Current Events > Is my brother in law wrong in this dispute with his dentist?

(+) Yeah! (+)

Short version of the story: He went to a specialist for an issue he was having with his teeth. The specialist worked on that issue. While he was there, he mentioned that he also needed a cleaning and said he was going to go call his regular dentist to make an appointment for that soon. Specialist said he could do the cleaning there if he had trouble getting an appointment at his regular dentist. BIL called his regular dentist and they said it would be about a month to get the cleaning, which is covered by his dental insurance. He decided to call specialist back, and he said he could get him in tomorrow. BIL says yes, and gets the cleaning.

After getting the cleaning, BIL gets a bill for about $250, and he is confused because his cleanings are covered by insurance. Specialist informs him that what he got was not a cleaning, but instead a [insert name here of something else, which is not covered], because he is a specialist, not a regular dentist. The work done was, as far as BIL could tell, essentially identical to a cleaning (but obviously there could have been differences BIL was not aware of), but not coverable because the guy was a specialist. The receptionist confirmed that the service was something else because of this. Neither the receptionist nor the specialist brought up this issue before he went in, or when they were discussing him doing this as an alternative to his regular cleaning (his specialist brought this up as an alternative to going to regular dentist for his cleaning, not a different service).

Anyways, gets into an argument with specialist, went back and forth, specialist demands full payment since he rendered his specialist service. BIL decides to pay half (about $125, more than he'd pay for his cleaning normally), and dispute rest with his insurance, insisting that the specialist misled him into a service he didn't need and charging him for what was, in effect, a regular cleaning. The receptionist just sent a letter to BIL saying that they are lawyering up, and demanding full payment (+$70 for the laywer fees). BIL wants to call his lawyer and fight it because he thinks he was bamboozled, but is now having second thoughts and thinking its not worth it.

Is BIL right in this situation? Should he just pay up anyways? Was he negligent by not asking about payment differences?

Is specialist a con artist and/or asshat? Or did the specialist finesse money out of BIL by omitting details from the unsuspecting BIL? Is that unethical?

Specialist called it a cleaning so if insurance covers cleaning fuck him he doesnt get a goddamn dime from me.

Dont call it a cleaning if that is not what it is being billed is. Dude straight up misled your brother to bilk money out of him.

Dude is a specialist at being a fuckwad clearly.

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If the specialist called it a cleaning then billed him differently thats fucked up.

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fan357 posted...

If the specialist called it a cleaning then billed him differently thats fucked up.

* ^ this lol

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Tell BIL to demand an itemized bill, have the lawyer and/or his personal dentist look at it to determine the exact differences.

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DrizztLink posted...

Tell BIL to demand an itemized bill, have the lawyer and/or his personal dentist look at it to determine the exact differences.

I can tell him that. I believe that does have the list (i.e. name of the service) though and the service is simply called something else. It serves the same purpose of the cleaning (and maybe does other stuff he didn't need), but it has a different name and includes other stuff and thus is not covered by insurance.

Sounds to me like your BIL got bamboozled. The specialist basically billed him a service he did not need or ask for. Looks like fraud.

If I'm in the pharmacy and see a script for generic atorvastatin, I can't dispense that generic drug and bill your insurance for brand name Lipitor.

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Fam_Fam posted...

pecialist said he could do the cleaning there if he had trouble getting an appointment at his regular dentist

Fam_Fam posted...

Specialist informs him that what he got was not a cleaning, but instead a [insert name here of something else, which is not covered], because he is a specialist, not a regular dentist.

Fam_Fam posted...

Neither the receptionist nor the specialist brought up this issue before he went in, or when they were discussing him doing this as an alternative to his regular cleaning

Yup, your brother in law is completely in the right. Lawyer up and fuck those assholes over.

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I would side with your brother in law. Paying half was a mistake though imo, wouldn't have paid anything if the intent was to challenge the charge outright, and he didn't have any sort of agreement with the office that paying half would be sufficient. So that was a weird move.

That being said medical offices do a lot of shady shit so challenging it isn't wrong.

Like my wife had to get a tooth removed. She had the examination, cleaning and referral made by a regular dentist and had the surgery performed by the oral surgeon. The oral surgeon's clinic tried to charge her for all the shit the regular dentist did in addition to the tooth extraction.

She also went to another clinic for a series of treatments and they finished the treatments early but they still charged her for the originally scheduled amount of sessions.

Always better to ask upfront about how things will be covered by insurance, if they accept that insurance, and make sure you're keeping records and shit.

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