Complaints

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• Initial Complaint

  Date:02/08/2023

  Type:Billing 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 North Penn endodontics (NPE) for a root canal operation on14Mar2022 (this has been the only time I ever visited their offices) and paid $261.40 on a credit card at that office visit. NPE filed their claim for reimbursement to my insurance company and there were many months of disagreement between NPE and MetLife due to a MetLife check to NPE being lost in the mail. Finally, the issue was resolved supposedly and claim is posted as resolved by MetLife on 07/06/2022. the total negotiated fee was $1031 (NPE is IN Network with MetLife so NPE cannot charge more than negotiated fee) and NPE was reimbursed $838.60. As such, I overpaid (and I confirmed this twice with MetLife) by $69 ($NPE paid $261.40 by me and $838.60 by MetLife = $1100). I thereafter received a bill in the mail for $794.60 from NPE for this procedure. I called NPE and they indicated this was a mistake and to ignore. Several months later on 31Jan2023, I received a letter from a collection agency in the mail indicating I owe NPE $794.60. I have tried to speak with the billing **** at NPE and cannot get through nor will they return my calls. MetLife even called them and left a message explaining that I owe nothing and NPE owes me money. NPE will not respond. I am very much concerned this will impact my credit rating not to mention they are completely incorrect and have unjustly submitted my name and address to a debt collector. I would very much appreciate assistance resolving this matter.

  Business Response

  Date: 03/14/2023

  Our patient,  *****************************,  was seen in our office 3/14/22.  She paid her portion of the bill and the claim was sent out to her insurance for processing of payment.  We have yet to date received the payment for this claim.  We have reached out to and spoke to ****** in May of 2022 and again in Sept of 2022 explaining we have not received payment from her insurance.  No resolution happened so in Oct 2022 we billed the patient for the full amount.  At this point it has been 7 months with no payment.  Pt didn't call in till the end of January 2023 to ask why she is being billed.  At that point we explained we still haven't received payment from her insurance.  They we received a letter from you.

  
  

  We can not hold onto an open balance indefinitely.  Our patient is well aware we need payment from her insurance.  If they will not pay then she will have to.

  
  

  I have made one last attempt to get payment from them.  I will be calling tomorrow to follow up on the claim.

  
  

  *****
  
  Insurance Team

  North Penn Endodontics

  Customer Answer

  Date: 03/14/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 19328834
  
  I am rejecting this response because:
  their response is highly inaccurate and neglects inclusion of critical elements (see my initial report of the sequence of events which are factual) and that I repeatedly called them to resolve the issue as well as repeatedly contacting the insurance company. the insurance company has deemed this request by this company closed a couple of times as they thought it was paid (as did I). A check WAS sent to this business from the insurance company and it was apparently lost in the mail.  Even though I repeatedly tried to resolve the issue, this ****************** kept telling me they were resolving it with the insurance company.  I pay my bills and do not appreciate their implication and. well as their lack of accountability in this matter.  The insurance company has indicated a check has been sent to this business and I will be looking for the refund this business owes me.
  
  Regards,
  
  *****************************