A visit to the dentist could be very painful and costly, not only for you, but can also for your medical insurance company. Most medical insurance companies will have to pay for procedures done in foreign countries, and it's legal rule for patients to have them done dental care abroad. The problem is the Federal Bureau of Investigation reports dental fraud is becoming a major and serious problem along the U.S. -Mexico border.
"What we tend to see is that there are dentists in Mexico who are fraudulently billing U.S. insurance companies," said Andrea Simmons, a special agent with the FBI.
"I was motivated to get it done there because the cost was supposed to be less than here," said Richard Meagher of West El Paso. In fact, some Mexican dentists will waive your deductible, but dentists on this side of the border said patients are not getting the same quality care.
"When you go somewhere such as Mexico they don't require the same lengthy degree program we do here in the U.S. Many of the programs are a combination of undergraduate schooling and dentistry where their level of education is just not equal to the United States' programs," said Daniel Castro, an El Paso dentist..
"If you go to a legitimate dentist and say, 'I've got to have this done,' and the insurance company says, 'I'm sorry, we've paid out the maximum on your plan for this year,' the patient is stuck having to pay for that procedure," said Simmons.
Despite these facts, some El Pasoans who can't afford dental care tend to insist on getting treatment across the border. In some cases it can lead to medical complications also.
"My father-in-law got his dentures in Mexico, and he can't even eat with them because they're too large for his mouth. But I would be tempted to go because dental insurance is to expensive, and I would loved to have my teeth worked on," said Debbie Cadena from West El Paso.
The FBI states medical insurance companies lose millions of dollars a year to fraud, which forces them to increase their rates.
The FBI also warns malpractice insurance is now very different in Mexico, where doctors are not compulsory to have it. Therefore, filing a lawsuit against a Mexican dentist can be difficult.
In order for consumers to protect themselves and their insurance company against fraud, they should make sure the date of service on their insurance statements coincides with the day a procedure is done. Consumers should also keep track of what procedures the dentist performed to make sure their insurance company isn't getting billed for additional procedures. Patients who don't understand the medical terms on their statement should contact their insurance company, not their dentist.