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Medical Forum / General / Dentistry / March 2008

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Dental Fraud - I want my money back

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wipeout64@hotmail.com - 28 Feb 2008 18:05 GMT
I read a prior post (Parents victims of dental fraud? What can be
done?), and have already begun to take the advice in that post by
going to the board of professionalism; however, they do not get
involved in battling for your money. I'll need to go to small claims
court for that. I do not want to go to a lawyer for advice because the
amount I'll end up paying him/her is the amount I'm fighting for.

On two visits to the dentist in one week, he charged for two
procedures when he only did one. He billed both me and the insurance
company. I need to prove that he did not do a filling in a tooth. The
filling was already there and done by a previous dentist. I asked this
dentist to make copies of all x-rays for me as I plan to use them to
prove that these two teeth never needed a filling (if that's
possible). By sight, the teeth in question do not have stains so the
fillings do not look old. On the paperwork of the predetermination
exam, he claimed he wanted to re-do them because they were stained. I
never gave him permission to work on these two in the first place. I
had told him not to do so. They're taking their lie further by saying
I gave them permission over the phone. Can you offer any suggestions
on how I can present my case in small claims court? Thanks
Dartos - 28 Feb 2008 20:22 GMT
 Can you offer any suggestions
> on how I can present my case in small claims court? Thanks

I'm not a lawyer and I've never been to small claims court.

That said:

If it's a matter of 'he said'-'you said', you lose.  You would
need some proof that the dentist absolutely did not do the
procedures that you were charged for.

Previous radiographs compared to new radiographs might be enough,
or might not be.  Judges aren't typically experts in reading
dental X-rays.

Few people have close up pictures of their teeth pre and post-
treatment.  Proof may be elusive.

I'm not saying the dentist is not trying to rip you off, but I
sure have seen patients misunderstand what work was actually
done.

Many times I've had patients come into the office and say,
"That filling you did last week/month/year fell out".  When
I check the records and look in their mouths, it is
almost always another filling on another tooth.  Not the one
that I recently worked on.

A few of these patients never did believe me and thought I
was trying to charge them again for defective work.

So, from here, it's hard to offer much real help.

Steve
wipeout64@hotmail.com - 28 Feb 2008 20:34 GMT
> wipeou...@hotmail.com wrote:
>
[quoted text clipped - 33 lines]
>
> Steve

Well, thanks for your reply. I understand that you're not saying that
the dentist didn't falsely charge me, but I would know if he worked on
1 or 2 teeth or if it were top and/or bottom of my mouth. (Forgive me,
I just had to say that.) However, I'm wondering if I take the matter
to BBB, then the  Atty Gen, then finally the Dept of Professionalism,
then the Sm Claims Court - in that specific order. If I fair well with
the Dept of Professionalism, (they will examine the evidence), then I
could probably use that out-come in the Sm Claims Court. The Judge
would probably lean toward a report from the gov rather than the
dentist.
Steven Fawks - 29 Feb 2008 15:26 GMT
> Well, thanks for your reply. I understand that you're not saying that
> the dentist didn't falsely charge me, but I would know if he worked on
> 1 or 2 teeth or if it were top and/or bottom of my mouth. (Forgive me,
> I just had to say that.)

No forgiveness needed.  However:

I have had patients ask in the middle of treatment, "What tooth
are you working on?"  Also once in a while there is a spot on a nearby
tooth that I will go ahead and fix that I didn't originally plan
on treating and the patient would not know unless I stop, give them
a mirror and explain what I'm going to do.  Usually, I just tell
them what's going on, but if they are stressed or on nitrous, they
might not remember everything I'm saying during treatment.

So, could two teeth be worked on without your knowledge?
Absolutely.

If one tooth is on the maxillary arch and one on the mandibular, it
is less likely to go unnoticed, and certainly if they were on opposite
sides of your mouth.

However, I'm wondering if I take the matter
> to BBB, then the  Atty Gen, then finally the Dept of Professionalism,
> then the Sm Claims Court - in that specific order. If I fair well with
> the Dept of Professionalism, (they will examine the evidence), then I
> could probably use that out-come in the Sm Claims Court. The Judge
> would probably lean toward a report from the gov rather than the
> dentist.

Peer review boards have both sides agree on an outcome and the
issue is *finished*.

For the rest, I don't know.  Sounds like you're really out for
vengence.  When I don't even know what happened *for sure*, it's
not something I would recommend.

Steve
Bill - 05 Mar 2008 16:33 GMT
On Feb 28, 12:34 pm, "wipeou...@hotmail.com" <wipeou...@hotmail.com>
wrote:

> > wipeou...@hotmail.com wrote:
>
[quoted text clipped - 44 lines]
> would probably lean toward a report from the gov rather than the
> dentist.-

If the dentist is a member of the dental association, then you can ask
the local association to open a Peer Review case. An board of
experienced dentists will examine the case and give an unbiased
conclusion, all at no charge to you.

If the dentist is found to be at fault, he will have to refund your
money.

The Peer Review is only available if your dentist is a member of the
dental association, which is one reason to check on that membership
before selecting a dentist. Non-member dentists know they are not
subject to Peer Review, so a patient with a problem would have to use
the small claims courts and pay the court fees up front.

In my region the majority of small claims cases are won by the
dentist, as most patients don't know how to present evidence, or they
have no real evidence. This is in contrast to the Peer Review cases in
which the examining panel of dentists already know where to look for
evidence and how to evaluate it.

Before you take ANY kind of legal or review action, it is better to
talk with the dentist yourself and try to settle the matter
personally. That saves time and trouble for everyone concerned.

- dentaldoc

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