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Business Profile

Orthodontist

Figueroa Orthodontics

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Orthodontist.

Complaints

Customer Complaints Summary

  • 1 complaint in the last 3 years.
  • 0 complaints closed in the last 12 months.

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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.

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  • Initial Complaint

    Date:11/07/2023

    Type:Order Issues
    Status:
    Answered
    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.
     
    Complaint: 20833509

    I am rejecting this response because:
    My contract for orthodontics with Figueroa Orthodontics clearly states that my daughter's treatment would be for "6-8 months."  Ultimately, it ended up being approximately a month longer, but, regardless, all of the services were clearly provided in 2022.  Figueroa put her braces on in January and took them off in September 2022.  I had insurance coverage for orthodontia in 2022 for this purpose.  Despite the fact that my contract for my daughter's orthodontia indicated a 6-8 month period AND she got her braces off by September 2022, Figueroa's failure to bill for the services until January 2023 is inexcusable.  At no point prior to the end of October 2023, did anyone from Figueroa inform me that Figueroa had waited until 2023 to bill for the services provided in 2022.  Figueroa now has threatened to charge me for services that were clearly covered by my insurance, had Figueroa followed reasonable business practices. 
    Sincerely,

    ************************* about the issue until November 2023, more than a year after the services, and several months after the issue arose.

    Business Response

    Date: 11/17/2023

    ******************************* coordinator had an extensive conversation by phone and email with ************** on November 11, 2023, to better explain the situation at hand.

    In 2022 we provided a treatment plan for the ***** family as well as financials that included an estimate of what their insurance will cover based on the correspondence we received from their Delta Dental policy. The family signed the contract which states that the insurance coverage is an estimated amount and any unpaid balances from insurance would be the familys responsibility.

     We submitted the initial claim on the day the patient started treatment 1/10/22  and received an initial insurance payment.  The Delta Dental policy states under the orthodontic payment, that following the initial claim payment the remaining orthodontic benefit will be paid after 12 months, provided there has been no lapse in coverage. Unfortunately, the policy was changed and the orthodontic benefits were dropped before the second half was paid out and we were not informed of this change.  When we submitted the claim for the 2nd installment, as we did not receive the anticipated payment automatically at the 12-month mark,  we never received an explanation of benefits stating that the policy had changed and there was no longer any orthodontic coverage. We had been in contact with Delta Dental regarding this claim and at no point did any of the representatives state that there was no longer orthodontic coverage. It was not until October 27, 2023, that we were informed of this information. We still attempted to reprocess and appeal this for payment on behalf of the family. Our first correspondence with the ***** family was on 10/30/23 regarding this matter as we had only been made aware a few days earlier the payment would not be forthcoming.

     We have offered the family payment plan options as well as having a conference with the insurance company to ensure everyone has the same information. We have continued to work with the Rileys and Delta Dental on the insurance appeal. 


    A copy of claims, EOBs, and contracts can be provided if a HIPPA release is provided for our records.

    Business Response

    Date: 12/18/2023

    After another reprocess of the claim Delta Dental of IL has now paid the remaining balance on this contract. 

Figueroa Orthodontics is NOT a BBB Accredited Business.

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