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TJ, Esq.
TJ, Esq., Attorney
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Experience:  JD, MBA
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A dentist billed me for services not rendered. He also billed

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A dentist billed me for services not rendered. He also billed and was paid by the insurance company for work not done. I filed a complaint with the IDPFR, and have been advised that after investigating my complaint are going to prosecute him for falsifying
records. Do I have the basis for a lawsuite, and could this be considered malpractice?
Submitted: 1 year ago.
Category: Legal
Expert:  Thomas McJD replied 1 year ago.
Were you injured in any way by his falsification of records, i.e. insurance premiums went up, insurance was cancelled, you paid a higher co-pay or deductible, etc.?
Customer: replied 1 year ago.
This is the second time I have responded to your request for more information. I was laid off from At&t in November of 2010. I went to the dentist to have dental work done before my med/dent coverage ended in May of that year. I got a notice in the mail in Feb. informing me that I had 1,081.00 in a Health reimbursement account that I was unaware I had. I was informed that I had until May to submit requests for reimbursement for out of pocket medical/dental expenses that I had already paid. I had several expenses that I had incurred and was reimbursed for, the monies were direct deposited in my bank account. I had paid 400.00 in out of pocket expenses to this dentist, but needed a statement showing what procedures had been done, charges billed to the insurance company and what I paid out of pocket. He refused to provide me with a statement because "He gave me a discount, and I was not due any money". He even threatened to contact the police to have me charged with "harassment and attempted fraud" if I continued to insist on getting a formal statement of my account. This is why I filed a formal complaint with the Illinois department of professional and financial regulation. Even though their investigation led to him being prosecuted, the deadline for submitting the claim for reimbursement had passed. And when he DID send me the statement, it was full of bogus charges. I feel that I did suffer harm as the result of his actions.
Expert:  TJ, Esq. replied 1 year ago.
Hello. The original expert who was helping you opted out, so I will attempt to help you.
It does sound like you have a basis for a lawsuit. He failed to timely provide you with an itemized statement of all work done and charges so that you could seek reimbursement of your out-of-pocket expenses. Illinois law requires that he provide you with your dental record. I have copied the relevant part of the law below:
Sec. 50. Patient Records. Every dentist shall make a record of all dental work performed for each patient. Dental records required to be maintained under this Section, or copies of those dental records, shall be made available upon request to the patient or the patient's guardian.
As you can see, the dental records must be made available to you upon request. You may wish to sue the dentist in small claims court. However, that is not considered malpractice. In the lawsuit, you would allege that the dentist had a legal obligation to provide the dental records to you, that he failed to provide the dental records in a within a reasonable time, and that you suffered monetary harm as a result.
Does that answer your question? Please let me know if you need clarification, as I am happy to continue helping you until you are satisfied. Also, your positive feedback is much appreciated. Thank you for using our service!
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TJ, Esq., Attorney
Category: Legal
Satisfied Customers: 9855
Experience: JD, MBA
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