An ex-employee at a South Carolina medical center’s dental practice who allegedly was fired for reporting inappropriate billing and payment practices has sued her former employer, according to a story published on October 28 in the Myrtle Beach Sun News.
Heiby Toone, who most recently worked as a customer service representative at Little River Medical Center’s dental practice, filed a lawsuit against the healthcare facility claiming she was fired after bringing billing and payment discrepancies to her manager's attention. Toone was employed at the center for 14 years until she was terminated in March 2024, according to the story.
Toone claims she suffered lost wages and gainful employment opportunities and experienced emotional distress and other damages because of the false claims made by Little River Medical Center. Toone is seeking reinstatement or front pay, two times the amount of back pay, interest on back pay, compensation for special damages, legal costs, and attorney's fees.
During her tenure, Toone worked in multiple departments, including billing and insurance, before being transferred to the center's dental practice.
As a customer service representative in the dental practice, she was responsible for reviewing patient insurance information and comparing dental records and charges during patient checkout and billing processes, according to the story.
In some cases, Toone claimed patients were informed that Medicaid did not cover specific services and therefore they needed to pay out of pocket or apply for the center’s discount program to pay for treatments.
However, Toone alleges that Medicaid histories and related records reviewed did not appear to reflect covered services, payments, or the use of Medicaid benefits for the treatments patients were told weren’t covered, according to the story.
In 2023, Toone emailed the dental practice's manager to report these alleged discrepancies. Weeks later, Toone claimed she was subjected to disciplinary counseling or a warning for alleged performance deficiencies. In January 2024, Toone was issued performance improvement documentation, according to the story.
Until then, Toone claimed she never had a disciplinary action filed against her and only received positive feedback and performance reviews.
In February 2024, the center’s information technology manager reported to management that Toone had assisted in identifying billing-related changes affecting missing patient history data. Additionally, the dental practice manager said that she was continuing to work on correcting irregularities that Toone had previously brought to her attention, according to the story.
On March 25, 2024, Toone was terminated due to alleged deficiencies in her performance, according to the story.
