12 Oaks Dental

Complaint: ***
I am rejecting this response because: There are a few key pieces of misinformation in the business responseFirst, MrK did not make any payment at the time of his initial visitThis was intentional and arranged through the office because MrK knew that MrsK was returning for some additional dental workIt was determined that MrsK would pay the bill in full after the additional dental workAfter MrsK 2nd visit she paid the bill and was told by the office that our account balance was completely settledThose were the exact wordsThat is also why we waited to pay the bill until after MrsKs 2nd visitThat payment included all work for visits from MrsK and mrKs first visit. Regarding the events that took place in MayMrsK was told the office manager would follow up with her to discuss the reason for the additional/new chargesThe office manager never contacted anyone in the knight householdWe were told we could set up a payment plan, but that was a red herringThe issue at hand was never payment or no paymentIt was where these charges came fromWe were told it was because insurance didn't cover certain work, but that shouldn't have been addressed with insurance prior to MrsKs payment at the end of the 2nd visitThis is why there is a disputeWe were told all of our work was paid for in full and then later told something differentNo proof or real rationale for the discrepancy was ever providedTwlevr Oaks Dental continues to about the true complaint here which is charges that emerged after full payment had been confirmedThat is the complaint and the business issue in question.
Regards,
*** ***

Complaint: ***
I am rejecting this response because: There are a few key pieces of misinformation in the business responseFirst, MrK did not make any payment at the time of his initial visitThis was intentional and arranged through the office because MrK knew that MrsK was returning for some additional dental workIt was determined that MrsK would pay the bill in full after the additional dental workAfter MrsK 2nd visit she paid the bill and was told by the office that our account balance was completely settledThose were the exact wordsThat is also why we waited to pay the bill until after MrsKs 2nd visitThat payment included all work for visits from MrsK and mrKs first visit.
Regarding the events that took place in MayMrsK was told the office manager would follow up with her to discuss the reason for the additional/new chargesThe office manager never contacted anyone in the knight householdWe were told we could set up a payment plan, but that was a red herringThe issue at hand was never payment or no paymentIt was where these charges came fromWe were told it was because insurance didn't cover certain work, but that shouldn't have been addressed with insurance prior to MrsKs payment at the end of the 2nd visitThis is why there is a disputeWe were told all of our work was paid for in full and then later told something differentNo proof or real rationale for the discrepancy was ever providedTwlevr Oaks Dental continues to about the true complaint here which is charges that emerged after full payment had been confirmedThat is the complaint and the business issue in question.
Regards,
*** ***

September 18th, 2015 To Whom It May Concern;This response is in reference to the complaint letter we received from your ID [redacted]. We are sorry to hear that Mr. K was upset about his experience here in our office. Both he and his wife are fairly new patients to our practice, we make sure to...

inform all new patients (especially those having dental insurance) that we are not contracted with any insurance companies and are considered out of network. Therefore, any charges are bot covered by insurance will be the responsibility of the patient. We do file and accept assignment as a courtesy to our patients.  After both their initial visits with us, there was a remaining balance due in the account once all insurance had been received. Mr K did make a payment for that balance and at that time the account balance was then zero. On that same date (March 3rd) Mr. K's wife came in for additional treatment. She had some restorative treatment (fillings) performed. Those procedures were filled with insurance and again balance was remaining once insurance paid their portion. A statement of account was sent following payment from insurance showing remaining unpaid balance due.   Mrs. K did call on May 26th and asked why there was a balance remaining on the account, at which time our business assistant explained the difference between the fees charged and amount insurance had paid. She was taken back by how little the insurance had paid and how much was still remaining. We did offer to make financial arrangements with her for the remaining balance, if that would be more comfortable for her. She replied, she felt there should be some type of discount. We again explained how we are not contracted with the insurance company so we do not accept their fee schedule. Our business assistant offered to talk with the office manager (upon her return from vacation) about any discount. On June 1st our business assistant returned a call to Mrs. K and left her a message informing her we would be willing to work out payment arrangements, but could not offer a discount, since we are a fee for service practice. Mrs. K did call and cancel her upcoming appointment-stating that she would be seeing a network provider, but did not mention balance. Two more statements were mailed in the following months, to which no response was received. A letter of concern was then mailed which prompted Mr K to call with payment and his concerns.  We do not feel a refund can be provided, as patient was informed of all fees prior to accepting any treatment. Insurance is a contract between the patient and the insurance company, being out of network we are not bound to their fee schedule or limitations. We will be happy to forward all xrays and records to a dentist of their choice, should they wish to see someone else.  Sincerely, [redacted]Practice Manager

To Whom It May Concern:
In responding to the rejection letter received, I have attached of a copy of the "statement" of account reflecting both Mr. and Mrs. K to help with dates, payments and treatment rendered. As mentioned in the initial response letter, patient payment was made after the insurance was received for both Mr and Mrs first visits (Feb 2015) to out office. We are in agreement that no payment was made at their initial visit with us. 
  Additional charges incurred for Mrs K services rendered on March 3, 2015, which is where the disputed balance stems from. There apparently was a miscommunication/ misinterpretation by both parties on the payment she was making and the balance remaining when she left the office that date. As you can see on the statement attached, there were no new or additional charges ever added to the account, only those services that were rendered. Services were covered by insurance and the (insurance) did not pay according to their fee schedule and plan, which was less than we could estimate. Since we are not contracted with the insurance company and remaining balance is that of the member.  
  12 Oaks Dental does not feel anything was handles unfair or unethically. We are saddened that they feel different and that we could not resolve the issue with them in person.
 
Thanks,
 
[redacted]Practice Manager

To Whom It May Concern:In responding to the rejection letter received, I have attached of a copy of the "statement" of account reflecting both Mr. and Mrs. K to help with dates, payments and treatment rendered. As mentioned in the initial response letter, patient payment was made after the insurance was received for both Mr and Mrs first visits (Feb 2015) to out office. We are in agreement that no payment was made at their initial visit with us.   Additional charges incurred for Mrs K services rendered on March 3, 2015, which is where the disputed balance stems from. There apparently was a miscommunication/ misinterpretation by both parties on the payment she was making and the balance remaining when she left the office that date. As you can see on the statement attached, there were no new or additional charges ever added to the account, only those services that were rendered. Services were covered by insurance and the (insurance) did not pay according to their fee schedule and plan, which was less than we could estimate. Since we are not contracted with the insurance company and remaining balance is that of the member.    12 Oaks Dental does not feel anything was handles unfair or unethically. We are saddened that they feel different and that we could not resolve the issue with them in person. Thanks, [redacted]Practice Manager

September 18th, 2015
 
To Whom It May Concern;
This response is in reference to the complaint letter we received from your ID [redacted].
We are sorry to hear that Mr. K was upset about his experience here in...

our office. Both he and his wife are fairly new patients to our practice, we make sure to inform all new patients (especially those having dental insurance) that we are not contracted with any insurance companies and are considered out of network. Therefore, any charges are bot covered by insurance will be the responsibility of the patient. We do file and accept assignment as a courtesy to our patients.  After both their initial visits with us, there was a remaining balance due in the account once all insurance had been received. Mr K did make a payment for that balance and at that time the account balance was then zero. On that same date (March 3rd) Mr. K's wife came in for additional treatment. She had some restorative treatment (fillings) performed. Those procedures were filled with insurance and again balance was remaining once insurance paid their portion. A statement of account was sent following payment from insurance showing remaining unpaid balance due.  
 Mrs. K did call on May 26th and asked why there was a balance remaining on the account, at which time our business assistant explained the difference between the fees charged and amount insurance had paid. She was taken back by how little the insurance had paid and how much was still remaining. We did offer to make financial arrangements with her for the remaining balance, if that would be more comfortable for her. She replied, she felt there should be some type of discount. We again explained how we are not contracted with the insurance company so we do not accept their fee schedule. Our business assistant offered to talk with the office manager (upon her return from vacation) about any discount. On June 1st our business assistant returned a call to Mrs. K and left her a message informing her we would be willing to work out payment arrangements, but could not offer a discount, since we are a fee for service practice. Mrs. K did call and cancel her upcoming appointment-stating that she would be seeing a network provider, but did not mention balance. Two more statements were mailed in the following months, to which no response was received. A letter of concern was then mailed which prompted Mr K to call with payment and his concerns.
  We do not feel a refund can be provided, as patient was informed of all fees prior to accepting any treatment. Insurance is a contract between the patient and the insurance company, being out of network we are not bound to their fee schedule or limitations. We will be happy to forward all xrays and records to a dentist of their choice, should they wish to see someone else. 
 
Sincerely,
 
[redacted]Practice Manager

Complaint: [redacted]
I am rejecting this response because:If I read the last response correctly, 12 oaks is acknowledging that an additional balanced was added to the Knight bill after already acknowledging that the bill had been paid in full. 12 oaks has noted that this additional balance was not the result of additional service, but the result of the insurance company declining to pay some amount. If this is indeed the case, why were the Knights ever told that the there was no balance remaining. 12 oaks wad misleading at best and dishonest at worst. In either scenario, it appears clear to me that 12 oaks ought to shoulder at least some portion of the responsibility for this discrepancy and sharing of misinformation. 
Regards,
[redacted]