Van Nuys, CA asked in Insurance Bad Faith and Health Care Law for California

Q: My Dentist filed a fraud claim to both a insurance company and Medi-cal in California.

Although the money was paid back I lost the benefit from Medicare that allows this procedure only once every 5 years. This was not the first time this office has billed for more than services I received. I thought that I was only approved for a cleaning only to find out I was approved for a deep cleaning with scaling.

I can't get anyone to help me. I will have to borrow money in order to pay for dental work that should have been covered. Neither the insurance company or the state will send me copies of anything I only know that they got their money back. The dentist also billed and recieved monies prior to what should have been the end of service. The Upper denture they made for me was so big it fell out of my mouth. They told me use glue !! That was not what I deserved or was entitled to. I was entitled to a correct fitting denture. The one I had/have I paid for 6 1/2 years ago. BUT why and how many commit fraud and just get away with it? Can something be done? I am in so much pain.

1 Lawyer Answer
Maurice Mandel II
Maurice Mandel II
  • Newport Beach, CA
  • Licensed in California

A: Fraud has a 3 year statute of limitations from the date of discovery. Perhaps you should sue the dentist for fraud. You could even go to Small Claims if it is less than $10,000. You should definitely consult with a Dental Malpractice attorney in your area.

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