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:02/19/2024

  Type:Service or Repair 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.

  I visited this dental office on this occasion for a consultation for a dental repair of a cracked bridge. During this initial visit he purposely cut my bridge with a tool to make the break look worse for pictures to be sure it would get pre-approval. I was assured by the dentist that he would make sure my *********************** would be covered by at least half of the total cost if not all of the cost by my insurance company. He said the process of this takes can take some time & needed me to cover the ******** would be reimbursed after a few weeks by the dental office once they get paid from my provider. Which to me was strange, as *** had lots of dental work before, even at this office, & never heard of this being an issue. He then explained that because it takes time to get paid by insurance providers they needed to charge me so they would get paid now. He assured me multiple times it wouldnt be long & they would stay on top of my provider to make the process 2 weeks or faster. This was not the case. After 2 months & many calls they informed me my check was ready for pickup at the office. The check was a hand written personal check for $939.50. The procedure was $3600. When I asked about this discrepancy, I was told you have the worst insurance **************** all they would cover. After a call to my provider to ask about this refund, I was informed my provider never gave pre-approval & said they requested many times to the office for X-rays before pre-***************** to them. The dentist didnt take the required X-rays before & after & that they would not get paid by my provider for the amount they requested for these reasons. Furthermore, my provider stated they have never heard of this process of ************************ to patients. I never should have been charged since they didnt get pre-approval. I was coursed into this procedure by the dentist because of his multiple assurances of being reimbursed in 2 weeks.

  

  Business Response

  Date: 02/26/2024

  This is in response to ********************* complaint.  There are many things that are just completely factually incorrect about this consumer's complaint.  I am the dentist that worked on him and the owner of the business and will respond to the complaint first and then give the real reason why the patient complained.  The patient came to our office on 10/12/23 with a cracked bridge on the lower right.  He was complaining on how the bridge was feeling and hurting so I gave the patient two options.  1.) He could wait until we pre-authorize the bridge from the insurance company (which would take a few weeks) and then use that Explanation of Benefits to get the bridge done with how much he owes and how much the insurance will pay or 2.) We could complete the bridge now and submit the treatment to the insurance company for completion and he would have to pay for the bridge in its entirety now (which was $3600) and whatever the insurance company paid towards the bridge he would get reimbursed that amount when we received that payment.  He chose option 2 because he was adamant about getting the bridge done now and did not want to wait multiple weeks for the authorization.  At no point was the bridge "purposely cut to make it look worse" as he states.   That is a flat out lie.  Anyways we completed step one of the bridge as normal.  We removed the old bridge and took a new impression for a new bridge and placed temporary crowns on the teeth for 2 weeks until we got the final bridge back.  The patient was clearly explained the insurance portion of it and the financial part before we started to the procedure and he agreed to it.  He paid $1800 on 10/12/23 and agreed to pay the other $1800 in two weeks when we delivered the bridge.  He came back to the office on 10/26/23 and we delivered the new bridge where he paid the other $1800 he owed and was explained to again that when the insurance paid their portion that he would be reimbursed for it.  He agreed to this and understood again on this date.  At no point during this appointment did he show any concerns or anything for the financial portion of it.  We received payment for his bridge from the insurance company on 12/5/23 in the amount of $939.50 and this amount was immediately refunded to the patient so his total out of pocket expense for the bridge ended up being $3600 minus $939.50 which is $2660.50.  This was all handled correctly and this is the amount he would have ended up having to spend if we had originally got with option 1 and pre-authorized the bridge ahead of time.  The REAL REASON why the patient is mad and has filed a complaint is because he thought the insurance would be paying for the entirety of the bridge and not the actual portion they paid.  It is pretty standard practice for dental insurances to not pay the full amount for major work and just pay a portion which his insurance company did and we explained that to him at the very first visit.  He is complaining and demanding a refund because he is trying to get his money back for the portion he owed for the bridge so he could essentially get a free bridge and not pay anything out of pocket which is simply not the policy of any dental insurance company when it comes to major work.  I guess he did not understand his dental insurance benefits even though it was explained to him multiple times.  It is very unfair of him to file a complaint because he is trying to cheat the system and not pay anything for dental work that was completed correctly. It is standard protocol that PPO insurances typically pay for part of a service and the remainder is to be paid for by the patient.