97bca1823f688210VgnVCM200000e66411acRCRDapproved/thenational/Articles/Migration/2009-Q1Dental insurance fraud is no white lie87bca1823f688210VgnVCM200000e66411ac____The UAE is the only nation in the Middle East that guarantees free health care for its residents, expatriates and nationals alike, so it is all the more discouraging to learn that this generosity is abused.<p>The UAE is the only nation in the Middle East that guarantees free health care for its residents, expatriates and nationals alike, so it is all the more discouraging to learn that this generosity is abused. As we report today, there have been several instances of dentists who have prescribed unnecessary treatments or who have made claims to insurance companies for procedures that they did not perform. In response, Daman, the national insurance company, is limiting the percentage of coverage it provides for the dental work of Emiratis, who had previously received free dental care.</p> <p>Administrators can't monitor every procedure that every dentist performs. And in dentistry, it is all the more difficult to enforce cost-cutting regulations because there is a such a fine line between the procedures that are cosmetic and those that are medically necessary. While it may be more difficult to establish what constitutes essential treatment, this does not mean that dentists aren't aware when they blatantly cross the line. A reporter from The National who visited different dentists showed how the grey areas can be abused. One dentist told the reporter his teeth required a simple cleaning, costing Dh300, while another told him he needed Dh41,000 worth of dental work.</p> <p>Daman already requests charts from dentists to check for discrepancies in treatment and for abuse of its policies, which adds both time and expense for honest dentists and administrators, raising costs for everyone. Dr Jad Aoun, director of third-party administration at Daman, is right to emphasise that "a balance between control and trust" must govern the relationship between dentists and insurers. Clearly this balance must tilt more towards control now that certain dentists have betrayed the public trust.</p> <p>If too much money is spent to pay for cosmetic operations, less money is available for urgent care. In this regard, lying to an insurance company is no white lie, but a crime that harms all who may require emergency dental care. "We need to get rid of the perception that lying to an insurance company is not a serious matter, it is," said Dr Auon. Perhaps limiting dental coverage will cause dentists and their patients to think again the next time they ask the insurance company to cover a non-essential procedure.</p> 84YYOPINION2009021500000020090215000000100ARhttp://adedit.ad.atl.publicus.com/apps/pbcs.dll/article?AID=/20090215/OPINION/5080828255080828220090215100000000