© Gary Inglese

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Dental Defense - Illinois Department of Financial and Professional Regulations Defense - Dental-Legal Issues - Dental Risk Management - Dental Contracts and Business Issues - Dental Office Transitions

© Gary Inglese

What do you do when the receptionist comes back to tell you that there is an investigator in your office waiting to speak with you?  What do you do when you receive a telephone call from an investigator?

The simple, best advice is “don’t panic.”  The following is not meant to be legal advice in any fashion and the licensed professional is advised to consult with an attorney concerning specific legal issues.  The purpose of this section is to let you know what to expect and what to anticipate when contacted by investigators.

Consider the following:

1. Determine why the investigator is there or calling.

  • Are you the subject of their inquiry or are they seeking information from you for another reason?  Ask.
  • Are they asking for information regarding a specific patient?  What is your status with this patient?  Is this a current patient or someone you saw some time ago?  Where there issues with this patient --- either treatment problems, collection problems, third party payee issues, etc.?

What to do if your license is being investigated?

© Gary Inglese

  • Is the inquiry about your license to practice your profession, controlled substance license, medications you have ordered or prescribed?
  • Have you recently referred patients to collections or had issues with third party payees?
  • Do you advertise in the media?
  • Have you had trouble with past employees or associate dentists?
  • Is your staff practicing advanced expanded duties?
  • Do you practice in a small community and/or you new in the area?
  • Have you had a recent argument or hostile exchange with a professional colleague?
  • Do you have problems with addiction or substance abuse or have you exhibited strange or erratic behavior?  Do you have a recent DUI?  Do you have a physical or medical problem that may impair your ability to practice safely?

2.  Is the investigator seeking patient records, radiographs, insurance documents and billing information?

  • Is this a current patient or are you a previous or subsequent treater?
  • Is this a patient you have had trouble with in the past --- either because of treatment issues, insurance problems, collection issues, etc.?  If the answer is yes, whether disclosed or not, you may be the subject of the inquiry.

3.  Who is the investigator?  Make sure you get their name and phone number.  Investigators have business cards and carry identification.  It should be shown to you willingly and don’t speak without seeing proper identification.

4.  Does the investigator want to interview you?  Are they merely looking for patient records or do they want to interview you?

5.  What is the status of your professional license?

  • Are all your licenses current?
  • Have you been previously disciplined?
  • Have you been making your student loan payments and court ordered child support payments?
  • Do you owe money to the Department of Revenue?

6.  What is the state of your records?  You cannot alter records.  Make a mental note to reread articles you have seen about recordkeeping and make sure from this point forward your records meet current standards.

What you do next:

1.  Speak to the investigator.  If that moment is not convenient because you are in the midst of patient treatment, ask if you can speak to the investigator at a more convenient time for you --- especially if they have appeared unannounced in our office. If you were contacted by telephone and cannot speak at that moment, make arrangements to call back at a more convenient time and do so.

2.  If you determine that you are the subject of the investigation, consult with an attorney.  Do not speak to the investigator further without an attorney present.

3.  If you are given or sent a release for patient records, make copies of the records and radiographs.  Never, never give up the originals.

4.  Review all documents given to the investigator with your attorney.  You cannot alter these records.

5.  You have the right to be represented by an attorney at an interview.  If you are the subject of the investigation, it is a small price to pay for peace of mind.  Remember that the investigator is trained in interview techniques and may have had access to more information than you have.

6.  The investigator will be taking notes at any interview or telephone conversation and anything you say or present will be reflected in their written report.  You will not have access to this report, so it is a good idea to take your own notes at this interview so you can recall what was discussed.  There is no such thing as a casual or “off the cuff” conversation, so be guarded in what you say until you determine what is going on.    

Remember the following:

  • Don’t panic – you will get through this. 
  • The investigator or prosecutor is not your buddy.  
  • Often in an attempt to defend or explain their actions, professionals often compromise their opportunity for an effective defense by answering questions and making statements, oral or written, without the clear understanding of what the investigation is about.
  • Don’t be in a rush.  The passage of time works in the favor of the accused professional.  While mindful of the law, where there is no time limit imposed or set time in which to respond, take your time.  Many problems can be resolved by negotiation rather than adjudication.
  • Before you answer any questions, ask your own questions.  Don’t agree to be interviewed or provide documents until you have a clear idea of who is requesting information and for what purpose.  If you are the subject of the investigation, you should terminate the interview until you have legal counsel present.
  • Investigators often attempt to minimize the importance of the subject.  Don’t fall for the line that “this is a routine interview.”  For whom is it routine?  An investigation is not a trivial matter and if the investigator will not disclose who is the subject of the investigation or says they will not tell you what the investigation is about, terminate the interview.
  • If the investigator attempts to intimidate you, terminate the interview.  This is a clear signal to stop talking and call an attorney.  A friendly investigator is more effective than a hostile one and while they may be friendly, they are doing their job and are not your friend.
  • “You have the right to remain silent” should mean remain silent.  This is possibly a Miranda Warning and signals a criminal investigation.  There is nothing to be gained and a lot to be lost by continued conversation.  You need legal counsel.
  • Usually you are not required by law to submit to an interview, especially without your legal counsel present.  It is sometimes strategically best to tell your story for the first time at a settlement conference, hearing or in court. Any story twice told where there are variations allows opposing legal counsel the opportunity to attack the credibility of the story teller.
  • An interview can be terminated at any time and if for any reason you do not like the way it is going, simply say that you will speak to your attorney and get back to them.
  • No need to justify or lie.  The investigator’s job isn’t to search for the truth; it is to gather evidence to prosecute the person being investigated.  The attorney assigned to the case to prosecute, a member of the licensing board decides whether there will be a prosecution, not the investigator.  Keep the explanation for the person who understands and has the power to do something, not the investigator.
  • Never provide a written statement at the time of an interview.  A written statement locks you into a position and never is to your benefit.  Review any written material provided with legal counsel.
  • More cases are resolved by settlement agreements than by other means.  Terms are often controlled by the amount of information the prosecution has obtained and what they think they can prove.  Most of the time, the less information the opposition has, the better for you.  Remember, you control the flow of information.  Only consider providing information through an attorney.