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:08/14/2024

  Type:Billing Issues
  Status:

  ResolvedMore 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 was referred to Exclusively Endodontics by ************** for a root canal. Before making my appointment, both ***** & the practice verified that they were in network. When I arrived at my appointment on 6/25/24, the front desk called Aetna & again confirmed that they were in network and the root canal was $580 and was fully covered. I did have to pay $295 for the 3d scan, which I paid immediately. The first part of the root canal was done and an appointment was made of 7/9/24 to finish it. A few days later, I received a bill for $1700. Aetna paid $839.20 and I owed $860.80 for the root canal. The bill also stated that the practice was out of network. I feel that this was a "bait & switch", telling me one thing and then changing the fees and coverages after the procedure was already in process! I tried to resolve the matter with both ***** and Exclusively Endodontics but both said that there was nothing that they could do and that I owed the balance due.

  Business Response

  Date: 08/28/2024

  We would like to respond to this complaint. The patient has Aetna PPO ******** plan. When she made the appointment, we asked her over the phone her insurance carrier. She stated ***** PPO. We are IN Network with this insurance. She never stated that over the phone, she had a "********" plan- which we are considered out of network.. She stated that her insurance pays at 100%. We only collected the **** fee of ******. This procedure is never covered under Aetna. After the treatment was completed, we submitted to her insurance. We received the *** with the payment on 7/1/2024 in the amount of  $839.20 for the Root canal treatment. The *** stated that this was a ******** plan, which we are not in Network. Being out of network, the patient pays the difference of what the insurance pays and our office fee. We would like to make this right for the patient. We will credit her balance, for the miscommunication between the patient and our office.

  We extend our apologies.

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

  Customer Answer

  Date: 08/28/2024

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. However, they did know from the beginning that my plan was *************** It was told to them by the Aetna representative, as well as myself. I presented my ************** card at the first appointment. I truly appreciate your help in this matter!
  
  Regards,
  
  *****************