Sunday, October 25, 2015


A booth at the state fair carried a large label that read “Fraud Prevention”. As I walk by a woman standing behind the counter of that booth directed her remark to me; “If someone tries to defraud you let us know.” She said what she said in a way that suggested she expect an answer. Consequently, I answered her question with a question, “Do you mean other than being cheated on by the medical community.” The look on her face was precious but fleeting. In the fraction of a second, it went from the triumph of finding someone who was being defrauded to assuming an attitude of doesn't bother telling me something we already know. I went to a dentist, with a toothache. The two-hour wait and two-minute diagnosis was gum disease, and treatment was a week on antibiotics. The bill was $140. Of course, there was a follow-up appointment. During that appointment, a periodontist cleaned my teeth and gave me an estimate for dental work he said I needed. The bill was $150 for that visit, but his estimate was $1194.00. My judgment was that I would have that work done, which I did which took two more appointments. After that was finished, and I paid for the work, there was another appointment with a dental hygienist. A very nice woman cleaned my teeth again, and a DDS, Doctor of Dental Science entered the examine room and proceed to do an examination. The bill was $150 and this time the estimate was $2000.00 for work I needed to have done. One single solitary tooth already had a crown on it. As one might expect, the decayed area was near the nerve. The dentist carefully explained he would have to remove the crown, do a root canal, fix the decay, and then make a new crown, which fits remarkably close to what all dentist charge for this kind of work. In my mind, this amounts to price fixing and is so excessive it amounts to fraud. I went to a physician because I was losing hearing. I explained to the nurse and then to the doctor that all I wanted was to check if I had water or wax plugging my ear canals or something other than age-related diminished hearing. The nurse handed the otoscope to the doctor. The physician then looked, glanced was a more accurate description of what she did, handed the otoscope to the nurse, and said I was OK; that is all she said. She started for the examine room door. I stopped her and explained again that I wanted to know if there was any wax, water, or inflammation or reason my hearing was diminishing. She said, “No”. She said she would walk me to the appointment desk, the same desk where I had just pre-paid $30. From experience, I knew my insurance company would receive a bill for $126.00 of which they would pay $96. If you care to do the math, $96 plus $30 equal $126. You can imagine my surprise when the physician said to the clerk, “Make a follow up appoint for him, in three months”. My response was follow up for what. Because of the way I am, I told the physician the two clerks and the nurse and anyone else listening in a normal tone of voice that I considered what they were doing as a fraud. I asked them to remove my name from all of their records. I told my daughter in law about that experience, and she casually said, “Oh yes, I know because that kind of thing happens to me all the time.” Is medical and dental fraud so common that we just accept it without question? Is this just good business? Like the attitude of the woman in the fair booth said, don’t bother to tell us with what we already know. URL: Comments Invited and not moderated

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