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Kauai dentist sentenced for insurance fraud

Kauai dentist Terry Allen was ordered by a state circuit court judge today to pay $20,878 in restitution to Hawaii Medical Service Association for insurance fraud.

He was also ordered to pay $2,500 to the Crime Victims Compensation Fund in addition to other court fees.

Allen, the former owner of Kalaheo Dental Group, and his office manager Diane Maldonado, were charged with fraudulently billing HMSA and Hawaii Dental Service.

On one occasion Maldonado used her niece’s dental plan to pay for services for her niece’s boyfriend while Allen, a non-participating HMSA provider, used the names and numbers of participating HMSA physicians to get higher payments from the health plan. In another case, Allen billed two different insurance companies for patients with dual coverage, resulting in overpayments that were never refunded.

Maldonado was sentenced in July and ordered to pay restitution of $3,413 to HDS. After four years, the crimes may be expunged from their records if they adhere to certain restrictions, the state Insurance Division said in a news release.

To report suspicious activity, call the state insurance fraud hotline at 587-7416.

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