William W. Francis, D.D.S.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
William WFrancis, DDS is a liarWilliam WFrancis, DDS
over charged me $Both the 2nd EOB (claim # ***) and the
3rd EOB (Claim
# ***) are fraudulentI can no longer trust William W
Francis, DDS
There is the evidence of his double billing practice in the
2nd EOB (claim # ***)
The MISC $which insurance coded
PP(PP
- THIS FEE IS PART OF THE FEE FOR THE TOTAL PROCEDURE.)THE TOTAL PROCEDURE is
the IMPLANT $
If
William WFrancis, DDS
had billed my Health Insurance the IMPLANT $which should be billed to
Delta Dental of Kentucky, I would have received an EOB from my Health Insurance
stating that I would have a balance due of $to himNow look at the
3rd EOB (Claim
# ***)William WFrancis, DDS fraudulently billed Delta Dental of Kentucky SURGERY $which
insurance coded *** (*** - THIS ORAL SURGICAL PROCEDURE IS REGARDED AS
A MEDICAL BENEFIT.)The Delta Dental of Kentucky, by same logic, had to state
that I had a balance due of $to him
I
have provided him both my Health Insurance and Dental InsuranceOtherwise, William
WFrancis, DDS
would not have done the IMPLANTIf William WFrancis, DDS still wants me to
provide him my Health Insurance one more time, William WFrancis,
DDS MUST cancel the 3rd
EOB (Claim # ***) FIRST to
avoid his double billing
No matter
what his cheating combination of claims, William WFrancis, DDS is unable to justify his over
charge of $on me
Regards,
*** ***

This 2nd letter is written in response to the *** ***'s response to my 1st letter of explanation After closer review of my first letter, there were two things that need clarification.The first involves stating that all dental and medical insurances were billed There are instances when procedures are purely dental, purely medical, and some that are coordinated between both insurers In this case, the procedures were purely dental As appropriate, my office billed dental only as it was inappropriate to bill medical When I asked my billing staff if all the proper insurance companies had been billed, I was told yes The patient understood that the procedures were dental and, in fact, when she verified her insurance coverage on April 29, 2014, she listed Medical Mutual of Ohio as her medical insurer On July 29, 2014, when the implant/graft/membrance were placed, she was asked if there were any changes to her insurance coverage and she said there were none In fact, her Medical Mutual Policy was cancelled on July 30, Since dental procedures such as implants, bones grafts, and membranes are normally only covered by dental, not medical insurance, my staff believed that they did bill everything appropriatelyIt was my misunderstanding that the patient's medical insurance had been billed It was not I would be glad to bill the patient's medical insurance My office has left a message for her to provide us with her medical insurance company's information We have not heard from her as of 4:PM Monday, June 8, 2015. The second clarification is that I lumped all adjustments, i.einsurance and courtesy adjustments together.I reviewed the patient's charges, payments and EOBs again If we follow EOBs from Delta Dental and disregard any courtesy adjustments on my part, the patient owes me $526.If, by chance, the patient's medical insurance disregards industry standards and does allow payment for the billed dental procedures, I will apply the payment against the $balance owedIf the payment exceeds $526, I will write the patient a reimbursement check If the medical insurance pays less than $526, I would expect the patient to pay the balance due. William WFrancis, DDS Oral & Maxillofacial Surgery Detroit Road, Suite 104 Westlake, OH 44145 (440) 892-(Phone) (440) 808-(Fax)

The patient's complaint is without merit.  Missing from her description is the fact that she had multiple procedures -- dental implant, bone grafting, regenerative membrane, and x-ray -- on July 29, 2014 with charges totaling $3575.  We were informed by the insurance companies that many of...

the charges would not be covered under the patient's policy; therefore, not all charges were submitted to the insurance companies when the first claim was filed.  However, as a courtesy to the patient, I wrote off $1150 and the patient paid $1205 on the day of surgery.  About two weeks later, the insurance company paid me $712, adjusted off $8, and I wrote off, as a courtesy to the patient, another $500.After all insurance claims were submitted to both the dental and medical insurers, the amount owed by the patient far exceeded the $1205 that the patient paid originally. The patient focused on one part of the explanation of benefits (EOB) and my office staff tried to explain to her that a significant amount of the charges were not covered by insurance and that I made courtesy adjustments in her favor. She refused to accept that.   I could have billed her for the "non-covered" services, but I didn't because I try to keep costs down as much as possible for patients since insurance companies pay so little on their behalf.  I took time to explain this to the patient face to face, since she refused to either understand or accept what my staff was telling her.  At the end of our conversation, she told me she understood.  I thought the issue had been resolved until I received your letter today. There was no fraud committed by me or my office staff as the patient claims.  Her dental and medical insurance companies were billed appropriately.  Much time was spent explaining the charges, allowances, and write-offs to this patient. If you have any questions or need clarification, please feel free to contact me.Sincerely,   William W. Francis, DDS Oral & Maxillofacial Surgery 27500 Detroit Road, Suite 104 Westlake, OH 44145 (440) 892-8655 (Phone) (440) 808-2139 (Fax)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
William WFrancis, DDS is a liarIf he did bill my medical
insurance company, I must see the EOB from him
Regards,
[redacted]

My daughter had two wisdom teeth pulled. I was referred to Dr. Francis and went in for a consultation. They told me my insurance would cover it. They called and my copay of $218.00 was due the day of service. Three months later, I got a past-due bill. When I called Dr.Francis' office, they told me my insurance did not cover it, but before I went to them they said it was covered. When I called my insurance (United Concordia) they said they never gave the authorization and all authorazations are in writing. When I called back the dentist office I asked for a copy of the approval and they said they did not have it and I still owe them $1265.00 and as a courtesy the would take off $ 253.00 so now I still have a balance of $1012.00. I feel they should not charge me. I would have never gone there. I would have chosen a place where my insurance would have covered her teeth. We have appealed the denial and it was denied again. When I call the office, they say sorry this is what you owe. I want to know how they said they had approval from the insurance company and now they dont. I feel they lied. This is poor service. I would never recommoned this dentist again. My dentist that referred them to me said if this were to happen at there office the would have wrote it off, not keep sending bills when clearly it was there mistake. They told me to bring $218.00 the day of the service and then they billed me for the full service.