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:05/19/2023

  Type:Customer Service Issues
  Status:

  UnansweredMore 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.

  Gresham Modern Dentistry and Orthodontics has refused to respond to many of my requests to resolve the below issue. I have sent correspondence to their online forms and sent letters via US Postal Service.The current issue is this company SOLD my information to a Debt Collection for a Debt that is not Valid. 1) HIPAA Laws - why was my personal medical information sold? 2) The dental work they did on me was not done correctly and caused more damage that had to be corrected and required a Root Canal!3) Their ******** did not add ** and seemed as creative billing. Billing other customers more than others for the same treatment etc.4) Billed my insurance for work that was not done correctly. Crown not fitted correctly and not sealed. I want this company to remove any debt they feel I owe them, and we can part ways on this horrible experience. Otherwise, I will be forced to file a complaint with the courts that will clearly cause everyone involved more time and money.

• Initial Complaint

  Date:05/02/2023

  Type:Service or Repair Issues
  Status:

  UnansweredMore 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 the dentist on 01/06/23 to have 2 crowns placed. But before I could be seen I was told regardless of my insurance (which I had provided) I would need to pay 1/2 of the bill =$1700. After the crowns had been placed the receptionist said she wasn't able to verify my ****** dental coverage because she was unable to stay on hold. But she said she would try again later. Weeks went by and I started getting EOBs from all my insurance companies except ******. I called and went into the office many times to check on the status of the claim. I even explained to them that they were supposed to have billed ****** first and would have to redo it all. In April I decided to call ********** to see if they knew of ****** making their claim. They said they would call them and explain they needed to back out all the other claims and bill ****** first. I checked with humana today 05/03/23 and it still has not been done. I am supposed to be refunded a high percentage of that initial $1700 that I had to pay when ****** pays. It has been 5 months. I need to have this resolved and reimbursed for that payment I shouldn't have had to pay in the first place.

• Initial Complaint

  Date:04/28/2023

  Type:Billing Issues
  Status:

  UnresolvedMore 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.

  Hello,I am writing to complain about my dentist's billing practices. I received dental services on May 16, 2022, from Gresham Modern Dentistry and Orthodontics in Gresham, ******. On that day, they gave me an invoice that showed two implant services provided: a first service identified with code number ***** at an undiscounted price of $2,100, and a second service identified with code number ***** at an undiscounted price of $1,155. Attached as document number 2 is the invoice they handed me that day showing those two services and nothing more. As shown on that invoice, I received a $100 promotional credit and then paid $274.22 out of pocket that day, with the expectation that they would bill my insurance and correct any overpayment.Those dental services were covered under two separate dental insurance policies I carried at the time of the services, and Gresham Modern was overpaid as a result. Attached as document 4 is the benefit explanation from my primary insurer, ************* Dental through the ********************************** That document shows that Gresham Modern was contracted to provide the services above at discounted rates of $798 for the first service and $326 for the second service and that they received 50% payment on those amounts from ************* Dental. But Gresham Modern also received payments for those same services through my secondary insurer. Attached as document 3 is the benefit explanation from my secondary insurer, Physician's Mutual. That document shows that Gresham Modern received additional payments of $451 for the first service and $300 for the second service. As shown by the accounting provided in the attached document 1, that means that Gresham Modern received a total of $562 from my primary insurance, a total of $751 from my secondary insurance, $274.22 from me out-of-pocket, and applied for a $100 promotional credit. But they were contracted under their agreement with my primary insurance to provide the services for only $1,124, meaning they were overpaid by $563.22.When I explained this to them, they did not dispute receiving those payments or that those payments amounted to an overpayment. Instead, they argued that they should be entitled to keep the overpayments rather than pay them out to me. But I am the beneficiary under those insurance policies, meaning any overpayment belongs to me. That is in fact what my insurers have told me. I am complaining because Gresham Modern did not refund me that overpayment --- even when much of it was paid out of my own pocket.I am also complaining because, in connection with these services, Gresham Modern appears to have tried to recoup some of their discount or promotional credit by submitting an additional claim for services they never included on my initial invoice. Attachments 3 and 4 both show a claim of $184 and $102.00 for some "complication" or another service never disclosed to me on any invoice. This could well be fraudulent billing that doesn't affect me, but it does affect my insurance company. And attachment 5 shows that Gresham Modern did receive payment on account of this additional service that they added without my knowledge.Finally, I am complaining about the services that Gresham Modern provided to me on 6/1/2022. Those services were basic prophylactic services for which I was entitled to 100% coverage by both insurers. Documents 6 and 7 attached here show that Gresham Modern was paid twice at 100%, resulting in another overpayment to them because of my double insurance. Again, they did not refund me the overpayment they had no authority to keep for themselves.Thank you for any assistance you can provide in correcting these improper billing practices and helping me obtain a refund of my excess insurance benefits and out-of-pocket payments.

  Business Response

  Date: 05/18/2023

  Due to HIPAA, I am not at liberty to discuss alleged complaint from the complainant.

  Customer Answer

  Date: 05/19/2023

   
  Complaint: 19991921
  
  I am rejecting this response because:
  
  Sincerely,
  
  *****************