Dr. Caden Ngo said he wanted to wait until he got preapproval back from my insurance company to determine whether the deep cleaning would be covered. He mentioned something about not wanting us to get stuck with a large bill in the event that it would not be covered.
One week later, I got a notification from my insurance provider that some claims had been paid to Dr. Caden Ngo for those exact services he hadn't yet provided. I asked the insurance provider rep if this was common to do before a procedure to which she replied "noooooooooo."
I wanted to give him the benefit of doubt that it was an honest mistake so I sent him the following email:
Hi Dr. Caden,
I received a notification from Aetna that a claim had been payed on my behalf.
It appears that you may have accidentally filed the periodontal scaling & root (for both my husband and I) as a claim for services rendered (instead of a free estimate for future services).
They have asked that you send a corrected claim and should be reaching out to you shortly (just a heads up!)
Will you please confirm once that has been taken care of?
Good news is that it does look like those services will be covered - please let us know when we can schedule to come in.
Thank you so much,
J (full name removed)
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To which he responded:
Hi J, yes I decided to send in the claim as though it were performed, that way I could get you two in immediately, I wanted to know how much they were going to actually pay, now I have to send a corrected claim, that will further hold up services...I was trying to be efficient. Thank you, dr.caden
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My response:
I did not realize that was standard procedure...
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J, I will call you in the afternoon, and try to better explain. dr.caden
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My brother-in-law is a dentist so I decided to give him a call. He explained to me that this is a form of insurance fraud and should be reported. He also said that I should hold off on the deep cleaning until after my first trimester.
Of course, I had let Dr. Caden Ngo that I was pregnant (I let him know verbally, checked it off on his patient form, and we also discussed during my visit) but when I brought it up again, he pretended like he did not know that I was pregnant. Dude straight up asked me if I was going to quit my job after the baby was born!
At this point, I let him know that I did not feel comfortable using him as my dentist and requested that he send in a corrected claim so that I could find a new dentist to which he agreed. However, he has not been cooperative.
He lied to me several times and told me that he had called my insurance provider but when I called to verify, the only record they had of him calling (and supposedly they log all of their calls) was prior to our visit, he had already called to scope out the details of our insurance plan...
Initially, he was very quick to respond to my emails (to the point, I wondered if he actually had any patients) but he has stopped responding to my emails for the past two weeks and my insurance provider has still not received a corrected claim.
I have now filed a formal complaint but may need to wait 6 weeks before the claim is reversed.