Large Map
  • Call 12 for Action
RI to get $172M in housing relief
RI to get $172M in housing relief

A major mortgage foreclosure settlement across the country has …

Truth behind Instant tax refunds
Truth behind Instant tax refunds

The Rhode Island Attorney General's office announced that the …

AG's office investigating bridal salon
AG's office investigating bridal salon

The Rhode Island Attorney General's Office is actively looking …

CFA: Cell phone shut-off risks
CFA: Cell phone shut-off risks

Local woman calls for help after her mother in-laws cell phone …

Bridal salon breaking vows on gowns
Bridal salon breaking vows on gowns

Local brides, calling for help: They claim a West Warwick …

Advertisement

Dentist charged, patients left to pay

Victim was billed for work that was never done

Updated: Monday, 02 Nov 2009, 9:57 PM EST
Published : Monday, 02 Nov 2009, 6:32 PM EST

CRANSTON, R.I. (WPRI) - A Cumberland woman says she's the victim of fraud.

Her Cranston dentist was recently arrested and charged with insurance fraud. Now she gets a bill for work that was never done.

Christine Payson and her husband had been patients of Dr. David Marcantonio's for years. Then, back on March 20th, 2008, they received a letter from Delta Dental stating that the insurance company would no longer be paying for service done by Marcantonio due to quality of care issues.

David said, "I couldn't believe it because we've been going there regularly. So as far as we knew everything was on the up and up."

The Paysons switched dentists. They thought that was the end of it until this past spring when Christine's new dentist said she needed a crown and submitted the paperwork into Delta Dental but it was denied.

According to Delta Dentals records Dr. Marcantonio in August 2005 had put one Christine's tooth.

Reporter asks: Did you ever get a crown?
Christine: Not on that tooth no!

Christine has the x-ray to prove it. Her new dentist says based on the x-ray, along with an oral exam there was no evidence of a crown on tooth.

The insurance company only pays for one crown per tooth every five years, so they would not pay for the work. The Paysons say they tried to explain to the insurer that Christine never had the work done in the first place.

Delta Dental responded:

"Since we no longer have a relationship with Dr. Marcantonio, we cannot compel him to work with us to resolve your issues."

Eyewitness News contacted Delta Dental. The company did reopen the Payson's case. They have agreed to pay for half of the bill for Christine's crown. The company also filed a lawsuit against Marcantonio and if successful in recovering any money, they will make it available to patients who had to incur additional expenses for dental treatment that had to be re-done.

A spokesperson for Delta Dental released the following statement:

“While we cannot comment on an individual patient, Delta Dental of Rhode Island takes provider fraud and quality of care issues very seriously. We have filed suit against Dr. Marcantonio for fraud and filing under false pretenses. We notified the RI Department of Health, the RI State Police and Dr. Marcantonio’s patients early on in this process. We continue to cooperate with the State Police in their criminal investigation, and we intend to vigorously pursue every available avenue on behalf of our members

According to state police, Marcantonio is charged with filing at least 34 fraudulent claims with Delta Dental worth $33,000 dollars. His dental license in Rhode Island has been revoked.

 

Copyright WPRI


Ground rules for posting comments: No profanity or personal attacks. Please comment on the subject of the story itself. If you do not follow these rules, we will remove your post. Keep it civil, folks!

Our commenting section is powered by IntenseDebate. If you registered for an account but didn't receive a verification e-mail, check your spam folder or click here for more information. For additional technical help, click here.

 

Advertisement
Advertisement