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August 24, 2012 at 1:43 PM

Phony doctor who bilked insurers sentenced to 1 year

A medical worker who submitted at least $4.1 million in bogus bills to insurers, sometimes while falsely claiming to be a doctor or physician’s assistant, was sentenced this afternoon in King County Superior Court to one year behind bars.

Kenneth R. Welling, 45, of Lake Forest Park, pleaded guilty in June in King County Superior Court to to one count of first-degree theft and six counts of second-degree theft.

Welling is a registered surgical technologist and proprietor of Shoreline-based Alpine Surgical Services. His license allows him to perform tasks like preparing supplies and instruments, passing them to the surgeon and preparing basic sterile packs and trays, according to the state Office of the Insurance Commissioner. But after patients had procedures done, he would often submit large bills with codes listing himself as a doctor or physician’s assistant. He is neither.

“This was a pretty audacious scam,” Insurance Commissioner Mike Kreidler said in a news release. “We were tipped off to it when a patient contacted us, saying that Welling billed her insurer $89,000 for six surgeries that never happened.”

Welling also billed for surgeries that never happened. Sometimes he would include post-operative reports, listing himself as the surgeon, the news release said.

No evidence was found to indicate that Welling was actually treating patients when posing as a physician. “As far as we could tell, the only time he pretended to be a doctor was when he submitted bills,” said Kreidler.

From 2004 through 2011, Welling billed five insurance companies at least $4.1 million for services he did not provide. He was paid $461,000.

“Part of the reason he got away with this for so long is that he’d rarely challenge an insurer who paid little or nothing,” said Kreidler. “He’d just send them the bills and hope they’d pay.”

As part of his sentence, Welling will be eligible for work release.

Comments | More in The Blotter | Topics: King County Prosecuting Attorney's Office, Office of the Insurance Commissioner., theft

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