STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

FLORIDA STATE BOARD OF DENTISTRY, )

)

Petitioner, )

)

vs. ) CASE NO. 76-1080

)

CASTLES W. MOORE, D.D.S., )

)

Respondent. )

)

RECOMMENDED ORDER

A hearing was held in the above styled cause pursuant to notice on August 25, 1976 in Court Room 417 of the Broward County Courthouse, S. E. 6th Street at 3rd, Ft. Lauderdale, Florida by the duly designated Hearing Officer of the Division of Administrative Hearings, Stephen F. Dean.

APPEARANCES

For Petitioner: L. Haldane Taylor

605 Florida Theatre Building

128 East Forsyth Street Jacksonville, Florida 32202

For Respondent: Castles W. Moore, D.D.S.

852 Northeast 20th Avenue

Fort Lauderdale, Florida 33304 ISSUE

Did Respondent fail to fill out insurance forms as alleged in the Administrative Complaint; and if so, is said failure a violation of Section 466.24(3)(a), F.S.?

FINDINGS OF FACTS

1. The Parties stipulated to the fact that Dr. Moore was a dentist, licensed by the State Board, holding license number 1464, issued by the State Board.

   
   

2. The Parties further stipulated that the facts alleged in the Board's complaint were accurate as of the date of filing.

   
   

3. Dr. Ackel testified concerning professional practices. It is a part of the professional services of a dentist to fill out forms necessary for insurance coverage, although they may charge a fee for the time required to do so.

   
   

4. The time required to fill out such forms, which are in the main prepared by clerical personnel in the dentist's office, varies from fifteen to forty-five minutes, to include the dentist's time taken to review the entries.

   The failure to prepare the forms results in nonpayment or delayed payment of insurance claims to the patient. Dr. Moore had delayed over a year the preparation and submission of the forms on the patients involved in this complaint. Dr. Ackel said this was the first such complaint that the Broward County Dental Association has had in his eight-year association with the Association's board which investigates patient complaints.

   
   

5. Dr. Moore, having been cautioned about his rights in this case, took the stand and testified that he had had multiple personal problems beginning in 1973. These problems included within a two-year period a personal bankruptcy, a son who flunked out of medical school at the halfway point and subsequently was critically ill with ulcers, another son who suffered a mental depression which resulted in his hospitalization, a reduction in his office staff, and a separation from his wife who also worked in his office. While Dr. Moore acknowledged his ultimate responsibility for the failure to process the insurance forms involved, he did request the Board to consider the foregoing facts in mitigation.

   
   

6. Dr. Moore's office is currently a one-man office with one receptionist who has been with the Doctor for twenty-two (22) years.

   
   

7. There has been an increase recently in dental insurance claims; and Dr. Moore, who is an older dentist who had a good professional reputation in the community until these incidents, has apparently not adjusted his office administration to keep pace with the changes. This, together with his various personal problems, prevented him from attending to these important matters.

   
   

8. Dr. Ackel stated that Dr. Moore had been suspended from the County Association for ninety (90) days as a result of its investigation and findings; however, that this suspension did not cause Dr. Moore to submit the forms.

   
   

9. Dr. Moore apologized to all the parties concerned, indicated that he was acting immediately to hire additional personnel in his office, and that all the insurance forms in his office would be filled out and submitted immediately. The Hearing Officer notes, however, that the statements of Dr. Moore's patients indicate he had made similar assurances to his patients.

   
   

   CONCLUSIONS OF LAW

   
   

10. The statutes provide that a dentist can have his license revoked or suspended for conducting his business affairs in such manner as to bring discredit upon the dental profession.

    
    

11. Clearly, Dr. Moore's failure to fill out these forms, which he admitted, caused the patients involved considerable trouble if not financial loss and does reflect adversely upon the profession.

RECOMMENDATION

The Dental Board's interest in this case is apparently twofold:

1. To rectify the existing situation and enable Dr. Moore's patients to obtain reimbursement, and

   
   

2. To prevent any further failures of this type by Dr. Moore.

The Hearing Officer would recommend the following Board action based upon the Findings of Fact and Conclusions of Law:

Dr. Moore's license be suspended for three to six months, said suspension or a portion thereof to be held in abeyance or suspended upon Dr. Moore's doing the following:

1. Immediately filing the insurance forms involved here, with copies to the Board, and

   
   

2. Permitting and reimbursing, if necessary, a representative or designee of the Dental Board with a reputation for effective office management within the profession to inspect Dr. Moore's office and make a written report to Dr. Moore and the Board suggested ways of improving his office management to prevent a recurrence of this type of failure.

DONE and ORDERED this 4th day of September, 1976 in Tallahassee, Florida.

STEPHEN F. DEAN, Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304

(904) 488-9675

COPIES FURNISHED:

L. Haldane Taylor, Esquire 605 Florida Theatre Building

128 East Forsyth Street Jacksonville, Florida 32202

Castles W. Moore, D.D.S. 852 N. E. 20th Avenue

Fort Lauderdale, Florida 33304

Docket for Case No: 76-001080

Orders for Case No: 76-001080