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:06/22/2023

  Type:Service or Repair 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 visited ******************* office on 2023-05-27. I had a plan to do a regular teeth cleaning, on top of that, I was told by previous dentist that my teeth #** might need a filling, so I told ******************* office that I might need to do a filling, upon their checking. My appointment was around 12pm. I'm a new patient.The dental assistant did X-ray for me. Then the dentist checked on me, conducted the teeth cleaning. After the cleaning, the dentist believed my tooth #** doesn't necessarily need a filling, instead, a Preventive Resin Restoration would be enough. I asked them will that be covered with my insurance plan, the dental assistant checked and confirmed it's covered for 24 months. I sat up and asked again, and I told them "please make sure it's covered, else I need to know the cost", then she reaffirmed me that it's covered. Shortly after that, the Preventive Resin Restoration is completed and I left.After a few days, I got their e-statement saying I owe *********************************************************** my plan actually doesn't cover for Preventive Resin Restoration, she said something about age constrain, which means patient can be covered if they aged below 16, but that's not my case. I told the receptionist what happened and she said she will contact ********* and see what they can do.After another few days, I got the text message to remind me the bill I owed. I called the office again, not sure if it's the same receptionist but she seems not aware of my earlier dispute. She explained to me again about why my policy doesn't cover for this treatment, and she agreed "the dental assistant must has missed the age constrain when checking the policy for you". I asked for follow up and a written notice explaining what happened, to make sure we are on the same page, because I don't know how to record our conversation over the phone. She said she will get some financial investigator to contact me, and she'll talk to *********. Never heard back from them.

  Business Response

  Date: 07/03/2023

  As a private dental office, we provide financial estimates based on summaries of patient insurance plan information that is provided by your insurance company. These benefit summaries are not always complete, and do not always show all specific contract stipulations for every patient.  We also can not guarantee payment by insurance companies, regardless of the information they have provided on expected coverage, as they have their own independent dental consultants that make determinations on the necessity of treatment and payment. Therefore all treatment costs provided in office, verbally or otherwise, are always our best ESTIMATES of the cost to you.    
  
  
  In your new patient paperwork, you were provided the office's financial policy, which you signed, that states that you understood that:  
  
  
  "You understand that if ******************* has treatment recommendations for you, you will receive an itemized list of the recommended treatment. This will also contain an estimate of what the fees will be for the recommended treatment. If you have dental insurance, the treatment plan *** include an additional estimate calculating what *** be paid by your insurance company toward the fees for your treatment. You understand that treatment plan estimates are not a guarantee of insurance payment, and you are ultimately responsible for all fees generated by your treatment." 
  
  
  and
  
  
  "Insurance: Insurance is a contract between you and your insurance company. We will bill your insurance company as a courtesy to you. Please note that services are not rendered on the assumption that the insurance company will pay us. You are ultimately responsible for payment of all fees generated by your treatment"  
  
  
  You were provided a verbal estimate of coverage in-office based off of the plan information we had received from your insurance company.  It indicated that Preventative Resin Restoration procedure SHOULD be a covered service for you. Upon claim submission, that charge was denied by your insurance company, as your particular insurance plan (the contract between you and your insurance company)  limits payment for that service to under a certain age limit. Those contract limitations were NOT disclosed to us on your benefit summary.  Fees not paid by insurance are then the patient's responsibility, per our office financial policy. 
  
  We understand that this has been confusing and frustrating for you, and apologize for the previous lack of clarity regarding your bill. 

  Customer Answer

  Date: 07/03/2023

   
  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.
  
  Sincerely,
  
  *************************