Monday, June 27, 2011

Is this insurance fraud and should I report it?

I had a very bad experience at my last dentist's office and walked out. The appointment was for a routine cleaning and exam. The dental hygienist was very rough and rude to me so I asked to see my dentist. They told me she was on vacation! I didn't understand why they had me come in when my doctor was out. Now, a year later, I have come to learn that my former dentist's office billed my insurance. I started looking into it when my current dentist's office sent me a bill for my last exam because I exceeded the number of cleanings covered by my insurance. I just sent in an appeals letter to my insurance company stating that the exam and cleaning did not take place a year ago. One of my friends told me the dentist's office is committing insurance fraud. I'm not looking to pursue legal action until I hear back from my insurance company. Until then, can I report it to an agency or organization, such as the Better Business Bureau? What are the possible outcomes?
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That doesn't sound right. I have to agree with a previous poster. I think you should try to contact your old dentist first before taking legal action. If you can resolve the matter with her, you can save yourself a lot of potential headaches. If that fails, you can try contacting your state insurance department. Insurance commissioner web sites will usually have a form on the web or one that you can print out to file a complaint. You can find your state commissioner web site through the national association of insurance commissioners. Just click on your state. As for the better business bureau, well, they are also an option, though to be honest, I have not heard the best things from other people in regards to them actually getting things done. However if you report your dentist to them, she will at the very least be exposed as being fraudulent. I have included the insurance department website below, as well as another page that you might be interested in reading, which discusses the signs of dental insurance fraud. Hopes this helps. Good luck.
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