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:07/12/2023

  Type:Billing Issues
  Status:

  ResolvedMore 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.

  My wife had an appointment with Lenga Perio on Oct 03, 2023 for gum treatment. We paid $230- for initial consultation. They submitted an estimate to my insurance which was not approved due to the code they mentioned. I spoke to them on Oct 17 & 18 and sent a fax on Oct 18 about an earlier gum treatment with a different code which was approved by the insurance. I requested them to resubmit another estimate with this code which they agreed. I waited more than two weeks but didn't hear anything from the insurance. Then I called Lenga Perio on Nov 07 and left message with the Receptionist, but they didn't call me back. I called again on Nov 09 and wanted to know about the estimate, but the Receptionist was very impolite and hung up on me. Instead of giving me an answer about the estimate, they left a message with my wife's tel informing her that they didn't submit any estimate at all to my insurance and cancelled her both appointments. But they didn't bother to tell us the reason and kept us totally in the dark. Since we have to look for another Periodontist and will have to pay again for consultation, I sent an email to Lenga Perio on Nov 09 for their non-professional behavior and asked for refund of $230- which I paid for consultation. But they didn't reply my email.

  Business Response

  Date: 07/01/2024

  Subject: Response to Your Concerns Regarding Recent Interaction with Lenga Perio
  Re: Ms. ***** ***** (patient)
  Complainant: ********** ******
  
  I hope this message finds you well. I am writing in response to the concerns you raised in your recent communication regarding your experience at Lenga Perio. I appreciate your feedback and would like to provide you with a detailed explanation of the events you mentioned.  Firstly, I want to acknowledge your frustration when navigating dental treatment and the complex nature of third party dental insurance.  You are not alone in experiencing inconvenience during this process.  It is crucial to clarify that the relationship between the insured party, yourself, and the insurance company is an independent arrangement that falls outside the purview of our dental practice.  At our clinic, our primary objective is to provide a positive and seamless experience for our patients. While we are dedicated to offering support and guidance, it is important to note that the handling and resolution of insurance-related matters are distinct and are solely within the domain of the insured individual and the insurance provider.  Our team is committed to assisting you by providing any necessary documentation, such as comprehensive treatment plans and supporting documentation, to facilitate your interactions with the insurance company. However, we do not have direct control over the approval or reimbursement processes dictated by your insurance carrier. 
  
  Regarding the issue with your insurance coverage, I would like to clarify that the recommended procedure has a specific code that aligns with the treatment plan proposed. Unfortunately, after submitting the estimate to your insurance, we were informed by you that the provided code was not covered under your specific schedule of benefits. In light of this, we communicated the situation to you and your wife, providing a thorough written explanation of the treatment recommendations and also sharing this information with your referring dentist.  Upon learning that your insurance did not cover the recommended procedure, you proposed a different surgical code for a procedure unrelated to the initial treatment plan. It's important to emphasize that submitting inaccurate procedure codes to insurance companies is considered insurance fraud. Therefore, we could not comply with your request to submit an unrelated code.  Throughout this process, our team attempted to communicate this information to you, despite encountering challenges with the tone and manner of your conversations. I regret any frustration you experienced, and I assure you that our intention was to provide clarity and maintain transparency throughout the insurance submission process.
  
  Regarding the cancellation of your wife's appointments, our team followed the instructions provided in the fax you sent on October 18, which explicitly stated to cancel the appointments if your request could not be accommodated. We communicated this decision to your wife promptly via email and phone calls.
  
  I understand your request for a refund of $230 for the consultation appointment. However, it's essential to note that the fee covers a comprehensive set of services, including clinical and radiographic examinations, evaluations, discussions, written correspondence to you and your referring dentist, as well as all submissions and correspondences to your insurance carrier. Given the nature of the services provided, a refund is not warranted.  I value your feedback, and I would be happy to address any further concerns or questions you may have. Our team is committed to providing quality care and ensuring that our patients feel heard and respected throughout their treatment journey. Thank you for bringing your concerns to our attention, and I appreciate your understanding.

  Customer Answer

  Date: 08/01/2024

  The business in question told us the partial truth, not the whole truth. If the new code would commit insurance fraud, why did they agree to submit a new estimate to the insurance based on that code. They decided not to submit another estimate, but kept us totally in the dark about it. I came to know about it only when I called their office. 

  
  

  Secondly, I requested to cancel the appointments since the insurance didn't approve the estimate. But when I provided the new code which was approved by the insurance before and they agreed to resubmit the estimate, the office didn't advise me to make new appointments. So the old appointments were still valid and the office staff who dealt with me were totally aware of it. Later they informed my wife about the cancellation.

  
  

  Thirdly, the office staff didn't tell me any reason why did they back out from their promise. When I asked about it again and again, they just hung up on me.

  
  

  They should have the courtesy to apologize for what they did with us.

  Business Response

  Date: 16/01/2024

  I trust this correspondence finds you in good health. Your concerns have been duly noted, and I empathize with the challenges this situation has presented. Allow me to comprehensively address your points and provide additional insights into the recommended treatment procedure and associated codes.
  Primarily, I wish to reiterate that the prescribed procedure aligns with specific codes that have been expressly authorized for submission during the predetermination process. These codes undergo careful selection to ensure adherence to both regulatory requirements and ethical standards.
  With regard to the communication discrepancy, it is our steadfast commitment to transparency that guides our actions. All steps taken have been meticulously documented, and treatment recommendations are consistently provided in writing. Given the involvement of multiple periodontists in your wife's care, there may be a potential conflation of events from different dental offices, contributing to any confusion.
  Concerning the appointment cancellations, we diligently followed the written directives provided by you. Regarding the alleged incident of being hung up on, I must clarify that, according to my receptionist, the call concluded after you hung up following a heated exchange. It is plausible that a disconnection occurred unintentionally, as neither party intentionally terminated the call.
  In the spirit of openness and accountability, I extend an invitation for a more in-depth discussion at your earliest convenience. Your feedback is invaluable, and we are dedicated to addressing your concerns to reestablish your confidence in our services.
  Thank you for bringing this matter to our attention. I appreciate your understanding and look forward to resolving any outstanding issues.
  Best regards,
  Yair L.

  Customer Answer

  Date: 29/01/2024

  I'm satisfied with their response. Please close my complaint.