surgeries without proper consent.
These findings indicate intentional deception.
Financial Impact
As a result of the fraudulent activity committed against Sun Life Insurance Company, losses totaled nearly $96,000 due to improper treatment. This figure does not include potential future costs associated with long-term health complications arising from the actions taken during the course of business dealings.
Next Steps
The case is expected to return before Judge Gordon Wong next week, where lawyers will provide recommendations regarding sentencing submissions.
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