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:09/20/2024

  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.

  2 claims were submitted on 2 different dates for X-rays by this dentist. I only received one of those X-rays. I spoke to the billing staff and they agreed an extra claim was submitted. They gave me a refund for the amount I paid out of pocket but will not correct it with my insurance. I have spoken with them and emailed for months and they simply wont correct it with my insurance. I spoke with my insurance and they said they just need a phone call from the dentists office. I dont know why the office wont make this right. My understanding is allowing a known false claim to stay on the insurance record is insurance fraud. I just want the records to be right.

  Customer Answer

  Date: 10/01/2024

  I have not heard from the business in response to my complaint.

  

  Business Response

  Date: 10/16/2024

  Thank you for the opportunity to respond to this notice. There was absolutely an initial clerical error on this patient’s account which resulted in an automated erroneous claim to their insurance company. Immediately upon our realization, we fully refunded this patient their co-pay – which they do not dispute. As well, we immediately, notified the insurance company of the error, and sent this patient a copy of their account ledger showing the correction. This patient’s account with our office is accurate. While we understand the confusion and truly sympathize, the frustration this patient continues to experience (which we share!) is ultimately with their insurance company; the hoops the company requires Providers to jump through; and the turn-around time it takes for their insurance company to update patient records. The patient expressed that their insurance company “Just need a phone call” to resolve the issue. We wish it could be that simple. With insurance, that is only the first of many steps. This patient’s insurance company required us to submit the correction by phone (which we had done promptly weeks ago). We were prepared during that phone call to issue the ins co a refund for the benefit overpayment. We were told we must wait for them to send us an Invoice (which we have not yet received) before sending refund. Once we do receive the invoice, of course, we will issue the refund promptly.That said, we did receive confirmation this week in the form of an EOB (Explanation of Benefits - also issued directly to the patient), that the account itself has been updated on their system. The erroneous claim has been removed on their end. And yet, we wait. We do encourage the patient to contact their insurance company should they wish to move this final step along. We are always happy to help and have made calls to that end. But, ultimately, their contract, and their complaint in regard to the delay, is with their insurance company.Respectfully Submitted,The Team at Smith Tano Dental Group (formerly Darryl Smith Dental Group)