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:01/19/2024

  Type:Product 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.

  This office charge me and my insurance company for services that were not performed

  Business Response

  Date: 01/23/2024

  In
  response to complaint file with the BBB of Utah #********:
  Here is the
  copied complaint from the BBB:
  “This
  office charged me and my insurance company for services that were not performed”
  Before outlining the
  response, I would also like to give key information about ******* and the chart
  notes and billing notes that our practice has on ******* *******.
  Clinic Notes:
  Wednesday, April 6, 2022 at 3:31:54 PM-
  CC:
  Pt. got married a couple of months ago and moved to Roosevelt from Utah County.
  Her new husband is from here. She works from home. Older kids.
  Quit
  smoking this last year after 30 years. Lower right has been sensitive when she
  eats. Can't necessarily point to a specific one but thinks it is #30. She
  didn't go to the dentist for 10+ years and then went and had an SRP, she was on
  perio maintenance appointments every 6 months and has gone religiously since.
  Anxious about dentist. Her dad was given a shot and ended up with paralysis of
  the tongue. Doesn't want nitrous!
  Pt
  presents for New Patient Prophy
  Comprehensive
  Exam-Completed by Dr. F*********. #30-B/U and Crown (distal decay; Dr.
  F********* can probe 1 mm up under buccal portion of crown) and #31-B/U and
  Crown (mesial decay with large, deep existing filling). Watch #4-MOD. Pt. is
  going to combine husband and her's insurance so she said she wants to get the
  crown done but she may need to wait and see if she has a waiting period with
  the insurance. Will have her talk with the girl's up front.
  Pano,
  FMX and Pt photos
  CAMBRA
  risk assessment: Moderate Risk
  Discussed
  tx plan with pt
  Pt
  probes in Perio chart- gen 2-4 mm and BOP with loc. 1-2 mm recession and 5 mm
  pockets LR.
  Pt
  tissue is Pink but rolled; pt. said she has been a little stressed with moving
  and getting married. Pt. also said she has had allergies recently. Praised pt.
  for making maintenance appointments a priority and that her tissue being rolled
  might just mean it is time for a cleaning. Discussed gingival therapy; pt. said
  she never had that done before.
  Overall
  calc is Light
  Pt
  home care looks Normal
  NV:
  perio maintenance cleaning; didn't have time to do at new patient exam.
  ~MG-RDH~
  ----------------
  Signed on Wednesday, April 6, 2022 by Madeleine G****, RDH ----------------
  -Monday,
  April 11, 2022 at 2:05:55 PM-
  
  Pt presents for Perio Maintenance
  Patient
  agreed to the Perio Maint. cleaning today after we discussed fee's for today.
  We discussed that we are NOT in network with her ins. so her cleaning wont be
  100% covered. Patient was understanding and stated that we can continue with
  her appointment today but she will return to her previous office.
  Med
  Hx: No changes
  Pt
  probes in perio chart
  X-rays
  taken: No Images
  Full
  mouth laser therapy, pt wore PPE and tolerated tx well (NC)
  Pt
  tissue is Pink and healthy
  Home
  care looks Normal
  Calculus
  is Normal
  NV:
  Recall 6 month perio maint discussed importance of getting crowns taken care
  of. Pt stated she will not be coming back if she has to pay for her cleanings.
  Pt states her cleanings are covered 100%. Discussed with pt that they are only
  covered 80% and pt stated she will just go back to her old office.
  ~KM-RDH~
  Account/Billing
  Notes:
  - Thu - Jul 21, 2022 -
  ******* called back today about her account. I let her know
  that insurance is processing the second part of her cleaning and that we are
  waiting for that to come back. I told her that once we get that additional
  payment on the account that I would call her and let her know and then we can
  talk about what is left on her account. She was very nice and understood.
  JN
  - Mon - Jul 18, 2022 -
  Tried calling ******* today to talk to her about her
  account. I left her a message letting her know I would be here until 1 today
  and then would be back in the office on Thursday.
  I called PEHP today and they needed some more information to
  process her claim from 4/11. I sent that via fax to ###-###-#### in order to
  get that claim paid.
  JN
  - Thu - Jul 7, 2022 - ******* called today still upset about
  her bill. She's mad she received a statement, I told her insurances hasn't paid
  yet and i tried calling them today and i was on hold for over an hour so i
  talked to ******. ******* asked how she can stop getting the statements showing
  she owes and i told her to pay the full $162.98 and she said she is not going
  to pay that and i just said okay and she said if i pay that ill dispute with my
  bank right away and get a letter from the bank and i said okay and she said
  then what will happen and i told her I’m not sure I’ve never had this issue
  before of someone wanting to dispute a payment and she didn't have much to say.
  She wants to talk to our office manager or to Dr. T********. I told her i will
  have ****** give her a call and she said okay because im done fighting with you
  guys when my cleaning is suppose to be covered at 100% and its stupid that I
  even paid the $80. I said the insurance paid $80 and you paid $47.01 and she
  said i know its not right when i should pay anything. I just said okay and i
  told her i will have ****** call her and they can see what they want to do and
  i told her to have a good day and then she was clam after ??? - she was a lot
  nicer this time in general
  KW
  
  - Mon - May 16, 2022 - ******* came in super upset about the
  payment she got from PEHP and said that we didn't do the perio cleaning and how
  no one told her we weren't in network with her insurance. Ali was the one who
  scheduled her and i said we bill all insurance except medicaid and medicare but
  we are not in network or contracted with any insurance. I know all of us say
  the same thing regarding insurance. She said i didn't tell her that, i said im
  really sorry if you missed that and the confusion. She was upset about the
  perio because she wanted a regular cleaning i said our hyg will only do what is
  best for you and we consulted with you before doing the service and she said
  she was done fighting with them so she just let them do it. She wants a
  discount because her insurance pays 100% for cleanings and i said we did the
  perio service that was needed. i told her she should be getting another check
  from PEHP for the cleaning because she came on two different days.
  KW
  When ******* ******* came into our
  office, we did what we call a New Patient comp exam. This appointment would
  normally be $494 but we do a “new patient” discount which bring it to $200.
  During the originally exam, it was discussed that a particular level of
  cleaning (perio maintenance), was required in order to properly clean the
  patients teeth. The patient was given the correct fees for the type and
  cleaning, and she scheduled it herself that same day. As seen in the notes
  above, the patient had already had these types of cleanings for several years
  with another dentist. She agreed to the fee and paid the estimated amount that
  our system had generated the same day it was completed.
  The patient had two different dental insurance policies,
  both of which were billed for her appointments. Her primary insurance paid
  $80.01 on 05/16/2022. It was immediately sent to her secondary insurance to
  cover whatever amount they would allow. Her secondary did not cover anything,
  according to their allowable amount which we are not privy to as we are an out
  of network provider. Her claim from her cleaning visit (04/11/2022) was sent
  out the day after she came in. Her primary responded, asking for more
  information on the claim such as her perio chart, x-rays, etc. All the
  necessary information was repeatedly sent to PEHP to receive payment. The first
  time it was sent was 07/10/2022, then again on 08/12/2022, and again
  02/08/2023, 05/15/2023, 06/22/2023,07/27/2023,08/23/2023, and finally
  10/23/2023. We currently are still waiting for a response on the last claim we
  sent to PEHP. We have worked tirelessly to maximize whatever benefits we could
  from the patients insurance.
  There have been multiple calls where the patient has been
  communicated with her insurance. She was fully aware of what was billed, the
  specific codes used, and the amounts.  Another
  thing to note, she received every letter and EOB (explanation of benefits) that
  her insurance company sent us. She was the one that initially received payment
  from her insurance. She was made fully aware by her insurance and our office of
  everything that has been done get her claims paid.
  She has also had no issues before with providing the
  necessary payments with us in the past. She made a payment of $47.01 on
  04/06/2022, $30.48 on 07/10/2023, and $62.50 on 09/27/2023. If she was as naïve
  and confused as she now insinuates in her claim to the BBB, I find it odd that
  she continued to pay amounts on her balance with us. If there had been more
  concerns on her part that she felt were unanswered, they were not communicated
  to us.
  The insurance issue is yet to be resolved, no late charges
  have been applied to her account, no collections has been threatened, and
  massive efforts have been made on behalf of this patient with little to no help
  or involvement from the patient, unless it was to complain. She was made
  explicitly aware of every charge that was ever put on her account and scheduled
  every appointment that was made in our office. We do our best to maximize
  patients insurance benefits and educate them on the limitations we have as an
  out of network office which is made very clear on patients initial appointment.
  We pride ourselves on our efforts and find it disheartening that this patient is
  maliciously filing false claims to reduce their bill and try to slander our
  name with false allegations of fraud.