Woman talking(l+r), Insurance form(c)

Lee Charlie/Shutterstock @alberta.nyc/Tiktok (Licensed)

‘I’ve never heard of this’: Patient gets charged for medical procedure she didn’t have. It gets worse when she calls her insurance company

'Insurance is such a scam.'

 

Grace Fowler

Trending

Posted on Mar 7, 2024   Updated on Mar 7, 2024, 10:06 am CST

After claiming she was a victim of dental insurance fraud, a patient says her insurance company is making her pay for it. 

In recent headlines, TikToker Alberta (@alberta.nyc) says she was a victim of dental insurance fraud by her own dentist.

In her original video, Alberta says she received a letter from an unfamiliar company, Your Smile Partners, telling her to “brush her teeth.” The letter also reportedly stated that if she did not respond, it would be considered consent for teledentistry.

Alberta says she chose to ignore the letter. However, she says she received a bill about a new claim for teledentistry a few weeks later, leaving her owing $100. She says the letter claims she had a dental procedure done over Zoom, which she denies.

What did her insurance say?

In an update video, Alberta says her insurance company refused to drop the teledentistry charges. Her video has reached over 299,000 views and 22,000 likes as of the publication of this story. She captioned it, “The saga continues.”

“My insurance company says I have to pay for a fake dental procedure that happened to me ‘via Zoom,'” Alberta begins. 

She again describes how she thought the letter was a scam from the beginning.

“I do not see a Zoom dentist for my teeth, nor do I really know what it would be like to get a Zoom procedure,” she says, adding, “not a checkup, a procedure.”

Using two pens around her, she begins pointing them into her mouth as if they were dental tools. “Like, would they be telling me what to do, and then I’m just extracting a tooth or something like that?” she demonstrates. 

Next, she says she told her insurance company, “Hey guys, I think this might be a wee bit of fraud.” She says she expected them to thank her since “they pay for part of it.”

“They paid for a copay out of their own pocket for my fake dental procedure,” she says. 

Instead, Alberta says she received a new letter from her insurance company. “They did not agree with my assessment,” she states.

Then, she begins to read the letter aloud. 

“You stated you did not receive any treatment. … You further mentioned that this dental office seems does not exist,” she reads. 

She says that besides being “incorrectly formed,” the second sentence makes her sound like a “conspiracy theorist,” which she denies.

“I’m just a girl with an internet connection that saw when I Googled the name of the dentist, the website doesn’t work,” she says.

She adds that when she Googled Your Smile Partner, “It basically just seems like they put up a template website of a dentist there.”

Alberta then goes back to the letter and reads, “Unfortunately, we’re not able to get in contact with the dentist to figure out whether the procedure did or did not happen, so we’re dropping your claim that this was fraud.” 

She tells the audience, “I feel like we’re getting into philosophical territory here, but like, I cannot prove that something didn’t happen.” 

Next, she adds, “If anything, the fact that they could not get in contact with the ‘dentist office’ feels like it should prove that it is a fake company.” 

According to its website, Your Smile Partners is a New York-based dentistry company that offers select teledentistry services. However, the booking links on its website do not seem to work. The Daily Dot has contacted the company via email and media contact form for more information.

Alberta says her favorite part of the letter is when it states, “In the future, we encourage you to ask your dentist to request a pre-treatment estimate.” Before ending her video, she responds by exclaiming, “Well, unfortunately, I’ve never heard of this dentist before. We don’t correspond. We, in fact, cannot correspond because nobody picks up the phone there, as you know.” 

@alberta.nyc The saga continues 🥲 #insurance #scam ♬ original sound – Alberta

The Daily Dot reached out to Alberta via Instagram direct message for more information.

What should I do if this happens to me?

A viewer in the comments section suggested that Alberta should “report both the dentist’s office and your insurance company to your state’s insurance department.” 

“They will investigate for you and get you an answer,” they wrote. 

Another comment said, “This is 1000% a find and replace form letter. They did not read a single sentence you wrote.” 

According to the insurance information website American REIA, dental fraud is “a crime where an individual intentionally and unlawfully receives insurance money through deception, which can be done in a variety of ways both by the client and the dentist.” The site states that one of the most common and “egregious” forms of dental fraud is “phantom treatment,” or charging for services that were never rendered.

“If you’ve fallen victim to dental insurance fraud or are aware of it (or for fraud prevention), you can report it via your state fraud abuse hotline or an anonymous tip line of your insurance provider (most providers offer tip lines),” the site states.

It also states that if a dentist committed dental fraud, as Alberta suspects is true in her case, “Depending on the severity of the fraud, the dentist that defrauded you can be subjected to fines, loss of license, or a prison term.”

Dentistry is not the only industry where patients have been charged for procedures they never had. In a previous Daily Dot story, a mother shared her hack for getting false charges removed from medical bills after she realized the hospital where she gave birth wrongfully overcharged her.

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*First Published: Mar 7, 2024, 1:00 pm CST