Legal Question in Health Care Law in California

I am a resident of CA. In 2010 my wife had dental work done, in 2011 I did. The work was done by Dr. A. At the time of service I confirmed that Dr. A was a service provider of my insurance co. They represented that they were, contacted my ins. co. and notified me of my obligation, which I paid at the time of service. In 2012 we changed dental offices, later that year Dr. H joined Dr. A. Recently I received a non-detailed bills from Dr. H dated 2010 and 2011 for the portions that my ins. denied because Dr. A was not a provider. I know I am responsible for a denied claim but is the Dr. liable for misrepresenting his relationship as a provider? Had I known they were not a provider, I would have changed to another. What is my best course of action?


Asked on 3/02/13, 3:54 am

1 Answer from Attorneys
Daphne Macklin Law Office of Daphne L. Macklin

You should contact the California Insurance Commissioner's office. If you did your due diligence to confirm that the doctor was an approved service provider, then the carrier should honor their contract.

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Answered on 3/02/13, 11:41 am


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