Complaints

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• Initial Complaint

  Date:12/21/2023

  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.

  I had work done on my teeth. My first visit I presented my insurance information. I was told by their receptionist she would obtain insurance authorization prior to work being done. I was told by her ****** that yes I was covered!
  
  She passed away and a new receptionist was hired. I received a letter from my insurance company regarding my claim. I immediately contacted there office and spoke with the new receptionist. I was told she would contact them and get it taken care. For 3 years I received NO statements from them. That receptionist left and a consultant was brought in. it appeared as though claims had not been completed and billing was not be handled. The consultant contacted me and asked me to call my insurance company letting them know which was my primary insurance, which I did. In 2023 another new person was hired and I received a call from her telling me I had an outstanding balance and it need to be paid. I explained my ongoing communication with the previous receptionist. She did not care to hear anything that had happened in the past.. I was told I ignored numerous letters from the insurance company and I explained to her that I had been in contact with their office because the letter stated to contact the insurance company or them and that’s what I did. Again, no statements during any of this three-year period we received to not even know there was still an outstanding balance. Because of their failure to file the claim correctly, the insurance company would not pay now they are demanding that I pay the entire amount.. I have tried contacting the doctor by phone and email and received zero response to try to work through this issue. they will take no responsibility regarding their failure of their previous receptionist, not sending statements and filing my claims correctly as I communicated with them over the phone. I was willing in my last email to **** the owner for a settlement and did not receive any kind of response from him.

  Business Response

  Date: 03/20/2024

  Tell us why here... In reply to the complaint filed from **** * ******** about a
  billing adjustment for claims with dates of service for 8/31/2021, 9/16/2021,
  4/7/2022, 10/13/2022 and 12/1/2022. Our Financial Policy, read, signed and
  dated 12/03/2020 by **** ********* clearly states, “We must emphasize that our
  relationship is with you, and not your insurance company.  While filing of insurance claims is a
  courtesy we extend to our patients, all charges are your responsibility from
  the date services are rendered”

  
  
  

  Our office filed claims on behalf of this patient, over 15
  times as verified by her insurance company. Each time we sent a claim to the
  patient’s insurance company, this insurance company sent the patient an EOB (explanation
  of benefits) clearly requesting the patient to Assign Coordination of benefits
  and other requested information, in order for the claims payment process to
  proceed. However, the patient failed to comply with her insurance company’s
  request over 15 times.

  
  
  

                  We did
  not charge late fees or any interest, which is in our right according to the
  patient’s signed financial policy statement. Our office manager has spent numerous
  hours explaining, in great detail, all aspects of patient’s claims and even
  came into our office on her own time to have a conference call in our office
  with the patient and insurance representative from the patient’s insurance
  company who verified that the reason the claims had never been acted upon by
  the insurance company was due to the fact that the patient failed to provide
  the information they requested more than 15 times and thus could not proceed
  with the claims.

  
  
  

                  We ran
  a routine audit of overdue accounts and outstanding insurance claims and
  discovered this account and outstanding claims were long overdue.  At that point, we contacted patient and sent
  her a statement for the total outstanding balance as our finical policy clearly
  states the patient is responsible for. We added zero interest or late payment
  fees, nor did we send patient’s account to collections, though it is in our right
  to do so. Our office has never had a complaint filed against us, to the Better
  Business Bureau prior to this incident.  

  
  
  

   

  
  
  

                                                                                                                  Sincerely,
  

  
  
  

                                                                                                                  MB
  D.D.S