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Greensburg woman charged in insurance-fraud case over dental work

| Saturday, Nov. 16, 2013, 12:01 a.m.

A Greensburg woman had charges filed against her for allegedly producing fake documentation for dental-insurance coverage.

Amy Lee Palmer, 38, of 1526 Broad St., was charged on Wednesday with insurance fraud, criminal attempt/theft by deception, theft of services and forgery at District Judge Roger Eckels' office.

According to the complaint, on Feb. 9, 2012, Palmer entered the office of Dental Surgeons and Associates in Scottdale after she called to say she fell at her mother's residence and had extensive damage to her teeth. She told the office she was treated at a clinic but needed additional dental work. She asked if her mother's insurance could cover the costs because the incident occurred at her mother's house.

Palmer was X-rayed and examined. She was told she has sensitive teeth, needed a root canal and has chipped crowns. A mold for a dental bridge was made, and Palmer was prescribed Amoxicillin and Vicodin for pain.

On Feb. 27, Palmer called the office numerous times to request pain medication, but could not receive any more medication unless she came in for an appointment. A doctor spoke with Palmer over the phone and agreed to prescribe Vicodin with no refills as long as Palmer agreed to schedule an appointment.

On the same day, Palmer called the office and threatened to sue the doctor for neglect, but she was told the office was trying to confirm if the insurance would cover her procedure. The office gave her until Feb. 29 to arrive and show paperwork for proof of insurance, but Palmer didn't show up, according to the complaint.

On March 8, Palmer reportedly presented a paper signed by Nakita Jones of Agency Insurance Co. (AIC) indicating that full liability had been accepted and that Palmer's procedure would be 100 percent covered for the $3,500 procedure.

The paperwork was submitted to AIC, which then contacted Dental Surgeons and Associates to inform the practice that the paperwork was fabricated; that there was no Nakita Jones employed at AIC; the policy did not exist; and that it doesn't carry that type of insurance.

The dental office contacted Palmer to inform her the paperwork that she submitted was a fake. Palmer told them she didn't write the letter and was going to have a caseworker with the Department of Welfare attempt to have the bill paid.

After the insurance-fraud section of the Pennsylvania Attorney General's Office started an investigation into the matter in August 2012, Palmer's mother paid the dental office for the surgery in the amount of $2,896.

A preliminary hearing has been scheduled before Eckels at 10:30 a.m. Dec. 12.

Palmer is free on $5,000 unsecured bond.

Mark Hofmann is a staff writer with Trib Total Media. He can be reached at 724-626-3539 or mhofmann@tribweb.com.

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