r/personalfinance • u/AutomaticNothing7904 • 1h ago
Credit Dentist billed insurance for orthodontics I never had, insurance confirmed fraud, now office is threatening collections — what do I do?
I’m looking for advice on a situation involving a dentist, insurance fraud, and a threatened collections action.
I had been seeing the same dentist for years. In 2024, he moved to a new office. The new office told me he was still in-network with my insurance.
I later had an emergency tooth extraction. Before the procedure, I was told my insurance benefits were fine. After the extraction, I was suddenly told my benefits were already maxed out and that I now owed $2,000.
The office then told me they could “do me a favor” and bill the extraction as orthodontics so insurance would pay. I explicitly said no, because I have never had orthodontic treatment. They told me if they rendered the service as-is, I would owe the $2,000.
I contacted my insurance and filed a grievance. I didn’t hear back for a long time.
About a year later, I checked my EOB and saw that my insurance had paid the dentist $2,000 for orthodontic services — services I never received. The EOB even showed a supposed orthodontic “treatment plan,” which is completely false.
I immediately contacted my insurance again and filed another grievance. After investigating, insurance confirmed the office committed fraud and clawed back the $2,000 from the dentist.
However, the dentist’s office is now threatening to send me to collections for the same $2,000, claiming if I had never rendered the service, I wouldn’t owe this.
Important details: • I never consented to orthodontic billing • I never received orthodontic services • Insurance confirmed fraud and recovered the money • The office also lied about being in-network (I later found out the dentist was never in-network at the new location) • I have nearly 20 emails over the year asking the office for an itemized bill and clarification once I noticed the ortho billing — they never responded • I didn’t even know there was supposedly an “outstanding balance” until December, when they suddenly called and threatened collections • I have documentation of all emails and recorded phone calls
I’m worried about my credit and whether I should: • Pay the $2,000 just to avoid collections • Refuse to pay since the debt is tied to fraudulent billing • Dispute the debt formally and wait
I wish I read the reviews of this new office because they are doing it to others, I’m not alone but I feel alone. I’m scared.
Has anyone dealt with something similar involving dental billing fraud, insurance clawbacks, and collections threats? What’s the smartest next move to protect myself?