This year, I required three root canal procedures. I selected Dr. Chia Chen Susan Chi, DMD, at Town Center Endodontics in Pearland for this treatment.
During the initial consultation, the doctor confirmed the necessity of all three root canals.
I specifically brought to her attention that one tooth was symptomatic and requested that the treatment commence with that painful tooth. While the doctor acknowledged my request, she ultimately proceeded in an order of her own choosing.
The work was completed in the following sequence: the two asymptomatic teeth were treated first.
Following the completion of the first two procedures, it was determined that the funds allocated by my dental insurance for the calendar year had been fully exhausted.
Given the pain I was experiencing from the remaining tooth, Dr. Chi proposed completing the third procedure, with the stipulation that I would cover the cost entirely out-of-pocket.
We discussed the fact that the procedure would exceed the insurance coverage limit, but it was understood that the claim should still be formally submitted to the carrier. Submitting the claim would obligate the office to adhere to the contracted rates established with the insurance company for that specific service.
Instead of following the contracted fee schedule, the office requested that I pay the full, unadjusted amount.
While it is standard practice for many dental offices to collect the full fee upfront, they typically submit the claim, receive the Explanation of Benefits (EOB), and subsequently refund the patient any overpayment based on the negotiated rates.
This standard procedure was not followed by Dr. Chia Chen Susan Chi's office. The office failed to submit any claims to the insurance provider, leaving the insurance company entirely unaware that any services had been rendered.
Upon investigating the matter, we discovered two primary issues:
1. **Overpayment on Initial Procedures:** For the first two procedures, we were charged fees that exceeded the contracted rates, resulting in an unauthorized overpayment for both teeth.
2. **Unilateral Pricing on Final Procedure:** For the third tooth, due to the complete lack of claim submission, we paid the full amount demanded by the doctor, which bore no correlation to the established fees outlined in her contract with the insurance company.
When my insurance company attempted to contact the doctor's office to obtain the requisite billing information, they were unsuccessful. It became clear that the doctor had unilaterally decided to set arbitrary, non-contracted prices for her services.
All attempts to resolve this discrepancy with the doctor's office were futile. The office insisted their prices were correct and claimed to have a "special contract" with the insurance carrier that permitted them to establish their own service fees.
However, the insurance company explicitly **denied** having any special contracts with Dr. Chi that would grant her the authority to unilaterally determine pricing.
I am documenting this extensive account to serve as a warning to potential future patients of this doctor. This is the first time in my history with medical professionals that I have encountered a situation involving such deliberate deception regarding billing practices.
Consequently, we ended up paying nearly **double the appropriate price** for her services. read more
