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Dental Coverage Dispute Pennsylvania

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  • Dental Coverage Dispute Pennsylvania

    So here is the situation:

    My mother was a full-time employee at a dental office. The agreement she had with the dentist that owned the practice at the time she was being hired was that she could receive free dental care for herself, her spouse, and children. She was only responsible to pay for whatever lab fees were involved in the dental procedure/treatment. This agreement was considered to be included in her benefits, and one of the reasons she decided to go work there over other places she had interviewed at.

    In the Spring of 2006, while she was still employed there, my mom and my father both underwent some dental treatment. And once again at that time, the dentist had told my mom she would only be responsible for the lab fees. A month or two later, my mom quit working for that office. About 8 months (in 2007) after leaving that office, she received an invoice requesting payment for the TOTAL cost of the dental treatment, not just the lab fees. So basically, the dentist/employer broke their agreement. My mother tried contacting him to discuss the situation and dispute the balance, but he was rude and unwilling to talk to her. She paid for the lab fees. Now, she has received a letter from a Debt Collection Agency hired by her former employer, threatening to report her to Consumer Credit Reporting Bureaus if she doesn't payoff the balance in full.

    To me it's obvious that the dentist/employer is in the wrong. Unfortunately, the dental coverage agreement had been made orally. There was no signed contract. However, my mom is still on friendly terms with two of her former coworkers from that dental office who can attest to the agreement, since they too were offered the same dental coverage. It looks as though this might end up in court. A friend of hers has suggested writing a complaint letter to the state labor department.

    Any suggestions or thoughts on the matter would be greatly appreciated. Thank you in advance.

  • #2
    I'm sure someone will disagree, but since there was no written contract, I don't see how there's much she can do. First off, she should pay the bill. I know what the dentist said, but that doesn't matter. Pay the bill, fight it later. Right now her credit is hurting because of collections. Personally, I would be upset if I were the dentist too. He went through the trouble of hiring someone, they and their spouse used his services when they're "free", and then bails soon after. I admit I don't have all the facts, but I think anyone would be upset with that scenario.

    Pay the bill. Take the doctor to small claims for the amount she didn't want to pay.


    • #3
      I, for one, agree with you.
      Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. Leo Buscaglia

      Live in peace with animals. Animals bring love to our hearts and warmth to our souls.


      • #4
        Thank you for both of your feedback.

        I just want to add that the fact that my mom stopped working there shortly after the dental treatment was completely coincidental. She had no intention of 'bailing out' at any point. My mom hates having to change jobs, and she had hoped to work at that particular dental office for the next decade or so until she retired.

        She stopped working because of an accident (outside of work) that had a serious impact on her health. To be more exact, her injury required surgery with doctor recommended bed-ridden recovery & rehabilitation of several weeks. When she had told her employer this, he had told her that the only way he would continue to employ her after her recovery period was over, was as a part-time employee. So basically she was given an ultimatum of returning as a part-time employee (with no benefits and a salary cut), or not to return at all. That is when she decided to stop working for him.


        • #5
          Your mother should get in touch with the collection agency and tell them she WANTS this case heard in court.

          She should tell them that she will subpoena the other employees to testify that this was an agreement. She should also state that she will subpoena all the information about the work that should have been covered, including the costs and the invoices to show that the dentist, having promised to charge lab work only, was paid for lab work but waited until after the termination of employment to go after the rest of the money. An honest business would have collected in full right after the work was done. It might even be possible to get the invoices for ALL other employees -- look for a pattern of lab charges only while employed then a hefty bill for all work after termination. I doubt any judge or jury would be impressed by such a practice.
          Senior Professional in Human Resources and Certified Staffing Professional with over 30 years experience. Any advice provided is based upon experience and education, but does not constitute legal advice.


          • #6
            Originally posted by joec
            Yes thats true Scott but if she demands the hearing she has to pay the filing fee.
            One of many things I did not know.

            Yep, Mom should tell them she won't settle and the only way for them to get any money is to go to court.

            Side note -- what is the effect of this on a person's credit rating? Someone says they owe, but are, oh, 180 days past due, does the collection agency get to crank down the credit ratiing even though they don't have good grounds?
            Senior Professional in Human Resources and Certified Staffing Professional with over 30 years experience. Any advice provided is based upon experience and education, but does not constitute legal advice.


            • #7
              Originally posted by joec
              Oww good question,I am not sure if credit rating is affected prior to a judgment or not.
              Touche, I didn't think about that.


              • #8
                I must agree with JoeC, let the dentist/collection agency take their first court move. It will be up to the dentist to tell the judge that the verbal agreement was never made and then explain why it took so long to send her a bill. Remember these collection agencies only collect a percentage if they are successful in their collection efforts.

                In the last 5 yrs I have, twice, problems with commercial vendors who have turned me to collection agencies. Both times I came out successful. Not paid a penny in either instance. And my credit was not & has not been affected. In both cases they needed my social security number to report me to the credit bureau, which they lacked. Not the case of the poster, it appears that as a former employee the dentist has that information.

                The poster should challenge the bill, in writing, to maintain all legal options open, if the need arises. The poster should dispute using the procedures outline under the Federal Credit Billing Act (FCBA) of the Federal Trade Commission the creditor must follow settlement procedures:

                … must acknowledge complain in writing within 30 days …
                … creditor must resolve the dispute within 2 billing cycles…
                … creditor may not take any legal or other action to collect the disputed amount…
                … creditor may not threaten the credit rating while bill is in dispute…
                … creditor may not report you a delinquent while bill is in dispute …
                … creditor must remove all finance charges, late fees and other charges related to error
                … customer may withhold payment on the disputed amount…

                I was able to succeed on both of my disputes because the creditor failed to follow Federal Credit Billing Act (FCBA). Any communication with the dentist must/should be by certified mail and or email, that can be tracked that it was received by the dentist. Just my opinion of real life experience.

                "A veteran - whether active duty, retired, national guard, or reserve - is someone who, at one point in his or her life, wrote a blank check made payable to The 'United States of America', for an amount of 'up to and including my life.'" (Author unknown)


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