Concerns About Dentist Insurance Fraud
I just learned that my dentist submitted a claim for periodontal scaling and root planing worth $1,700 to my insurance. While he noted the treatment in the computer system, he never documented anything during my visit and did not even perform a proper probing. Despite this, I went ahead with the procedure and ended up paying nearly $800 out of pocket without realizing what was going on. After discussing my situation with a registered dental hygienist, it’s become clear that I may have been misled. I am planning to report this to my insurance as potential fraud.
If my insurance conducts an investigation and confirms fraud, will I be responsible for repaying any money to the dental practice, given that the treatment was actually performed and I was diagnosed? It seems like everyone here recommends SRP, so I feel uncertain about the situation.
I’m really sorry to hear about your experience. It sounds incredibly frustrating and upsetting. If your insurance finds that fraud occurred, they typically won’t require you to repay the dentist since you were unaware and had the procedure done based on what you believed was a legitimate diagnosis. However, it would be wise to consult directly with your insurance company for specific guidance based on your policy and situation. Reporting the dentist is a good step; it’s important to hold them accountable for unethical practices. Additionally, you might want to consider discussing your experience with a legal professional who specializes in healthcare disputes to understand your rights and options moving forward.