Dr. Mark Choe, DDS, Fairfax Advanced General Dentistry P.C. Center for TMJ Disorders overcharing through breach of contract with United Concordia Fairfax, Virginia

<p>I tried emailing the ripoff report editor to say my paragraph spacing did not appear on my report so it is very hard to read and is a disservice to anyone who may want to read about this company, but I have not received a reply in two weeks. It does not appear to be possible to edit any report even for formatting only, so I will repost with HTML breaks.<p><br>

<p>Dr. Mark Choe, DDS, whose office window advertises No Pain, All Gain, deserves more online recognition than his request for patient reviews suggests he has been receiving up until now. The dentist seems well schooled in advanced dental procedures such as orthodontia, surgery and implants which many general practitioners refer people to specialists for, so he would seem to have a better understanding of all the subfields of dentistry than most general dentists and thus be better able to assess a patients overall dental health and needs than others. Given his apparent qualifications I remain puzzled as to why Dr. Choe requested that I write a review on Dr, Oogle; never in my 44 years has a dentist asked me to review him. Perhaps he would like to broaden his patient base beyond the Korean American community to people who could pass as Anglos. At any rate, I wish I could have given this friendly dentist more stars on Dr. Oogle, as I appreciated his offer not to charge me for an x-ray procedure Id already had done recently at another dentists (for exostoses) and which Dr. Choe repeated before I had time to protest. Poor communication with a patient, especially when amends are made, is nothing to merit a one star rating. But there really is no excuse for engaging in marginally legal activities. If zero stars were an option and did not make it appear that I neglected to complete the rating, I would assign zero stars. </p><br><p>Dr. Choe asked me to post a review on the first day he saw me, before he had actually performed any procedures other than X-rays, cleaning, and an exam, so he may wonder why it has taken me this long to post it. Let me say first that it has always been my policy never to review health care professionals, because patients like myself are not qualified to do so. As with any repair service for homes, cars, or appliances, members of the public who are not do-it-yourselfers are only qualified to assess pain, not gain, a fact of which service providers are keenly aware. Savvy service providers make sure that they appear clean, prompt, and polite, regardless of whether they provide any lasting benefit. Go to a site like Angies List and you will see numerous favorable reviews of furnace installers who cleaned up after themselves, reviews written by home owners who may never have needed a new furnace in the first place. These people undoubtedly have heat in their homes at the time they post the review, but they can have no idea whether the work behind the baffle was performed properly or whether other components perhaps more directly responsible for their difficulties, such as an electronic thermostat, wont presently fail. </p><br><p>Similarly I cannot be expected to judge whether reconstructive dentistry is medically necessary or even advisable. In 44 years before coming to Dr. Choe, I have had two fillings, each for a cavity. Dr. Choe is the first dentist I have encountered who has offered fillings not for cavities but for chipped teeth he attributes to grinding (bruxism). While my front teeth were actually chipped through activities like catching my wifes teeth in a kiss, and while it seems physically impossible to grind the undersides of two rear molars with my upper teeth, the important thing, once again, is not the dentists acuity in diagnosis or whether the dentist provides a few seconds of pain-free treatment in the chair but whether the patient gains anything from the procedure. Unfortunately I have no way of judging the veracity of Choes hygienists allegation that if the dentist were not to drill and fill 10 of my cavity-free teeth, the hairline fractures in the tips of my front teeth would be likely to lead to broken teeth. Presumably Dr. Choe, who can boast technology that highlights imperfectly formed teeth on an LCD screen, is privy to recent scientific research that indicates a need for seemingly cosmetic $1300 procedures which all my prior dentists would likely have deemed unnecessary for anyone except movie stars. For the two rear chewing teeth, unlike all but one of the eight front biting teeth, I did feel pain both before treatment, and during the drilling, but I also felt some pain for weeks after the fillings, when eating sweets or very hot and cold foods, because the dentine under the tooth was exposed. Once I borrowed my wifes root brushes and brushed inside the gums rather than on the surface of the gums, the receded gum line in the vicinity of the molars magically rose to meet the enamel line, and I have experienced substantial reduction in sensitivity. It does not require hundreds of dollars in fillings to purchase a root brush, but what do I know? I am not a dentist. </p><br><p>In the interest of full disclosure, my experience in dentistry is limited to having performed oral surgery on myself. Sharp, pointed bone spurs (tori or exostoses) were poking through my upper jaw and causing the sort of pain children get with new teeth, and none of the four dentists I visited including an oral surgeon and a Johns Hopkins University Hospital dentist was wiling to do anything about it until such a day as I should need dentures that could not be easily fit around the spurs, since these growths are considered normal rather than pathological. So I stopped using fluoride toothpaste (research shows high fluoride volcanic soil produces what in the days before omnipresent fluoride was considered abnormal bone growth in both hooves and jaws of animals that forage in it) and filed down the exostoses with files from Home Depot and pumice stones from CVS pharmacy. Two days later I filed away the skin when it began to granulate back in, so as to form a dry socket of the sort these guys worry about after wisdom tooth removal, and then a couple months later flaked off the remaining bone matter with my fingernail when it began to dislodge itself. The procedure, which I invented (at least, I have not seen it described on the Internet before, and I did months of research), resulted in far more pain in the short term than the offending material had originally caused, but also far more long term gain than I would have obtained visiting dentists regularly to have them merely X-ray the spurs and observe their growth. So what do I know? With no dental training, I seem to be a classic case of the crazy patient who requests treatment when it is not necessary but rejects treatment when it is.</p><br><p> While I do not consider myself at all qualified to evaluate gain to the patient, I consider myself very qualified to evaluate gain to the dentist. Because I do not have a movie stars budget for dental treatment, I am a member of a managed care dental plan. According to the plans web site, Dr. Choe is also a member of this plan. He is what is called an in-network provider, which means he is contractually obligated not to charge the plan more than 80%--or the patient more than 20%--of an amount which the insurance company considers reasonable and customary, even if he would charge a higher rate to someone not covered by the plan. By attempting to recover more than this amount from the patient, Dr. Choes office is guilty of the controversial practice known as balance billing. </p><br><p>At this point, I hope it is becoming clear why I am writing this review. It is not to punish Dr. Choe for anything or to attempt to obtain any discount from him. People who care about money dont write reviews like this. They threaten to write them, but they obtain refunds in exchange for not writing them. Fortunately I discovered through reading my insurance companys Explanation of Benefits that a certain procedurewhite fillings for rear teeth--was not covered by my insurance, so I promptly remitted the exact amount specified by my insurance company for this procedure. While this amount makes my total payment still nine dollars short of the original amount the dentist had requested, I actually paid the dentist more than the amount indicated on my latest bill, which reflected a write-off based on my negotiations with his office manager.</p><br><p> According to law, these negotiations, which happened before either I or the office manager (or even the four insurance representatives I spoke with) were aware of the Explanation of Benefits, should never have occurred to begin with. As an in-network provider, Choe is contractually obligated not to charge anything over the fee schedule provided by the insurance company, and this includes fees negotiated down from the dentists stated rates. His office manager claimed that fee schedule she had obtained from the insurance company was apparently out of date and that therefore she was entitled to charge according to the old schedule. However, as the insurance company told me, this is nonsensethe correct current fee schedules are always available to providers online, and all the office manager needs to do is adjust the charges to make them comply with the contract. One would have thought that a dentist who uses email to encourage his patients to write reviews on Dr. Oogle and who displays teeth with alleged hairline fractures on LCD screens would be sufficiently Internet-savvy to download the latest fee schedule. Now Im willing to cut Dr. Choe some slack in the records department, since I myself did not know to look at my EOB link, and since none of four insurance company telephone customer service representatives I spoke with seemed to know about the EOB or realize that the information therein might differ from that in my claim detail statement. However, once a dentist is in possession of the correct fee schedule, he is obliged to honor it, whether it goes up or down, just as I am obliged to pay more or less property tax when my home is reassessed. I cant complain to my city government that I bought my house on the assumption that my taxes wouldnt ever go up or tell them I paid my taxes based on the last tax bill I happened to have lying around. </p><br><p>If you are the child or grandchild of a first generation Korean immigrant who is likely to be unaware of the laws of this country and easily taken advantage of by unscrupulous people, it is very important for the protection of your parent or grandparent that you understand that there are different types of civil law, not just civil and criminal law. If you have an HMO (Health Maintenance Organization) dental plan, and Dr. Choe is an in-network participating provider in this plan, the state of Virginia (along with most other states) provides consumers legal protection against balance billing. That means that if you have been balance billed by Dr. Choe (or another dentist or doctor), you should write to the states attorney general and request an investigation. If you can afford to hire a private attorney, the lawyer can write a letter to Dr. Choe insisting that he dismiss any outstanding charges or else be taken to court. If, on the other hand, you have a PPO (Preferred Provider Organization) dental plan, as I do, you will need to be a bit more creative if you want Dr. Choe to uphold his end of the bargain. Only about half of the states in the United States have consumer protection laws against in-network balance billing for PPOs, and Virginia is NOT one of them (nor is Maryland or DC, if you happen to live in the tri-state area). Of course, the practice of balance billing is still a violation of contract law. You could certainly report Dr. Choe to your insurance company and hope that after enough complaints, the company complains back to Dr. Choe that he is making it difficult for them to sell insurance plans, since the patients he would otherwise not be seeing are not receiving any discounts. But Dr. Choe could always tell them fine, make me an out-of-network provideryou say Im breaking your contract, so just take me off the contract. This exchange does nothing to reduce the bill you didnt expect to receive when you thought you would be receiving in-network rates. </p><br><p>Since in Virginia if you have a PPO plan, you cant legally stop Dr. Choe from charging you the difference between the contractually permitted rate and the rate he wants to bill you at, my suggestion would be to pay a visit to a bank before visiting his office and withdraw the entire amount of the dentists excess bill in pennies. Then, hopefully in front of his staff, his other patients, and the Christian paraphernalia featured prominently in the lobby of Dr. Choes office, you can dole out the pennies one by one. If, as in my case, the dentist has claimed that the insurance company was remiss in providing him its current fee schedule, you can ask him to let you know when the insurance companys responsibility to keep him informed of its current policies ends and where his responsibility not to balance bill you begins. Wherever he says his responsibility begins, you can stop handing him the pennies. If he has charged you several hundred dollars more than the allowable charges, even if his conscience does not get the better of him, the realization that the process of getting paid and disposing of the coins may take several hours should be sufficiently embarrassing to the dentist and disruptive to his practice that he will never balance bill another patient, including you.</p><br><p> I sincerely regret the few moments of pain this review may have caused the seemingly very competent and learned Dr. Choe, but I hope he will understand that said pain is justified by the very substantial gain it may offer his past and future patients. </p>