My Dental provider billed me for something my insurance paid them for is this fraud?

UPDATED: Sep 30, 2022

Advertiser Disclosure

It’s all about you. We want to help you make the right legal decisions.

We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.

UPDATED: Sep 30, 2022Fact Checked

Get Legal Help Today

Compare Quotes From Top Companies and Save

secured lock Secured with SHA-256 Encryption

My Dental provider billed me for something my insurance paid them for is this fraud?

My dental clinic told me that my oldest son was not covered at time of service for an exam and cleaning in Jun 2016. The insurance company said they issued a check to the dental clinic and that the check did clear. The insurance company also stated my son was covered at time of service and there was no break in service. I need to know if this is an issue of fraud and if so what kind? Double billing?

Asked on June 5, 2017 under Business Law, Georgia


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

It may be fraud, if they knowingly lied to you about coverage and payment. It may be theft by deception, if they "tricked" you into paying when you did not have to and so stole your money by trickery. In no event are they entitled to your money if they were independently paid for the work: they don't get to double collect. You could sue them (e.g. in small claims court, as your own attorney or "pro se") for the money if they won't return it. In the suit, you would present proof that the insurer paid them.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

Get Legal Help Today

Find the right lawyer for your legal issue.

secured lock Secured with SHA-256 Encryption