My dentist has been overpaid for services and won't reimburse me. What can I do?

I became a new patient in Dec 2007, and have had 4 visits since. I was told before my first appt, they were not under contract with my insurance company. I would have to pay for each visit upfront, and would then be reimbursed by my insurance company for the portion they would cover. However, I have received statements from my insurance company stating they have sent the checks to my dentist, and that i was using a contracted dentist. I have contacted the dentists office 3 times, and each time they come up with some excuse as to why I cannot pick up the check. I have contacted the practice administrator and have not received a response. They owe me a little over $1000. From what I have been told from others, they have no legal right to withhold that from me. I plan on contacting the Board of Dentistry. Is there anything else I can do?? Any info will be appreciated!!

My dentist has been overpaid for services and won't reimburse me. What can I do?
law suit. probably small claims though, as someone else said below. No attorney in it.





you hold legal grounds, this would be classified as a false practice im sure. When you signed all those papers to be their patient it should have said somewhere in there about your reimbursement and if it did not you will not hold much water.
Reply:I would call one more time to the supervisor. Leave a message. Next I'd go to the office and see if they have it. Explain that you were told numerous times that it would be here. Then if they deny it ask to speak with their supervisor. If this fails (and even if it does work), I'd contact the Board of Dentistry and tell them about the ordeal. Finally, I would find a new office with a good reputation!





EDIT: If they become rude and forcefully tell you that they cannot give you anything or that they won't. Tell them that you had wanted to do this nicely and didn;t want to be obnoxious but that it is very necessary that this be sorted out. Don;t tell them ahead of time if you plan a lawsuit. Don;t give them time to cover things up.
Reply:You can file a claim in small claims court. It is a court where no one gets to have an attorney, it's just the people talking to the judge. You bring your receipts and letters from the insurance company...and if there is a local rep then he/she could be subpoenaed to testify. Then each side tells the story and the judge decides.





also...look at your local news departments and see if they have a consumer advocate type of person. It's usually on the radio, but sometimes on FOX network they have "troubleshooters". They might be able to help you.
Reply:sue his ***
Reply:My experience with small claims court is that it's worthless and a waste of time. Other than that, I think the above suggestions were good. You need to get some of this communication in writing, sending letters via registered mail; documentation could be crucial. Also, you need to document dates and times of phone calls, plus writing down the names of the people you spoke to.
Reply:Hi...sorry to hear what they have done to you. Your best bet is to get papers for a Small Claims Court and have them served after talking with the Insurance company for assistance with their Medical Fraud Department.


More often than not, most people would say it is a "poor bookkeeping practices." No, it is Insurance Fraud and "Backbilling" -- bo th Illegal.


Be prepared to get a new Dentist should you file with Small Claims %26amp; I sincerely, would not bother with the Board of Dentistry---they really won't do much against the dentist or any other Professional. It is stil a Good Ole Boys Network.





Add Interest and the court costs.
Reply:Call the dental office again and let them know you will be informing the insurance company as well as the Board of Dentistry (if that is what it is called there, i'm from BC Canada so it is the college of dental surgeons here) if you do not receive your check from them in a timely manner and that you expect a response from the office manager to this phone call. You have not said when the check was sent to the dental office though and these things take time to process, it is not as immediate as patients would think and you also do not mention their reasons given for not having your cheque ready. Good luck, hope this helps.
Reply:Everything you do needs to be done in writing!!!! You need to ask for copies of the claim that was mailed. There are two boxes requiring "signatures" or "signature on file" If they told you they were fee for service, then they need to only have the top box signed. The second box is where, if they signed it or used signature on file, then they have requested the insurance benefit be paid to them, but if the payment is to go to you, then that box should be empty. You need a copy of that. The other thing to consider is all claims typically take about 4 weeks to receive and then when the insurance company says they've paid it doesn't necessarily mean the check has been received, there is a period of processing from when the check is actually cut and mailed. You need copies of all processing from the insurance company. You have a right to receive all that information. Some dental offices do refunds all at one time. It depends on how busy the practice is. They may do refunds at the end of the month. Don't go to small claims just yet, its not been all that long. If you feel they are really being dishonest, then you need to first write a letter to the dentist, with proof of what the insurance has paid, with copies of what you've paid the dentist, and then inform them that there practices are subject to review by the ADA, check out your local board of dentistry, and see how to start an ethics review. Good luck. Write letters, keep copies, and be patient.

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