Complaints

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• Initial Complaint

  Date:07/05/2024

  Type:Billing 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.

  First, I wish to file a complaint against *** ******. He submitted a bogus insurance claim. Is this insurance fraud? The date of service was 6/08/2023. I had a loose tooth (#13) due to an accident. It was so loose I could have taken the tooth out. *** ****** jiggled the tooth for less than five seconds and it fell out. He submitted a United Healthcare claim for the following procedure: “Extraction, Erupted tooth req removal of bone, sectioning of tooth and including mucoperiosteal flap.” *** was billed for $353.00, but paid Legacy Dental $155.
  
  They did file a bogus claim. I hope you pursue this issue because it is completely erroneous.
  
  As mentioned this morning, I wish to address the following part of the email I sent you.
  
  I contested the charge with ***** *****, the office manager. She falsely told me they would not submit a claim. I found out recently they did bill ***. I am requesting a refund. This amount was deducted from my benefits. I had to pay some $225 for additional dental insurance and paid $100 to Legacy Dental in December, 2023. I am requesting a $155 refund.
  
  I thought about it and remembered talking to ***** *****, the office manager at Legacy Dental. On the phone, she assured me she would take care of it. Thereafter, I went into the office for "additional treatment" and I asked her about it again. She said she did not make notes, but remembered talking to me about it. She did not charge me for the "additional treatment." I do not remember the exact amount of the "additional treatment" visit. As I recall, it was about the same amount as the 6/8/23 $155 visit. Therefore, I rescind my request for a $155.00 refund.
  
  If you have any questions, please feel free to contact me.
  
  Thank you very much,
  
  ***** *******

  Business Response

  Date: 07/25/2024

  the tooth in question was removed with out incident and followed the standard of care, the patient was charged for the procedure and we were paid. there is no need to refund this patient any money for a procedure that was completed exceptionally well. furthermore at the end of the statement she rescinds her request for a refund. The patient would be charged for any treatment performed in our clinic as is standard operating procedures at this office. This complaint should obviously be dropped. 

  Customer Answer

  Date: 07/26/2024

  
  
  Complaint: 21945511
  
  
  
  I am rejecting this response because:

  
  Regarding the complaint, you sent them only the issue with the 2023 tooth removal? You did not include any information about the defective bridge and their refusal to do anything about it?  Besides the insurance fraud, this is the main issue.You did not include information about the other issues? This happened a few months ago. I was recently told this $3000 bridge needs to be replaced!!

   

  Complaint ID 21945511 references Dr. ***** ****** jiggling it for less than five seconds and it fell out.  In 2023, they, in turn, said it was a surgical extraction, submitting the below claim to UHC.

  
  

  
  

  I filed a complaint with *** and they are investigating it as "insurance fraud." That should be pursued and is out of my control at this point.

  
  

  The other issues occurred a few months ago. If I am not mistaken, I think it is under the same complaint ID (********). I submitted the below at the same time. Within the below paragraph, there are multiple complaints: 1. The bridge that does not fit and were paid nearly $3000; They do not accept responsibility and refuse to refund the money.  As I told you recently, I saw a dentist and he said the bridge needs to be replaced.  2. The $55 reevaluation charge; I was told that I would not be charged; Dr. ******** said he would refund the $55 which I can prove with a test message; I have not received reimbursement and the insurance has not received it to my knowledge; 3. I contested the charge for cleaning my teeth when the hygienist did not clean my teeth. Also, I requested her name and they refused to provide it. I wished to file a complaint against her. I wrote in the original complaint:

  
  

  Second, Legacy Dental did shoddy and incomplete work and submitted claims to ***** for such.

  
  

  I had a failed implant. Earlier this year, it was decided that a bridge would be the best option. On April 11, 2024, Dr. ***** ****** attached the bridge and cemented it. He was disrespectful. He did not ask me how it felt or looked before he permanently cemented it. I did not even see the bridge before he cemented it. I advised the office manager that the bridge was unacceptable and needed to be replaced.

  
  

  On May 1, 2024, Dr. ****** was to reevaluate the bridge without charge.  Again, he was disrespectful. As I was waiting in the dental chair, Dr. ****** came up behind me, slapping Vaseline all over my lips and smearing it above and below my lips. He did so without saying anything to me. Regarding the bridge, he told me that he would need to redo my upper and lower teeth if I wanted anything better. He did not care that the bridge is uncomfortable and does not fit. He was oblivious to the bridge sitting too low and the teeth on the other side of my mouth were too high and hitting. The bridge slants and dips in the middle. I can feel gaps between thebridge and my teeth. He did not care. He admitted that he did not try to match the color of my teeth to the bridge. Did he forget? No, he chose not to do it. He also did not show me how to floss manually. He said it was time consuming… ***** paid him nearly $3000.00 and this amount was deducted from my benefits. I am requesting a full refund, payment for removal of the bridge, and all related expenses when I have the bridge redone.

  
  

  Before going to the May 1 appointment, I checked with the office manager about a charge for the reevaluation. She assured me there would not be a charge. On April 22, 2024, the office manager wrote, “Correct this is a no charge visit so Dr. ****** can eval bridge -Legacy Dental.” Nonetheless, they charged $55 for the reevaluation and submitted the claim to *****. In a text message on May 6, Dr. ****** ******** said he would refund the $55 charge for the reevaluation. He wrote, “You are upset about being charged (sic) seeing the dentist which insurance paid $55.00 (sic) I will take care of that…” There is no evidence that he refunded the charge.

  
  

  Dr. ******** refused to refund nearly $3000 for the bridge. In essence, he said they were not responsible. He said someone else made the bridge. In the aforementioned text on May 6, Dr. ******** wrote, “The scan sent to the lab that makes bridges (sic) designs them to fit the anatomy of the mouth…” Dr. ****** scanned my mouth. They initiated the process. They sent the information to the other facility. Legacy Dental was paid some $3000 for the bridge.  I told him they are responsible and will be held accountable.

  
  

  In addition, the dental hygienist who “cleaned” my teeth on May 1 went through the motions. She did not clean my teeth. My teeth were coffee stained after she “cleaned” them just as they were before the appointment. When Dr. ****** reevaluated the bridge, he was aware of it, yet he did not mention it. Again, I was charged for incomplete and inadequate services. I guess if you complain about a bridge that does not fit, they retaliate. They submitted a $171 claim and ***** paid $66. This charge was deducted from my benefits. Also, they have refused to provide the name of the dental hygienist.

  
  

  ****** ****** ** ************
  
  
  
  ***** ****
  
  
  
  ***** *******
  
   
  
   
  
   
  
  
  
  **********
  
  ***** *******

  Customer Answer

  Date: 07/30/2024

   I appealed the billing for tooth # 13 and **************** agreed with me. Legacy's billing was OVERTURNED BY UHC. I provided you with the same information that I provided you. Please see the below and I will attach the letter from ***.

  
  

  In Legacy's response, Dr. ******** wrote, "...the tooth in question was removed with out (sic) incident..." Nonetheless, they used code D7210 as shown in the below screenshot; a year ago, they told me and claimed it was a surgical extraction ("extraction, erupted tooth..."); they billed the insurance for such. In reality, Dr. ****** jiggled the tooth for less than five seconds and it fell out. I am NOTIFYING *** about Dr. ********'s comment to you saying the tooth was removed WITHOUT INCIDENT. Regarding insurance fraud, I think they will want to know such.

  Business Response

  Date: 08/02/2024

  the bridge fits well, and follows the standard of care completely. Dentists will do their best to match color of any patients existing teeth, but the fact that porcelain and tooth structure are different materials inherently leads to a natural difference in appearance between natural tooth structure and a crowned tooth. As far as the complaint about the bridge that has a dip, the bridge must be made to adapt to her opposing teeth, if her opposing teeth drop down some the bridge must be made to those specs. **** ******* did request an appointment and time with a doctor and assistant. She would be charged as is standard practices for any appointment needed for a patient. We do not provide free appointments to patients. She did receive an adult prophylaxis, the hygienist who cleaned her teeth would have removed as much stain and calculus as possible. there is no guarantee that all her coffee staining would be removed. that is not standard practice. 

  Customer Answer

  Date: 08/07/2024

  
  
  Complaint: ********
  
  
  
  I am rejecting this response because:

  In June, 2023, ***** ****** jiggled tooth # 13 for less than five seconds and it fell out. I was told it was a surgical extraction. They filed a claim with UnitedHealthcare and used ADA Code D7210 (extraction, erupted tooth req removal of bone...). I have attached the July 26,  2024 letter from UnitedHealthcare. After their clinical staff reviewed the medical records, they OVERTURNED the claim and "recovered the $155.00 amount from the provider's office…” I received the $155.00 reimbursement check a few days ago.

  Recently in the BBB response, ****** ******** stated that tooth # 13 was "removed with out (sic) incident..." If that were the case, why was it submitted using ADA Code D7210. I have advised UnitedHealthcare about ****** ********** "removed with out (sic) incident" comment and asked them to forward it to the fraud department, etc.

  In April, 2024, ***** ****** seated a defective bridge. It does not fit. The bridge on the right side is too low. It slants and dips. I feel gaps. It is uncomfortable. It looks like I do not have any teeth. The teeth on my left side sit too high after he seated the bridge and they are hitting. Before permanently cementing it, he did not ask me how it fit. The color is completely off. He did not even try to match the color. ****** ******** and ***** ****** are fully cognisant of the above. What did ****** ******** say in the August 2 BBB response? He wrote that “the bridge fits well.” ****** ******** has not even seen me; I have never met him.

  At one point, ****** ******** implied they were not responsible for the bridge. He texted the following grammatically incorrect sentence, “The scan sent to the lab that makes bridges designs them to fit the anatomy of the mouth.” On May 8, 2024, I texted ****** ******** and ***** ****** the following: “You are responsible for the services your office provides. It does not matter if someone else made the bridge. You received payment and are responsible for such. You will be held accountable.”

  I saw ANOTHER DENTIST and he AGREED that the BRIDGE NEEDS TO BE REPLACED. He said such some three months after ***** ****** seated it. He will be out of the office for two weeks.  When he returns to the office, I have asked the office manager to speak with him requesting a letter stating the bridge needs replacement. She said he did not write a note on the chart. I may have to return for the appointment so he can look at it again if he does not remember.

  Regarding the charge for the bridge evaluation, ****** ********  has vacillated contradicting ***** *****’ statements; he also contradicted his own statements. ***** ****** seated the bridge on April 11, 2024. Shortly thereafter, I advised ***** *****, the officer manager, that it did not fit and needed to be replaced. I requested an evaluation appointment and confirmed that I would not be charged. I advised them that the bridge slanted and dipped, etc. On April 22, 2024, I texted ***** *****, writing the following:: "...I presume I will not be charged for (sic) March 1st visits (sic)? The bridge needs to be replaced." To clarify, I texted her again saying I meant May 1st. ***** ***** confirmed I would not be charged: She wrote, "***** (sic) Correct this is a NO CHARGE visit so *** ****** can eval bridge -Legacy Dental." Nonetheless, I was charged $55 for the brdige evaluation. On May 6, ****** ******** texted me stating he would refund the $55 charge. He texted, "You are upset about being charged seeing (sic) the dentist which (sic) insurance paid $55.00(sic) I will take care of that." In the August 2 BBB response, however, ****** ******** contradicts earlier statements. He wrote, ***** ******* did request an appointment and time with a doctor and assistant. She would be charged as is standard practices for any appointment needed for a patient. We do not provide free appointments to patients.” I have yet to receive a refund and the insurance has not received such.

  In January, 2024, they received payments for several services. They received $144.00 for a core buildup. They received $647.00 for a crown. They received $647.00 for another crown. They received $540.00 for a pontic. They received  $144.00 for a core buildup.  In February, 2024, they were paid another $647.00 for a crown. Each of the aforementioned charges were for a defective bridge. They did not even seat the bridge until April 11, 2024 and they had already been paid thousands of dollars. In May, they billed me another $55 for an evaluation of a defective bridge. They charged me such even though I was told I would not be charged. They charged $66 for periodontal maintenance, but did not clean my teeth.

  After I complained about the defective bridge, they rescheduled the periodontal maintenance with a different dental hygienist. On May 1, 2024, I had an appointment to have my teeth cleaned and to have the bridge evaluated. The dental hygienist did not clean my teeth. She played with the utensil, but she did not clean my teeth. They were paid $66.00. It was the same day that ***** ****** evaluated the defective bridge. I requested a refund and they refused. I have contested such with the insurance. I asked for the name of the dental hygienist so I could file a complaint against her. ****** ********* has refused to provide her name. I am filing a complaint against each of their dental hygienists, stating what happened and leaving it to the Kansas Dental Board to proceed accordingly.

  ****** ********, on May 6, 2024, texted me claiming, "The scan sent to the lab that makes bridges designs them to fit the anatomy of the mouth… (sic)." I replied with the following: “You are responsible for the services your office provides. It does not matter if someone else made the bridge. You received payment and are responsible for such. You will be held accountable.” I will file complaints against ****** ******** and ***** ****** with the appropriate agencies, including, but not limited to, the Kansas Dental Board. If necessary, I will pursue legal action.

  I have attached the UnitedHealthcare letter where they overturned the tooth # 13 claim. Also, I have attached all of the text messages with Legacy Dental. When possible, I will provide the requested letter from the dentist who said the bridge needs to be replaced.

  ****** ******** and ***** ****** are an EMBARRASSMENT to the dental profession.
  
  Thank you,
  
  ***** *******
  
  
  

  Business Response

  Date: 09/03/2024

  MESSAGE FROM BUSINESS:
  
  

  I spoke to *****'s former insurance company United Healthcare about the charge for a surgical extraction patient had done in our office, ***** filed a complaint that she thought the code used was incorrect and wanted a refund, the insurance company sent her a check for $155.00 which should not of happened because the patient had no out of pocket expense and sent Legacy Dental a letter asking the office to refund the amount paid to us for the services we rendered. I spoke to Donna at UHC and explained the situation she informed the office they will send ***** a letter asking her to refund the $155.00 back to them and for our office to ignore the refund request from us. They will not be sending a corrected letter to us but gave us a reference number that it has been taken care of #********. Regarding the fee for $55.00, the patient came in for her cleaning and wanted the Dr. to check bridge. patient left the hygiene room and went to the doctors room where he spent more time then a usual exam visit would of been, he took a CBT scan that cost is $480.00 that we did not charge her or the insurance for, several photos and used bite paper to show that her teeth were hitting like they should. ***** was loud and being disrespectful to the doctor and left the office. We have done everything we could to keep this patient happy, going far beyond to help with insurance options, responding to her questions and doing a filling on one of her teeth and not charging her or the insurance for when she was upset about charging her insurance for the extraction code. ***** has caused several man hours to the office dealing with two insurance companies that she has filed grievances with needing chart notes and all images and multiple phone calls. We are declining issuing a refund to the patient of $55.00 that was not paid by her for the exam, as the insurance company paid for the exam.
  
  Thank you,
  ***** *****

  Customer Answer

  Date: 09/11/2024

  
  
  Complaint: 21945511
  
  
  
  I am rejecting this response because:

  Legacy Dental’s most recent response is a joke. As usual, it is filled with false information.

  ***** *****, the office manager at Legacy Dental in Shawnee KS, stated the following: 
  She said that I did not have out-of-pocket expense regarding the fraudulent claim Legacy Dental submitted for tooth #13.(June 8, 2023). UHC overturned the payment and provided me with a $155 check. They did so because $155 was wrongfully deducted from my benefit amount. In addition, ***** ***** provided me with inaccurate information regarding charges to my account. I did indeed incur out-of-pocket expenses. I paid $324.43 for Delta Dental premiums (October through December premiums $74.81 each month) and a $100 payment to Legacy Dental in December, 2023. I have attached the information.

  ***** ***** continues, “I spoke to Donna at UHC and explained the situation (sic) she (sic) informed the office they will send ***** a letter asking her to refund the $155.00 back to them and for our office to ignore the refund request from us. They will not be sending a corrected letter to us but gave us a reference number that it has been taken care of #********.”
  

  I have yet to hear anything from “Donna.” I have yet to receive a request for a refund of the $155.

  However, I have received letters where UHC apologizes for the events that occurred with Legacy Dental. Please see the attached letters dated 06/24/24 and 08/28/24. 
  
  Additionally, ***** ***** made other false statements. She said when I had my teeth cleaned I wanted  Randy Nguyen to look at the bridge. This is untrue. The previously attached text messages clearly show that she again made false statements.

  
  She said that the CBT scan cost $480 and they did not charge for it. That is interesting because ***** ******** said the same scan on the same day cost $380. Vodonick’s statement can be found in the text message file attached to the complaint. So which is it? If you make false statements, perhaps you should discuss such.

  
  On July 26, 2024, I wrote in this BBB complaint that Randy Nguyen was “disrespectful.”  I wrote the following, “...Dr. Nguyen was to reevaluate the bridge without charge. Again, he was disrespectful. As I was waiting in the dental chair, Dr. Nguyen came up behind me, slapping Vaseline all over my lips and smearing it above and below my lips. He did so without saying anything to me.”

  
  In the September 3, 2024 response, ***** ***** wrote that I was “loud and disrespectful.” Surely, she does not have to resort to copying my statements. Again, ***** *****  made completely dishonest statements about me. I was not loud, but I should have been considering the way I was treated and the shoddy work for which they charged thousands.

  I received the dental records after I contacted the office. In the dental records, they listed the name of the dental hygienist who “cleaned” my teeth the same day that Randy Nguyen “reevaluated” the bridge. I requested the name of the dental hygienist. Why? I wished to file a complaint against her. At Legacy Dental, I guess if you say the bridge needs to be replaced they retaliate by refusing to “clean” your teeth. The dental hygienist billed Aetna $171 and was paid $66 for cleaning my teeth. This amount was deducted from my benefits. The problem was she did not clean my teeth. She went through the motions. Legacy Dental refused to provide this woman’s name when I requested it. I told them I was filing a complaint with the Kansas Dental Board. Now, I know her name.
  

  I will file complaints against Randy Nguyen, ****** ******** and the dental hygienist. I will do so with the Kansas Dental Board.

  I will also file legal action against the aforementioned parties.

  They took advantage and ripped off an individual who has MS and is on Social Security disability.
  
  Sincerely,
  
  
  
  ***** *******

  Customer Answer

  Date: 09/12/2024

  Why would Randy Nguyen place a dental bridge that goes down to my gum? Why would he not highly recommend placing a dental bridge where there is space between the gum and the bridge? Why would he tell me that only using a water flosser is necessary? Why did he say that I do not need to manually floss? Randy Nguyen’s actions were completely unacceptable.
  

  I went to another dentist and was told that it was not a good idea to have a dental bridge that goes down to the gum. It is extremely difficult to keep it clean, etc.  Also, it is difficult and time consuming to manually floss... I was told it should be manually flossed in addition to using the water flosser.