Problem with a dentist

New York / USA

Hello.
My mom went to a dentist her in Queens, New York to make a bridge and 3 crowns.
My mom has a Medicaid as insurance.
The doctor told her that Medicaid will only pay for this procedure $700 and the rest, which is $1500 she should pay herself.
He asked for all money upfront.

She paid him $1500 and he started doing her the crowns.
It lasted around a month as he was making crowns hat wouldn't fit and had to redo them a couple of times and still cannot do normal crowns. My mom got annoyed as the dentist couldn't do his job and asked him to refund her money as she doesn't want to use his service anymore. He asked her to give him a chance to make other crowns that would fit.

About a week ago my mom found out that he did charge her insurance not $700 but $2000. She went to him but he denied he charged that much. Finally he said he did charge the insurance $2000 that he was not authorized to do and asked not to notify the insurance company of the fraud because he will get in trouble. He promised that he would finally make her nice crowns and she would be happy. Well, my mom believed and she did nothing.

A week ago he made her other crowns which wouldn't fit with other teeth because they were a considerable different color and a way too big. I saw them in place, they were very ugly.
My mom told him that this is not acceptable, asked him to return her her money and to get back his crowns. He refused to refund her money saying his spent her time doing the job. He is also no longer afraid that he might be charged with fraud since he refunded all fraudulently charged money back to the insurance company. My mom left him the crowns and left as there is nothing she can do.

She were seeing the other dentist during and after the process and he said that the dentist who was making the crowns did a very bad job in preparing the teeth on which the crowns should be put. He reduced the teeth too much. He said he might be charged for that if sued as there is an obvious harm.

What can I do?

I'm sure there is some kind of "Dentist Association" to which he belongs.
I'm sure there is an agency who deals with insurance fraud.
I'm sure he can be charged for everything he have done and he will return the money he didn't deserve.

I need an advice here please.
I want to send complains to as many places as possible.
I can also afford to hire a lawyer, does anyone here wants to take the case?

Thanks you in advance.

[ellencee]

UNH
Call a medmal attorney in your area and make an appointment for your Mom to meet with the attorney. Consultations are usually free. Be sure to mention the fraud issue. The dentist may have a pattern of doing this and needs to be reported.

If her teeth have been reduced too much, there is little that can be done except for some very painful surgery to lower the gum tissue around the tooth (teeth) in hope of gaining enough tooth above the gum line on which to place crowns or bridge-work.

Maybe your mom can get a nice set of implanted teeth at no cost to her since her as settlement. I know I would prefer implanted teeth as opposed to the surgery to lower the gum line or dentures.

Good luck!
EC

You ask about where to send your complaints.
All states have a Dental Licensing Bureau Write to them. Also your county will have a Dental Society. Write to them.
Your local Health Department may have a free dental office. Go to them and see if they can help you.
Then go to the District Attorney's office and file a complaint for fraud against the dentist. Notify yor insurance company that he set out to defrauid them and has defrauded you. I say this because no doubt he has told the insurance company that he had "made a mistake" and that they had overpaid him. He sure didn't tell them he was defrauding them.
Then, of course, see a malpractice lawyer who specializes in dental cases. Look in the Yellow Pages.
I am fairly sure that the second dentist you saw should be able to fix your mouth. I say that without seeing you or that dentist. But many dentists are skillful workers and dental work is more like a jeweler's than a doctor's. Do not be afraid of more dental work. Having crowns is far better than having plates or even "implants".