Halboth fraudulently diagnosed that a 2010 crown provided by the patient’s previous dentist did not cover the tooth and that the tooth would “rotted out” within a few years. When the patient indicated that Delta only covered a new crown every 5 years, Halboth said “you won’t have a tooth in 5 years.” Halboth recommended immediate replacement by himself and submitted a pre-approval claim to the patient’s insurance company. The patient submitted the case to peer review and met with three MDA peer review dentists, which after examining the crown and X-ray, concluded that the crown was sound. Halboth’s office never verified the benefits available under the patient’s insurance plan and began taking numerous sets of x-rays. Insurance did not pay for the 1 every 5 years and patient was billed. When the patient offered to pay for half of the X-ray, she was informed that she's lucky not to have been billed $35 for the copy sent to peer review. The office also threatened to take the patient to small claims court even though the patient never said that she was not going to pay the bill. The office also overbilled Delta for the services performed.
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