Complaints

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• Initial Complaint

  Date:02/28/2024

  Type:Order 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.

  ************ charged the three of us in my family a total of $1011 for "***" on our first visit without providing the following information:1. The insurance implication of allowing **** to do the ***--a commitment to her clinic. The insurance will not pay for the *** anymore when we change our service provider.2. The peculiar schedule of the clinic, which is impossible for us to accommodate, making a change of service provider unavoidable. 3. I am shocked that when the insurance company overpaid **** $900+ because ****** clinic sent the wrong codes (according to the insurance company), **** kept quiet about it for months until we called the insurance company.

  Business Response

  Date: 02/28/2024

  We sought legal representation to amicably resolve our differences, but the patient's demands are unreasonable and no further attempt to settle this matter will continue.  

  1)Billing: As we understand it from a providers perspective, there is no commitment and you are allowed to see any provider you want. Just because you had the *** completed at All Day Smile, does not mean you, as patients, are forcibly required to stay at their office. What is allowed under your insurance is between you and your insurance plan.
  2)  peculiar Scheduling: There is no special scheduling, here. Each and every dental office has their own respective schedules and hours of operation.************** office hours have been the same for the past seven (7) to eight (8)years. Similarly, ************** scheduling practices have not changed since you first sought evaluation by her office, and she has never had a patient complain regarding this. It is not ************** or her offices responsibility to make sure your schedule aligns with theirs. It is also not their obligation to amend their work schedule for your convenience.
  3) There was NO fraudulent act of sending incorrect codes to the insurance company.  In addition, NO overpayment by the insurance to our office was done and if there was ever an issue, the insurance company would have contacted us regarding this matter.  Procedures that were rendered were billed correctly to the insurance and was paid correctly by the insurance company to our office.  With respect to the billing issues wherein certain services were billed under the wrong member of the same insurance plan,this issue has been duly discussed with your plan and was corrected by the insurance.  Proof of that explanation of benefit can be provided by the dental insurance company.  ** financial expense or consequence resulted from this.

   

  Regards,

  Hang **** DDS

   

  Customer Answer

  Date: 02/29/2024

  Suspected Insurance Fraud: We called the insurance months after the office visit and found from the insurance staff that All Day Smile (ADS) had billed the insurance company for treatments never performed. We informed the insurance company as such. The insurance company said ADS submitted the codes they should not have. We called ADS, who said the insurance company committed all the mistakes.

  Fact1: ADS knows they were overpaid.

  Fact2: ADS did nothing about it for months until we found out accidentally.

  If we have not found out, what would have happened?

  Fact 3: When we inquired ADS for an update on the status of the return of their overpay, we never got a straight legitimate answer, we got bad attitude instead. 

  Scheduling that is impossible for my family (and many families) to accommodate: When we tried to schedule treatments for a second office visit, we were told that the doctor performs treatment only in the morning, and never in the afternoon. The kid would have to take school hours off to receive her treatments. This means that there is no way we can stick to ADS. Is it even hard for ADS to understand that they need to inform us of their unusual scheduling before making us commit to them? 

  Adding to that, ************ tried to prevent me from reporting to the ********** Dental Association by offering to pay back all the *** expenses, and then welched on her proposal and hired a lawyer to demand that my whole family (including the little kid) must sign a general release.  What kind of a being would go after a minor like that? Does that being have the heart of a dentist?

  There is also another warning sign that ************ may put her patients in danger. She kept spelling my last name, which is only 3-letters long, wrong, after multiple corrections. Is it just her being disrespectful, or is she even capable of any detail-oriented work? Is it a sign of some sort of physical/mental impairment? I am concerned for her patients.