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:08/21/2023

  Type:Order 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 am filing a complaint against this dental officer for diagnosing many procedures not covered by my insurance carrier. Also, the dentist's office is supposed to be in my insurance carrier's *** network; however, the dentist officer charges outside the *** network. On 09/20/22, I received a treatment plan from *************** office. The treatment plan noted an extraction for tooth 14. The treatment plan listed the following treatment codes D7999, D7210, D7953, and D7210, totaling $464.80. I paid the dental officer $464.80 on 09/23/2022 in advance of the treatmentthe procedures for the extraction occurring on 12/29/2022. My dental insurance **** processed the claim for D7210. The claim was billed for $162.00, and the **** payment plan was $129.60, leaving me a bill amount of $32.00. The dental officer did not file the claims listed in the treatment plan. For this procedure, I paid the dental office $464.00; my insurance paid $129.60, totaling $593.80. Based on my calculation, I should have only paid $32.40. I should be reimbursed for $561.40. A representative of **** stated that the dental officer should have filed all the procedures with their claim.On September 20, 2022, my dental treatment plan included codes D2740 and D2950. On December 29, 2022, I had a procedure done on tooth 31, which cost me $541.00 out of pocket. **** processed my dental claim for D2790 and D2950. The dental office billed **** for $769.00 for D2790 and $163.00 for D2950. **** network paid out $332.00 for D2790 and $74.00 for D2950, leaving a balance of $406.50. As I paid $541.00, I am entitled to $134.50.d a treatment plan from the dental office for tooth three and tooth 13, and for procedures LL, LR, UL, and UR, two items are blank. **** was billed for D0120 and D4910 and paid $30 and $58.80. I paid $123.00. My health insurance paid out for Intraoral images on 1/30/2023 for $95.00. My co-pay is *****.

  Business Response

  Date: 08/22/2023

  This is my response to *********************************** complaint to BBB# ********.  We take great pride in taking care of our patient's with utmost professionalism and transparency.  I would like to address his concern one by one.   

  His complaint starts with diagnosis of problems that are not covered by his insurance.  As his healthcare provider, it is my  duty to diagnose dental disease present in his mouth when he comes in for an exam.  Insurance coverage has no bearing on informing patient about their condition.  

  We do not start any treatment without presenting a treatment plan to patient and financial agreement of their responsibility.  We will be attaching all treatment plans signed by patient.  Services that are not covered by his insurance and necessary to provide treatment were explained to him before starting treatment.  His insurance downgrades crowns to material that is not current standard of care in our office.  

  We are attaching all necessary paperwork to show that he was aware of all charges.  According to our records, he has a credit of $161.40 which will be mailed to his address that  we have on file.  

  If you have any additional questions, please fell free to contact us. 

   

  Sincerely,

  *********************** DMD

  Diamond Dental Group 

  Customer Answer

  Date: 08/22/2023

   
  Complaint: 20487853
  
  I am rejecting this response because: The dental office is a part of my *** plan. The dental office failed to comply with the terms of the *** agreement as all the service provided were not billed to my insurance company. Furthermore, the dental officer never informed me I would be charged for services that was not covered under my insurance provider. The dental office response is disingenuous. I discussed the matter with my insurance provider and confirmed that **************** is contracted with GEHA. The representative with **** confirmed that all claims should be filed with them even if it will not be paid. 
  
  Sincerely,
  
  ***************************

  Business Response

  Date: 08/22/2023

  As previously stated in the above respond a refund check in the amount of $161.40 has been mailed to *****************  Diamond Dental has sent over information that shows we have done everything by office polices.  **************** did sign off on all treatment before any treatment is done.  Our office front desk reviews all procedures with patients before they agree to pay the office also. 

  If you any additional questions, please feel free to contact us.  

   

  Sincerely,

  *********************** DMD 

  Diamond Dental Group

  Customer Answer

  Date: 08/22/2023

   
  Complaint: 20487853
  

  I am rejecting this response because While I cannot dispute the dental office's compliance with their office policy, the dental office's actions are unethical and fail to comply with the Rules and Regulations of the ****************, particularly regarding rule 150.08.01 unprofessional conduct. I believe dental offices take advantage of particular patrons who do not understand how to read the insurance codes noted on their treatment, which is a deceptive practice. A review of my treatment plan shows an astronomical which raised my suspicion of overcharging. I understand that dental practices are loosely regulated, but the pattern of this dental officer is concerning. 
  
  I am not agreeable to the dollar amount and will not cash the check *************** office sent, as I would not be made whole.
  
  Sincerely,
  
  ***************************