Do I have any kind of case for cost misrepresentation?

Asked over 1 year ago - Stoughton, MA

Recently I had to do a root canal work on my 2 teeth. I had to do something quickly in a matter of few days.I have found a local clinic which gave me an appointment on Saturday. Doc came to a conclusion that one tooth will need root canal work (RCW) and most likely another one will, too. He asked if I knew what RCW meant and explained that he'd have to open both teeth, clean the damaged tissue, see if the nerves are possible to save. If not- he'd have to kill and remove the nerves, and patch the teeth with a temporary filling. Then I'd have to take a course of antibiotics, and then come back in a week to have a RC filled with a permanent filling. Then, he said, the tooth will need to be capped because otherwise it becomes brittle and may crumble off easily. I did not specifically asked if this was all considered to be one process. Unfortunately for me, I assumed it WAS one process, as without cap it seemed my teeth would not be operational. Then doctor left, and billing lady came in and told me that each root canal would cost $1200, and as my insurance won't cover everything, I will have to pay $1700 out of my pocket, and she asked if I still wanted to proceed. I agreed. Then doctor did the cleaning, and I left till next Saturday. This past Saturday I came back and thought I would leave the place with at least a temporary crowns of some sort. The specialist took care of the root canals, filled them and put in the temporary filling to cover them till the crown is put on. Then I went to the front desk, and before I paid for the visit, I was told that I would have to come back twice, one time - to take impression of my teeth and put a temporary crowns on, and second time - to put permanent crowns on. And because the amount I have to pay is so big - $3320 - the are okey with me paying in 2 increments, $1610 each visit. WHAT? it took me 15 minutes to figure out that the charge of $3320 they were talking about was a NEW charge I had to pay, apart from $1700 I was already due to pay today. I just could not believe it (well, also, being drilled in your had for good 40 minutes does not help). I "knew" that I had the job to be done, and in the end of it, I would have teeth "capped" and functional, and that it would cost me personally $1700 (or $2400 before the insurance). Now I am bound, I HAVE to do something with these 2 teeth that are only covered with a temporary filling, and it will cost me extra $3320. Should I have known it would cost this much, I would perhaps just do the emergency canal cleaning, and would have a temp filling till I'd shop around for something else, perhaps a cheaper clinic or even till I at least would do some financial planning and find money.. with my husband being out of work and me staying at home with our baby, it's not that easy.. I feel like I have been if not directly lied to, than not told the whole picture in hopes I'd proceed with the procedure. Unfortunately, I have never asked for a treatment plan and so I did not see the numbers. Yesterday when I was presented with a treatment plan that showed I'd still have to come up with extra $3320, I aksed why I never heard of this being separate procedures, on which billing lady replied that she "told me last time, but I was probably in so much pain I did not understand her". I was NEVER presented with any number other than $1700. All it is at this point, is my word against theirs. I do feel mistreated and am under great stress now trying to figure out what to do with my 2 half done teeth until the temp filling will crumble off and they will get infected..
Thanks!

Attorney answers (4)

  1. Daniel DeMaria

    Contributor Level 14

    6

    Lawyers agree

    Best Answer
    chosen by asker

    Answered . I agree with my colleague in all respects, and just wanted to throw in some additional points.

    First, you should try to contact the dentist to resolve this matter amicably. There may be a good chance he'll reduce his fee, it may not be exactly what you want, but it could come close, this would be fast and cost-effective.

    Secondly, under Mass. Gen. Law 93A, you may be able to recover treble damages, and this can be used as a strong motivator for the dentist to simply settle the claim instead of risking having to pay you 3 times your money back (for the charges you weren't told about). In this regard, contact a lawyer for a free consultation, perhaps one of the attorneys who answered/answers this Avvo question.

    Thirdly, if you paid by credit card, and the charges were unauthorized, you can call the credit card company and file a dispute with respect to the $1700 you've already paid (since you didn't get what you thought you were getting. This would ONLY work for the $1700, it would NOT work for the $3320). This advice is of course based on the limited facts presented and on my understanding that this situation is analogous (i.e. identical to the following) if if you stay at a hotel and are told the room rate is $89/night, and then when you check out they suddenly tell you it's $119. You could file a credit card dispute with respect to the $89. This is the easiest, simplest way of handling these sorts of things. You need to be careful you don't commit fraud, however. The Credit Card company will send you an "Affidavit of Fraud and Forgery" (or something similar), and you want to make sure you explain everything that happened, without omitting anything important, or sugar-coating any facts. As long as you're completely honest, the worst that can happen is the Credit Card company will deny your claim. From experience, a lot of companies can't be bothered to reply to the Credit Card company's requests for information, and so the person contesting the charges often "wins" on a default basis.

    Thirdly, you may wish to file a complaint with the Massachusetts Board of Dentistry. The complaint form is available here: http://www.mass.gov/eohhs/docs/dph/quality/boar..., and more information on the process is available here: http://www.mass.gov/eohhs/provider/licensing/oc....

    You don't really benefit from filing a disciplinary complaint per se, but it will protect others, by putting the dentist on notice that his billing people aren't explaining things clearly, and there is an off chance, the dentist will offer to return part of your money.

    Good luck, and try not to stress out too much.

    Atty: 845-704-7777. This answer is provided for informational purposes only and does not constitute legal advice.... more
  2. Emma A. Kremer

    Contributor Level 15

    5

    Lawyers agree

    Answered . I'm sorry that you are dealing with this frustrating situation. You may want to consult a litigation attorney for a thorough review of all the facts and have the dental records reviewed by an expert. I would recommend not posting any more information that can identify you in the event that you do pursue litigation. While you provided a lot of facts, it is difficult to say whether this is misrepresentation if you knew what procedures were going to be performed. If the dental work was not performed properly or they overcharged you or performed unnecessary work, you may have a claim for professional malpractice or misrepresentation. You may want to speak to the dentist's office to see if there is something you can work out with them first. If you are still unhappy with what happened, you should consult an attorney with experience in such cases. Best of luck.

    Please be sure to mark if you find the answer "helpful" or a "best" answer. (It lets us know how we are doing.)... more
  3. Jeffrey Ira Schwimmer

    Contributor Level 19

    4

    Lawyers agree

    Answered . As a point of information, dental malpractice involves a physical act on the part of the dentist (or an omission of conduct) which has caused the patient physical injury. That is different from where the dentist does not provide the service contracted and paid for, or where a charge different than agreed upon was made - which is more in the nature of a "breach of contract" action. I personally believe your situation falls within the breach of contract domain and not dental malpractice. Follow the advice of the MA attorneys who have responded to you to pursue a claim of misrepresentation. Just as an aside, and without any intent to sway your decision, I will share with you my personal experience of having needed not one, but ffour root canal procedures. In each instance, the cost for doing the root canal, which varied in price from $1,200 to $1600 for one tooth, was separate and apart from the cost of getting a permanent cap/crown - that averaged another $1,200 just for that. Of course, different locales, in different states, can reflect different costs/prices. You may be surprised to know that the ADA does not recommend a pricing chart for its members. And at least in NY, nor does the local dental associations. In fact, one dentist frankly told me that each dentist is free to charge what he/she believes the market can bear. Now, that is one tooth ache!

  4. Robert Bruce Kopelson

    Contributor Level 20

    3

    Lawyers agree

    Answered . You should check around and see what other places would charge for the same services. if they are in the ballpark, you probably havent been damaged. if they are excessive, perhaps you can negotiate a lower typical price. Check with you ins co to be sure that you have no addl benefits tht could cover part of this. A root canal is separate from a crown. Mabe you can get ins to pay some more.

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