General Dentists - Phoenixville, PA

"My Complaint is in regards to unnecessary dental work, and a fraudulent insurance claim. The referred PA code is ; § 33.212. Misleading, deceptive, untrue or fraudulent representations. As used in section 4.1(a)(2) of the act (63 P. S. § 123.1(a)(2)), the phrase ‘‘misleading, deceptive, untrue or fraudulent representations’’ includes the following conduct by dentists, dental hygienists and expanded function dental assistants: (2) Misrepresenting or concealing a material fact in obtaining payment for dental services. I went to Devon Dental associates as I had a cracked tooth (#15) It was not savable according to the Dentist. Upon entering the office the first time I was told I had a great dental plan. I asked to have the tooth removed, to which I was told that it would be more expensive to do this. I now understand that this is not the case, and removal is considerably less. I chose the crown as this was less according to the dentist. At no point was I told the actual dollar amount I would have to pay, I remarked that cost was important and that I did not want the tooth. The day I had the crown fitted I left the office and stopped by reception. They could not tell me the actual amount that I would have to pay, they did inform me that it was probably $400. I was shocked, and my immediate response was “Is this made of Gold?” to which the response was, “Yes, it's actually Gold & Platinum” I left without paying the $400 as I knew there was something wrong. I received a letter from my insurance company (Metlife) stating that the Dentist had submitted a claim for a tooth that was not covered by my plan. I have contacted the Dentist who have said that they contacted my insurance company the first day I came to them, they also said they checked my coverage. They also state that they discussed costs with me. This never happened, the only time cost was mentioned was unspecific value about pulling a tooth being much more expensive than a crown & when I left the last time and they said my payment could be $400.00. The Dentist is clearly trying to defraud the insurance company by submitting costs for a crown that was not covered, and falsifying the fact that I requested to have a tooth pulled. The facts are very clear, my insurance company were defrauded for financial gain. I am requesting that this Dentist be prosecuted for Insurance fraud. "