Complaints

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• Initial Complaint

  Date:01/13/2023

  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 recommended to get a consult from this practice. I filled out their forms, including their Financial Starement, which I signed. Nowhere did they say in that document that there was a charge for a consult. I refuse to pay their bill and I chose not to use their services. Email was sent on Wednesday and they immediately sent to collections as I received a call today. None of the documentation says that there is a charge for consultations.

  Business Response

  Date: 01/25/2023

  The patient scheduled an appt in our office with one of our specialists for a consultation to evaluate recession before the patient initiated  Orthodontic treatment.   The patient carry’s dental insurance and provided us her information so that we could bill her insurance to utilize her dental insurance benefits for her consultation.

  
  

  The patient’s insurance was billed out as a Comp Perio Eval evaluation which is the ADA code for the service that was provided.  Our specialist completed a full periodontal charting and explained to the patient what the plan would be moving forward.  As per our office protocol, we billed the insurance company for the service that was rendered this patient.
  
  The insurance sent an Explanations of Benefits (a.k.a. EOB) stating that the patient had already utilized the plans benefit for this type of visit.  Therefore, as per our agreement with the patient’s insurance provider, we wrote off our contracted portion of the service and the patient was sent a bill for the remaining portion.  This is the portion that we do NOT write off and is the is the part of the service we rendered that is owed by the patient.     It clearly states on the EOB that the patient is responsible for their portion of the bill -$65.  Attached is the EOB stating this. 
  
  This is the patients contract with her dental insurance company. 
  
  All EOBs are sent to the patient. So the patient would be notified that they owed this balance.   We sent the patient two bills that were unpaid and on the second bill the patient sent us an email simply stating that she will not be paying her open balance and stated that our service should not be billable.  Yet the patient has been to other offices and knows that a consult is a billable service based on the fact that the visit to our office was denied for frequency. Which means the patient was seen elsewhere and according to her plan the patient is only allowed one consult, as per her plan policy.
  
  The patients claim was that our office policy does not say that we DO bill for every service and in this case, the patient was billed for a consult. 
  
  There is an ADA dental code associated with each and every specialized service we provide.  Her insurance company allows a benefit for the service that was rendered to this patient.  All services that are provided to a patient are billable, regardless if the individual patient decides on their own that they felt that a particular service would be non-billable.  It would be unreasonable for any dental office to list in their Financial Policy EVERY service they provide.   
  
  For the patient to decide on their own that because she did not see a specific service listed on our  financial policy then she does not owe the balance goes against her agreement with her insurance.  The service was provided and is billable, therefore the patient is responsible for the balance owed.   Again the EOB clearly states this.
  
  If you have any further questions, please don’t hesitate to reach me.
  

  Holly W*********
  Office Manager
  Main Line Periodontics & Dental Implants, PC

  Bryn Mawr Central
  29 Morris Ave
  Bryn Mawr, PA 19010

  Customer Answer

  Date: 02/01/2023

  [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. 
  
  Regards,
  
  ***********************
  

  As an FYI, I did NOT receive a first bill, only the second.  And if you are going to put it through to insurance and try to claim it which is your right, why would you send a handwritten bill?  It would have made more sense to me if you had shown me that you submitted it and it was not accepted.  Send me another bill and I will pay it.