Scam Alert
Dental
Most dentists are honest, ethical professionals who
provide their patients competent and caring treatment.
A small but disturbing number of dentists, however, are dishonest.
They exploit their position of authority to bilk trusting patients
with useless and often painful treatment, and shady billing practices.
These dentists want to line their own pockets with insurance money
— often jeopardizing your own health and coverage.
Worthless treatment. Dishonest dentists
perform useless surgery on perfectly healthy patients to hike their
own insurance billings. The dentists remove healthy teeth, do root
canals that aren’t needed, and drill for cavities that don’t
exist. Sometimes children’s teeth are even drilled without
painkiller. Often the surgery is botched: Shoddy crowns or fillings
fall out. Patients have found surgical debris embedded in their
gums. Patients also become painfully infected and disfigured, and
need more surgery to correct the treatments.
Inflated billings. Dishonest dentists do minor
procedures such as routine tooth cleanings, but bill your insurance
plan for costlier treatments such as phantom root canals or cavity
fillings.
Phantom treatment. Dentists bill insurers for treatments
they never perform. They send the insurer forged bills for fake
treatment, medicine and supplies they never used. They may bill
the policies of current patients, or invent “patients”
they’ve never even met.
Unlicensed dentists and employees. Sometimes dentists
illegally treat patients despite losing their licenses for previous
infractions. Some dentists also have hygienists, assistants or other
staff perform treatments — even though they aren’t licensed
or qualified. The dentists then bill insurers as if the dentists
performed the treatment themselves. And you could receive shoddy
treatment.
Fake dental plans. Con artists sell fake dental
insurance to people and businesses. This leaves you dangerously
unprotected when you need costly dental treatment. Typically the
plan operators are shady businesspeople, not dentists.
Painful, dangerous and disfiguring surgery.
Needless surgeries such as worthless root canals can be
painful and endanger your health and wellbeing. The surgeries can
become swollen and infected. You may need more surgery to correct
the earlier procedures, which often are botched.
Your policy limits can max out. Falsely billing
your dental plan can exhaust your policy limits. Thus you could
have little or no coverage when you need treatment for painful dental
problems in the future. You may have to pay expensive bills out
of your own pocket, or delay needed treatment.
Your dental premiums may rise. Fraudulent claims
against your policy could force your insurance premiums higher.
That’s more money out of your pocket.
Verify you need the treatment. A
dentist may urge treatment that seems unusual or unneeded. Trust
your instinct and delay the procedures until you verify you need
them. For example: A dentist insists you need eight cavities drilled,
and pressures you to do the drilling right away even though your
teeth feel fine.
Get a second or third opinion. Visit two other dentists
to confirm you need the treatments. Ask friends or colleagues for
dentists they trust.
Check out dentists. Call your state insurance department
and state dental board. Was the dentist disciplined for wrongdoing?
Currently licensed? History of patient complaints?
Ask what to expect. Ask your dentist what discomfort
(if any) your should expect, and how long it should last.
Review your explanation of benefits (EOB). Make
sure you and your insurance plan are billed only for treatments,
medicines and supplies you received. Some EOBs are mailed, and some
are posted on your insurer’s website.
Suspect a swindle? Tell the authorities. Contact
your insurance company and state
insurance department. Contact Medicare
or Medicaid
if you’re a recipient of these benefits. Have your facts,
dates, names, treatment details, bills and other evidence of fraud
all organized and ready.
Stay with your kids? Some dentists perform useless
surgery on kids. Ask if you can stay in the treatment room to make
sure you child is ok, the procedures are as painless as possible,
and only the promised treatments are done. If the dentist asks that
you not be present, find out why and make sure the explanation makes
sense.
Check out your plan. Be careful of sales pitches for dental
plans you’ve never heard of. One warning sign: High-pressure
sales tactics to sell unusually generous benefits at suspiciously
low prices. Be especially careful if you’re buying coverage
as an individual or small business. Contact your state insurance
department to ensure the plan is licensed in your state.
