Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:11/13/2022

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I went to Dr. ********************** for dental work. For each visit, I prepaid and made sure to verify my dental benefits. Before my last visit to her office, I prepaid and verified the services they were going to provide were covered. They told me I was 100% covered on all services after the prepaid out of pocket amount. I went to the appointment and had the procedures done. I checked with the receptionist before I left to clarify again I did not owe anything. A few months later, I received a message that I owed them money. I called and spoke with the receptionist who verified she did remember me prepaying and stated I should've been taken care of, but she would check. From there, I received additional emails with three different amounts I "owed" them as they stated my dental insurance did not cover the claims. I asked why they told me multiple times it was covered and that my prepaid amount was all I owed and I do not feel I was given an accurate response. I informed them that I also work in the medical field and if we misquote a patient, we remove the extra charges as it was our error. I again stated I would not have done the services had I not know they were covered (which was also stated multiple times during my appointments). They have now sent me to collections for what I believe is the 5th amount of $175 that I've been told I owe. I don't believe this is right and I have done all my due diligence as a patient and paid all of my owed dues. I'm really saddened this has happened and it's been very frustrating. This happened in 2021 and they have now sent to collections. I did also file a claim during that time and my dental insurance stated they never contacted them to check benefit coverage.

  Business Response

  Date: 12/19/2022

  
  
  We understand Ms.*******'s concerns. Due to HIPPA we can not go in details but we can explain some basic rules with any insurance companies. When employers are in market for insurance companies they ask the quotes from several companies. Employers have budget set for dental insurance. Insurance companies have to give the best plan and still have to fit in the budget. Generally the lower bids if not the lowest get the contracts. So how do they compete with other insurance companies? They set the limit for maximum, they provide the coverage for silver fillings only , they can opt out of covering dental implants etc. These are multi pages legal documents and since we are not the employee or employer we do not have access to all the small details. Having said that we try our best. That is why it always says that "estimated insurance coverage" It is same for medical too. Our general advice to everybody be aware of your own insurance coverage and pay attention to all correspondence they send you ( by law they send patients all explanation of benefits) and call them in doubt .
  This is just a generic explanation of the 3 rd party coverage and we file the claims as a courtesy on patients behalf. ( Let us be realistic- as a patient even I do not have time to file my own claims so I understand)
  If Ms. ******* has more questions regarding her invoice it is best that she calls her insurance company and they will explain her everything pertaining to her case or she can call us and we can help her understand.
  

  Customer Answer

  Date: 12/22/2022

  (The consumer indicated he/she DID NOT accept the response from the business.)
  I have worked in the medical field for over 10 years specifically with insurance. My comprehension on this matter is not in how insurance works, but the ethical practices of the office. I was informed several times that the procedures they added were covered and assured upon my last appointment that I did not owe anything. I then received several messages with multiple different amounts owed with no explanation as to how or why I kept receiving different amounts. I was told varying ranges from $30-$75. When I contacted the office, I explained when my office misquotes or does not take proper precaution to authorize a service, we write the service off as courtesy to the patient as it's our fault. I did my due diligence, pre paid my visits and verified multiple times these were covered services. There is still no accountability as to why I was told I owed several different amount and they finally decided it was $75. I spoke with their billing coordinator in length on the price and coverage I had left and was told I would be covered. I believe the office is trying to scam me for money and at this point, it is ridiculous. They need to do the right thing as the error was on their end not mine and I paid what I was told I owed prior to the service being completed. Please stop advising me to call my insurance and call the office for explanations on how insurance works- I understand how it works. If you would like to correct this issue on your part and stop avoiding why I was given so many different amounts owed, I will be more than happy to speak with the office on the phone.

  Business Response

  Date: 01/11/2023

  Our office has a signed financial policy for every patient including her and that explains that any unpaid portion from insurance is patients responsibility. It also states financial charges will be applied every month to unpaid potion. This is our final comment on this case. If she has any more questions she can call her insurance company.