SmileCare — dental malpractice/billing fraud
I am writing in regards to several incidents that have happened in relation to myself and SmileCare. I had went to SmileCare in Folsom on June 13th, 2008 to have mine and my son's teeth cleaned. During the visit, my son and I had x-rays taken, my son did have his teeth cleaned, and one of the dentists put anti-biotic plugs in my gums, however, I did NOT have my teeth cleaned.
My son also had a filling done on two joining teeth, and it was at that time I asked the dentist if she could fill in a gap between my teeth. She said she could. As the doctor proceeded to fill the gap, she said that she could not get the product to adhere to my tooth, and that she would have to remove the overlay that was on it, and redo the whole thing.
As she was trying to remove the porcelain overlay, she slipped and took a chunk out of the side of my tooth, and busted my lip. She apologized for it, but I was not aware of the extreme amount of damage she had done at this time.
After the local anesthetic wore off, I was in pain, but figured it would go away in a day or two. I then felt this gouge out of my tooth that the dentist had been working on, and knew right away, that this was from when she was drilling in my mouth and slipped.
I immediately called the Folsom SmileCare office, and asked to speak to the dentist. The girl that answered the phone took a message and said she would have her call me back. I did not receive a call back. My son had been complaining that his teeth still hurt, and when I looked at his filling, it was gone. I called again the next day, and once again, left a message explaining that there was damage to my tooth, and my son's filling had fallen out, and I was told that the dentist would return my call later that day. I still did not receive a call back. I called again the next day, and every day for a week and a half, leaving messages, and still no returned calls.
During that time, I unexpectedly had to move to Arkansas, and left immediately. I was no longer in CA, so I could not simply walk into the office that had seen my son and I.
I then started calling SmileCare's 800#, and filed a claim with their Quality Assurance dept. I spent the next 2-3 months trying to find out what was happening with my claim. Most of the time, Jackie at ext. 5374, was not taking messages because the mailbox was too full or she would simply hang up on me. I finally started calling any extension I could, so that I could get someone to handle this. I then spoke to Ezrialda at [protected], who told me she would handle this. She never did.
I then started working with another representative by the name of Georgia Bradshaw, ext. 5303. I then had to start the whole claims process over again, because the other women had simply done nothing. And once again, my calls went unanswered and once again, could not leave messages for Georgia, because her mailbox was full all the time. The few times that I spoke with Georgia, I had to explain everything over and over, she never took any records of our conversations.
After 6 months of trying to get my tooth fixed, and my son's filling redone, SmileCare agreed to fix my son's teeth, but would not fix my tooth, stating that they had fixed the "filling" I had, due to "reoccurring decay". A completely false record of the events that took place. Also, by agreeing to fix my son's teeth, they admit to damage on him, that occurred at the exact same time as mine, but stated that the x-rays I had taken in December, were far too long after the incident to prove that my damage occurred when I said it did.
At NO time during any of this process did anyone tell me to go see another dentist to get new x-rays. And had I know this, I would have went immediately to my dentist in Arkansas.
Not only did I NOT have reoccurring decay, they did NOT fix a filling. SmileCare also claimed that I did not act in a timely manner so I could not prove that they were at fault. I explained in my letters to SmileCare that this was not at all what happened, and that the records of the dentist were fraudulent. SmileCare had billed my insurance company for a filling and a cleaning, both of which were not done.
I appealed the decision of SmileCare, and the next contact I received, in the form of a letter dated Jan. 29th, 2009, was from a Mariam Youssef, Quality Assurance Supervisor/SmileCare Dental, stating that I was once again denied, but they would refund me $23.20, for the cost of the filling.
I then started calling the extension that Mariam Youssef had given as a contact number, and yet again, was given a message that the extension was full and unable to take any new messages. I have called at least 3 times per day, every day, since I received the letter, and have never been able to contact this QA Supervisor, or anyone in that position.
I am simply wanting SmileCare to repair the damage their dentist caused to my tooth. SmileCare has x-rays of my tooth in question, prior to this damage, and it is clearly visible, that there was NO reoccuring decay. Not only did they NOT perfom these actions, they made fraudulent claims to my insurance company, stating they had, and received payment for them.
I have spent thousands of dollars taking care of my teeth over the years, and now I have damage caused by a dentist at SmileCare, that I cannot afford to fix myself, or I would have already done that. SmileCare is responsible for this damage.
SmileCare has done everything in their power to avoid paying for their mistakes, and they way that they have dealt with me as a patient, is absolutely immoral, and dishonest. I hope that this does not happen to anyone else, as the Corporation of SmileCare has walked all over me.
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