This is the record of what happened to me while having dental treatment from David E. Kem, D.D.S., 3902 West Camelback Road, Phoenix, Arizona 85019. I taped my final consultation with Dr. Kem, and quotes from the tape are included here with foot counts from the tape.
On or about April 8, 1999, I consulted with Heather Kobyluck, Dr. Kem's office manager, to set up an appointment for a cleaning to be charged to my insurance. An appointment was made for the fifteenth of the month. On 4/15/1999, I saw Mary Ann McDowell, Dr. Kem's hygienist. She examined my mouth and referred me to Dr. Kem. I told Dr. Kem that I wanted my teeth cleaned. Dr. Kem indicated a series of procedures that needed to be done. I raised my left hand and told him, As long as I have insurance. Dr. Kem nodded his head and stared at me. I informed Dr. Kem that any work needed to be completed by August or September of this year as I was moving out of the state. An appointment was set up for April 27, 1999.
On April 27, 1999, prior to starting the root canal on tooth #31, I told Dr. Kem that I had a filling that fell out that needed to be replaced today. Dr. Kem said, We'll get to that. Aida took an X-ray of the tooth; apparently, I was never charged for this X-ray, as there is no mention of it either in Dr. Kem's bill or the Defendant's Disclosure Statement No. CV 99-07360 RB. As will be shown, this missing X-ray charge fits in with Dr. Kem's style of record keeping, a form of record keeping not conducive to a patient's being able to keep track of remaining insurance coverage.
As of the date of this writing, this filling has not been replaced, as is evidenced by a gaping hole in my tooth. The cleaning was never done, as demonstrated in foot count 222 in the tape transcript of the 7/28/99 visit: I said I want my teeth cleaned when I came in here, and use up my insurance. The insurance is gone, but now I got a filling over there, and now I can't, I can't I gotta pay for it, right? the transcript continues:
230 Mr. Najdul But not from a dental standpoint, I come in here for my
teeth cleaned. . .
232 Dr. Kem Ok.
The work that was done included planing and scaling, two root canals, three crowns, two build-ups, and two unrelated fillings. As of this date, tooth #31 has never been repaired to my satisfaction.
During the course of treatment, I paid Dr. Kem in full for his services. The amounts personally paid by me were as follows:
My dental insurance policy paid Dr. Kem $1,600.00. After a grand total of $3,420.00 being paid to Dr. Kem, I have the same missing filling that I mentioned on my initial consultation with him, my teeth weren't cleaned, and I have unresolved problems with the crown on tooth #31.
Following foot count 304 in the tape transcript of the 7/28/99 visit, Dr. Kem states, and, again, for me, or for Heather to know 100% everybody's insurance and exactly how much it covers, you can't. And so that's why we encourage you to try to keep track of it yourself. From on or around April 8, 1999 until the beginning of July 1999, I never received a billing statement from Dr. Kem's office.
Incidentally, this is the same man who accepted responsibility for the cost overrun in the following section of the 7/28/99 tape transcript:
289 Mr. Najdul But you should've told me, Hey, lookit, the insurance is only gonna cover this much, and the rest is on your own.
290 Dr. Kem I I I
290 Mr. Najdul It's your responsibility.
291 Dr. Kem I I realize that.
Dr. Kem's subsequent statement that he can't know everybody's insurance inside and out is small consolation after an outlay of $3,420.00 while still having unfinished work that was ignored in favor of high-priced work that didn't even include the filling that I mentioned to Dr. Kem on April 27, 1999.
On Heather's presenting me with a bill in the amount of $456.25 on 5/20/99, I asked Heather which portion of the services were being paid by my insurance. I also asked Heather to let me know when we were getting close to the upper limit of my insurance. On at least three occasions I remarked to Heather, This is an awful lot of money to get my teeth cleaned. On 6/7/99, I also instructed Heather to not let the charge for the services surpass the insurance ceiling. On 7/8/99, after work had been done and before being presented with the bill for $592.50, I was told by Heather, I'm afraid your insurance didn't cover this. I paid the $592.50 but, had I known that this day's work was beyond my insurance coverage, I would not have allowed that day's work to proceed.
Dr. Kem's bill makes no mention of the 7/28/99 visit. Dr. Kem's bill supposedly declares all visits, including those that were No Charge (N/C). The bill lists N/C visits on 7/14/99 and 8/18/99. Why was the 7/28/99 N/C visit not on Dr. Kem's bill? It certainly was a N/C visit:
372 Dr. Kem we're still addressing the one tooth, tying to get the sensitivity gone, and checkin' the bite, that's still continuing that treatment on that one tooth. There
isn't an additional charge for us to maintain that
378 Mr. Najdul Yeah. That's what I came in here for, to get this fixed.
Don't be confused by Dr. Kem's apparent reversal of the above statement:
378 Dr. Kem and then today, and today is a separate charge to get them us (sic) finished cleaning them up.
Since there wasn't a charge entered on Dr. Kem's final bill for this visit, and since his final bill shows me paid in full, I believe that we should go with foot count 372, above, and conclude that the visit was a No Charge.
How did the record of this N/C visit evade Dr. Kem's bill, yet receive mention on the Defendant's Disclosure Statement?
Perhaps the omission of the 7/28/99 appointment from the bill serves a purpose, namely, to obscure the sordid history of the crown on tooth #31.
On June 7, 1999, when crown #31 was scheduled to be seated with permanent cement, it was discovered that the crown required additional porcelain, necessitating that it be returned to the dental lab. Eight days later, on June 15, 1999, the crown was permanently seated on tooth #31 and adjusted. Twenty-six days later, on July 8, 1999, it was adjusted again. On July 28, 1999, as is evidenced by the tape transcript, crown #31 was adjusted yet again. It is amazing that this adjustment was not mentioned in the 7-28-99 entry in the Defendant's Disclosure Statement. In fact, no tooth adjustment was mentioned in the Defendant's Disclosure Statement, the visit that's mysteriously missing from Dr. Kem's bill. The tape transcript's foot counts 187 193, 372 375, and 490 566 discuss and describe Dr. Kem's adjustment to crown #31.
The crown on tooth #31 still requires adjustment. I consulted with Dr. Salwin of Glendale Dental Group on September 22, 1999, who informed me that the bite had to come down.
I was in continuing pain throughout this treatment, and I am still in pain. The tape transcript at foot count 565 quotes me as saying
565 Mr. Najdul See, I've been taking Tylenol.
565 Dr. Kem and then if we need to and I think that ibuprofen
566 Mr. Najdul See, every time I touch it with my tongue it moves. Right now it's sore.
Work commenced on tooth #31 on 4/27/99 and ended on 7/28/99. My insurance benefits have been exhausted, and the tooth needs further work. In addition, the crown on tooth #31 is still not seated properly (see 566 above), in spite of its being seated with permanent cement by Dr. Kem on 6/15/99.
The crown on tooth #31 was adjusted at seating on 6/15/99. It was again adjusted on July 8, 1999. It was again adjusted on July 28, 1999 as the tape transcript shows a fact that Dr. Kem's bill omits.
I owe no balance to Dr. Kem for this work that, as of this writing, has still not been completed to my satisfaction. I constantly experience pain in this tooth, one that has had a nasty history of being
189 Dr. Kem up too high, or somethin'.
Dr. Kem constantly returned to what should be done, regardless of my statement at foot count 270 that After the coverage is gone, I'm gone. On 7/28/99 I said that I was not going to pay for any further work, a point I never held as a secret from any member of Dr. Kem's office at any time.
I am not claiming that the work performed by Dr. Kem was not dentally necessary. What I maintain is that Dr. Kem's office repeatedly ignored my requests to be kept abreast of my insurance claims, and that Dr. Kem apparently doesn't understand the meaning of the phrase
270 Mr. Najdul After the coverage is gone, I'm gone.
Dr. Kem's work concentrated on actions that exhausted my insurance without warning and without regard to my early and repeated insistence to fix my filling and clean my teeth. These were the primary reasons that I sought his services. These actions have left me in pain, requiring extra work on tooth #31, and in need of the work that I constantly requested him to do.