Complaints

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• Initial Complaint

  Date:04/25/2025

  Type:Sales and Advertising 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.

  2/24- quoted ($250.80) out of pocket for estimate with my provided insurance 3/4- paid $250.80 to schedule procedure 3/12- procedure date 3/25- received bill for $307.20 - did not receive information regarding tooth fragment protrusion after procedure. Had to go back to referring dentist for removal which cost me more. **** Falendars office was/is constantly in after office hours even midday 4/25. Several attempts were made to reach out prior to this complaint submission with same response. - good faith estimate was very far off (100%+) with no explanation of why and verbal threats of collections the day after I received the bill -office coordinator says the never use prior authorizations with insurance even though I requested during consult to get accurate out of pocket expense. -did no provide cleaning instruments for healing sockets as other dentists recommend.

  

  Business Response

  Date: 04/28/2025

  Response from Lawrence G. Falender,D.D.S.:
  In response to Mr. ******** complaint, we would like to clarify the following:
  Insurance is a contract between the patient and their insurance company. While we provide patients with an estimate based on our experience with their insurance carrier, it is always stated as an estimatenot a guarantee of final costs. Mr. ******* was given an estimated out-of-pocket amount based on our prior dealings with Delta Dental. He did not request a pre-determination or prior authorization, though we do offer this service if a patient requests it.
  Unfortunately, Mr. ******** policy through Delta Dental of Massachusetts does not cover anesthesia or sedation for surgical extractions, even in cases involving multiple extractions as with his treatment. The charges in question are for anesthesia services not covered by his insurance.
  As part of our standard procedure,all patients, including Mr. ******** are asked to read and sign a financial policy form. This form clearly explains that all insurance and patient responsibility amounts are estimates. It explicitly states that insurance coverage is not guaranteed and that the patient is ultimately responsible for any balance.
  Regarding Mr. ******** concern about our office hours: Our business hours are posted online and at the office.On Wednesdays and Fridays, our office closes at 1:30 PM. Our phone records show that Mr. ******* called twice on afternoons when the office was already closed.
  Addressing the issue of a tooth fragment: Mr. ******** statement is incorrect. We confirmed with his general dentist, Dr. ***** ***** office, that Mr. ******* was seen and a small bone fragment was removed without the need for local anesthesia, and no charge was incurred. This is a normal and occasional occurrence following extractions. At no time did Mr. ******* contact our office to allow us to evaluate or address this matter ourselves.
  Finally, Mr. ******* would have received an Explanation of Benefits (EOB) from Delta Dental, which outlines what was covered and what was not. In many cases, patients receive these EOBs before we do.
  Staff Timeline of Communications:
  March 23, 2025: Mr. ******* contacted our office. Our front office staff informed him that his insurance had denied coverage for the anesthesia and advised him to reach out directly to his insurance company.
  March 25, 2025: A billing statement was sent to Mr. ***************** 17, 2025: Mr. ******* called again. We explained that his insurance had denied the anesthesia/sedation charges. He was reminded that he had signed paperwork acknowledging that treatment costs were estimated, and insurance coverage could not be guaranteed.
  When Mr. ******* stated that we had "promised" the quoted cost was final, staff reiterated that all figures provided are estimates only, as outlined in his signed documents.
  During this conversation, ********** became upset. Our team member, ******** ********* took over the call to assist. She reviewed the Explanation of Benefits with him, offered to send a copy of the signed documentation for his reference, and offered payment arrangement options.
  When Mr. ******* stated he would not pay the balance, he was informed that if no resolution could be reached, the account would be sent to collections as per our office policy.
  We strive to be transparent with all patients regarding insurance estimates and patient responsibilities, and we regret that Mr. ******* is dissatisfied despite our efforts to explain and resolve the matter.

  Customer Answer

  Date: 04/29/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  2/24/25- I provided my insurance for pre-authorization and was given the estimate of $250.80

  2/17/25- I called into the office to ask about why the extra charges were 100%+ of the original estimate. No explanation was given, only that my insurance did not cover the balance. At that time I was told I would be sent to collections within 10 days. No payment arrangements were offered at that time, only collections because I did not elect to pay until I knew where the extra charges came from. According to delta dental EOB they did cover a significant portion of my anesthesia ($334) which is validating the incorrect statement made by Dr. ********************* office. 
  

  I have never had this type of disrespect, nor predatory practice with any other doctor or dentist before. Luring a customer in with a lower out of pocket expense, and following up with a bill 100%+ over the estimate, along with threats to go immediately to collections is why I am making this complaint to begin with. 
  

   

   
  
  Regards,
  
  **** *******

  
  

  

  Business Response

  Date: 05/01/2025

  We appreciate the opportunity to address the patients continued concerns.
  The patient states that he was given an estimate on 2-24-25 and this was based on info from Delta Dental. No pre-determination was asked for by the patient.   My staff provided him with an explanation of why the IV sedation was not covered. Additionally, my staff person offered payment arrangements which he refused. As a side note, his note showing a time he spoke with office was 3/17/25 vs. 2/17/25.
  To clarify, the amount of $334 referenced in our previous communication reflects the Delta Dental allowed fee, which is the discounted rate agreed upon through our contractual relationship with the insurance provider. While this amount was allowed by Delta Dental, it was not covered by the patient's plan, making it the patients responsibility to pay. This is consistent with the Explanation of Benefits (EOB) the patient would have received from Delta Dental. Also, on the ***, Delta refused the sedation and stated the patient owed $550, which my staff as a courtesy reduced for him. The issue is with his insurance company as other Delta Dental plans would have covered this.
  We take great offense at the accusation of "predatory practices." This claim is not only baseless and defamatory, but also undermines our longstanding commitment to ethical and transparent patient care. We provided clear treatment plans, including estimated out-of-pocket costs, before proceeding with any services.
  If these false and damaging claims persist, we will be forced to consider legal remedies to protect the reputation of our practice and its providers. We remain committed to resolving any legitimate concerns through appropriate and respectful dialogue, and encourage the patient to contact our office directly if they wish to do so.
  

  Sincerely,
  Indianapolis Oral Surgery

  Customer Answer

  Date: 05/02/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  Transparency would include giving patients the correct out of pocket cost upfront after the customer requested that information, and provided insurance for the office to do so.  Not a based on our previous experience estimate. Transparency would be that you provide a pre authorization for all of your patients so this wouldnt happen. 
  

  I would have been more than happy to have respectful dialogue but your office staff has alienated that, and after our phone conversation, made it uncomfortable to continue on with any other communication efforts beyond BBB. 
  
  Regards,
  
  **** *******