This business response was received by Revdex.com via email and is a copy/paste by staff member *** Hello [redacted] ! Thank you for your help todayHere is our response: Our patient, [redacted] was seen in the summer of to begin the process for upper and lower partial denturesThough we do accept managed care plans (such as Caresource, United Healthcare, Paramount, etc)- we are not/ we have never been in network with straight Medicare or MedicaidWe make a point of making this very clear to each and every patient because we understand that it is sometimes confusing that we accept some plans but not all Per our standard procedure, we began the process with sending a pre-authorization (or prior-authorization) to Mr [redacted] insurance on file, United Healthcare Community Plan/ DentaquestThis is always the first step as the managed care plans always require authorization for prosthetics.We received a response from United Healthcare/ Dentaquest approving Mr [redacted] upper and lower partialsI have included this determination in the attachments to this emailTypically at this point, we begin the process for making the partialsIn this case however, Mr [redacted] did not come back to us to get started until the end of July of When a patient comes into our office and we check them in, we always ask them to please update us on any changes to their information- especially any changes in insurance informationMr [redacted] did not provide us with any such updatesThough we were still in network with United Healthcare Community Plan, we received a denial for Date Of Service 7/28/for Mr [redacted] partials with denial code: "2035- Patient is not eligible for services: coverage is not active"I have attached that denial to the email as wellMr [redacted] claims that we stopped accepting his insurance in the middle of his procedureThis is not the truthYou can see on the included EOB that we were paid for two other unrelated patient's work on 7/22/and 8/4/They would have been denied as well if we had not been in networkI feel that we followed the proper procedures for such a situationBefore beginning treatment, we submitted a pre-determination that was approved and at the time of treatment, we asked the patient to update us with any changes to his informationWe can only work off of the information we are givenWhen a patient's insurance denies a claim, in most situations the responsibility for payment falls on the patientIn this case, Mr [redacted] is responsible for the cost of his treatmentIf you have any other questions, please feel free to reach out to me! I will help in any way I canThank you and have a great day! Anna M [redacted] Hylan Dental Care ( [redacted]
From: Lauren H [redacted] K [redacted] Date: Mon, Feb 29, at 2:PMSubject: ID [redacted] To: ***[email protected] Dear ***, This is a response into complaint # [redacted] , regarding patient [redacted] Elder Roger came into Hylan Dental Care on 6/25/to have an implant placed on tooth number &We took an impression for a flipper (temporary teeth) that was seated on that day After that day, Roger never returned We have a signed treatment plan from Roger stating that he understood he was responsible for his portion It is protocol for a patient to come back in for a heal check weeks after implants [redacted] NEVER came back to the office If he would have come back for his heal check, we would have been able to evaluate his implantsWhen implants are placed, healing caps are placed on the implant They are screwed on and placed in a temporary fashion until healing is complete It is possible that the healing cap came off and the implant did not fall out Regardless, Roger never came back for his heal check It is possible that his implant is still in his mouth and everything is fine We would like it if Roger could come back for his heal check so that we can determine the state of his implants Out of the goodwill of our hearts, we refunded [redacted] $2,because he claims he was not satisfied If we were able to check his condition, it would make it a lot easier to evaluate this situation Please let me know how you would like to proceed Thank you, Lauren Hylan Dental Care
Revdex.com: II called [redacted] dental and they said that the statement of not excepting a refund is falseThat they excepted the first refund why not a secondHyland is dancing around this refundI have given a letter from Hyland clearly stating a full refund for and I have given letters showing explanation of benefitsI have shown my burden of proofWheres Hylands proof? I had to get letters from [redacted] dentalWheres Hylands proof of denial from [redacted] dental that they wont except a refund? 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 Regards, [redacted]
Company responded via phone as follows: The consumer came in with her son March 6, Her son need a root canal on tooth #15, a root canal was done and completedShe returned on March for a root canal on tooth # DrF* had an emergency so it took longer to
see her son Before the root canal could be finisheda temporary filing was placed due to the file being short DrF* wanted to fix it at that time, but she demanded they leave since her son had been sitting for so long Her copay for both visits was fully refunded as well as the insurance portion for tooth #which was an incomplete root canal Tooth #can not be refunded due to the root canal on the tooth being completed The insurance cannot be refunded since the work was completed There are no further refunds we can issue to the consumer
Business Response:We saw consumerWe wanted to help her get out of pain, as she was in tearsKnowing that we do not accept her insurance, we told her this and that she had the option to payShe did not want to pay so we placed sedative filling in her mouth for free in the hopes that her tooth
would calm downWe then followed up and called her later to see how she was feelingShe said she was feeling betterA few days later she went on our *** page and complained about us not getting people numbNot only did we place numbing gel on her, we also gave her an injectionWe contacted her after the Facebook post and she explained that she thought everything was fine but she still didn't think that we got her numbWe are a good dental facility trying to give everyone the best care, even if they can not pay we were able to do this as volunteer work
Our dental office contacted *** dental and they told us in order to possibly refund the money we need to start an appeal process. After that, specialists will need to review the case to see if the patient should receive the refund. The dental office is not allowed to randomly send the money back, as *** will not cash the check.If you want us to appeal the process, we are more than happy to. I am not sure of the results that will come.We want to make the patient happy, we are only given certain limitations with insurance companies
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***
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.Hylan Dental,This response is not accurate. There was not a numbing gel or injection given. This is completely false. This did not happen. I was very willing to pay for a numbing injection and had begged to do so. The employee that placed the filling was a dental assistant that to my knowledge is not qualified to give an injection and the dentist had only came into the room briefly to state that I needed a filling. The dentist looked at the x-ray however the dentist at no point examined the tooth first hand. Had I of been numb I would of been able to have the filling placed. After the several attempts and being told if I could just bare with the pain to allow this filling placed it would be over. It is true that I was in tears, as this happened after the several attempts to place the filling with it causing agonizing pain. The filling was also composed of only cotton that the employee had torn off and attempted to place in the tooth. I gladly paid for the x-ray ($40) and was not charged for the filling that was unable to be placed. I was completely capable of paying for the filling as well as any numbing techniques that would go with the minor procedure. Even though my insurance was not accepted I was under full understanding with this and at no point was 'volunteer' work done or was it an expectation. It is truly disheartening that the response was dishonest. An apology for what happened and recognizing the truth and problem is much more honorable.My resolution remains the same, either please be upfront and honest with patients or please change your practices. The goal is not to cause defamation of this business. In fact I have referred many people to this business in the past (my mother had dentures here as well as my significant other had paid more than $20,in crowns.) This experience took me by utter surprise. This business needs to be aware of what had happened. I would not want this to happen to anyone else. This could have been fixed with a simple apology for not numbing a patient before a procedure on the day I was at the appointment. There was no need to rush a patient in agonizing pain out of the office. This was a wrong doing that I would of hoped would of been brought to attention and recognized so that this would not happen to a patient in the future
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
*** ***
[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 [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]
This business response was received by Revdex.com via email and is a copy/paste by staff member [redacted] Hello [redacted]! Thank you for your help today. Here is our response: Our patient, [redacted] was seen in the summer of 2015 to begin the process for upper and lower partial...
dentures. Though we do accept managed care plans (such as Caresource, United Healthcare, Paramount, etc)- we are not/ we have never been in network with straight Medicare or Medicaid. We make a point of making this very clear to each and every patient because we understand that it is sometimes confusing that we accept some plans but not all. Per our standard procedure, we began the process with sending a pre-authorization (or prior-authorization) to Mr. [redacted] insurance on file, United Healthcare Community Plan/ Dentaquest. This is always the first step as the managed care plans always require authorization for prosthetics.We received a response from United Healthcare/ Dentaquest approving Mr. [redacted] upper and lower partials. I have included this determination in the attachments to this email. Typically at this point, we begin the process for making the partials. In this case however, Mr. [redacted] did not come back to us to get started until the end of July of 2015. When a patient comes into our office and we check them in, we always ask them to please update us on any changes to their information- especially any changes in insurance information. Mr. [redacted] did not provide us with any such updates. Though we were still in network with United Healthcare Community Plan, we received a denial for Date Of Service 7/28/2015 for Mr. [redacted] partials with denial code: "2035- Patient is not eligible for services: coverage is not active". I have attached that denial to the email as well. Mr. [redacted] claims that we stopped accepting his insurance in the middle of his procedure. This is not the truth. You can see on the included EOB that we were paid for two other unrelated patient's work on 7/22/15 and 8/4/15. They would have been denied as well if we had not been in network. I feel that we followed the proper procedures for such a situation. Before beginning treatment, we submitted a pre-determination that was approved and at the time of treatment, we asked the patient to update us with any changes to his information. We can only work off of the information we are given. When a patient's insurance denies a claim, in most situations the responsibility for payment falls on the patient. In this case, Mr. [redacted] is responsible for the cost of his treatment. If you have any other questions, please feel free to reach out to me! I will help in any way I can. Thank you and have a great day! Anna M[redacted]Hylan Dental Care ([redacted]
[redacted]This note is to inform you that we took Patient [redacted] out of collections. Although, she did have services rendered at the office, we didn't want to make this patient angry. We wrote her balance off of our books, and the patient no longer has a remaining balance.It is...
our goal to give patients the best care in every way possible. We don't want to make anyone angry.Please let me know if you have any other questions or concerns.Thank you,LaurenHylan Dental Care216.835.4567
Revdex.com:
II called [redacted] dental and they said that the statement of not excepting a refund is false. That they excepted the first refund why not a second. Hyland is dancing around this refund. I have given a letter from Hyland clearly stating a full refund for 14 and 15. I have given letters showing explanation of benefits. I have shown my burden of proof. Wheres Hylands proof? I had to get letters from [redacted] dental. Wheres Hylands proof of denial from [redacted] dental that they wont except a refund?
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.
Regards,
[redacted]
From: Lauren H[redacted] <lh[redacted]@gmail.com>Date: Mon, Feb 29, 2016 at 2:58 PMSubject: ID [redacted]To: [redacted][email protected]
Dear [redacted],
This is a response into complaint # [redacted], regarding patient [redacted] Elder.
Roger came into Hylan Dental Care on 6/25/2015 to have an implant...
placed on tooth number 8 &9. We took an impression for a flipper (temporary teeth) that was seated on that day. After that day, Roger never returned. We have a signed treatment plan from Roger stating that he understood he was responsible for his portion.
It is normal protocol for a patient to come back in for a heal check 2 weeks after implants. [redacted] NEVER came back to the office. If he would have come back for his heal check, we would have been able to evaluate his implants. When implants are placed, healing caps are placed on the implant. They are screwed on and placed in a temporary fashion until healing is complete. It is possible that the healing cap came off and the implant did not fall out. Regardless, Roger never came back for his heal check. It is possible that his implant is still in his mouth and everything is fine.
We would like it if Roger could come back for his heal check so that we can determine the state of his implants.
Out of the goodwill of our hearts, we refunded [redacted] $2,500.00 because he claims he was not satisfied. If we were able to check his condition, it would make it a lot easier to evaluate this situation.
Please let me know how you would like to proceed.
Thank you,
Lauren
Hylan Dental Care
216.835.4567
This business response was received by Revdex.com via email and is a copy/paste by staff member *** Hello [redacted] ! Thank you for your help todayHere is our response: Our patient, [redacted] was seen in the summer of to begin the process for upper and lower partial denturesThough we do accept managed care plans (such as Caresource, United Healthcare, Paramount, etc)- we are not/ we have never been in network with straight Medicare or MedicaidWe make a point of making this very clear to each and every patient because we understand that it is sometimes confusing that we accept some plans but not all Per our standard procedure, we began the process with sending a pre-authorization (or prior-authorization) to Mr [redacted] insurance on file, United Healthcare Community Plan/ DentaquestThis is always the first step as the managed care plans always require authorization for prosthetics.We received a response from United Healthcare/ Dentaquest approving Mr [redacted] upper and lower partialsI have included this determination in the attachments to this emailTypically at this point, we begin the process for making the partialsIn this case however, Mr [redacted] did not come back to us to get started until the end of July of When a patient comes into our office and we check them in, we always ask them to please update us on any changes to their information- especially any changes in insurance informationMr [redacted] did not provide us with any such updatesThough we were still in network with United Healthcare Community Plan, we received a denial for Date Of Service 7/28/for Mr [redacted] partials with denial code: "2035- Patient is not eligible for services: coverage is not active"I have attached that denial to the email as wellMr [redacted] claims that we stopped accepting his insurance in the middle of his procedureThis is not the truthYou can see on the included EOB that we were paid for two other unrelated patient's work on 7/22/and 8/4/They would have been denied as well if we had not been in networkI feel that we followed the proper procedures for such a situationBefore beginning treatment, we submitted a pre-determination that was approved and at the time of treatment, we asked the patient to update us with any changes to his informationWe can only work off of the information we are givenWhen a patient's insurance denies a claim, in most situations the responsibility for payment falls on the patientIn this case, Mr [redacted] is responsible for the cost of his treatmentIf you have any other questions, please feel free to reach out to me! I will help in any way I canThank you and have a great day! Anna M [redacted] Hylan Dental Care ( [redacted]
From: Lauren H [redacted] K [redacted] Date: Mon, Feb 29, at 2:PMSubject: ID [redacted] To: ***[email protected] Dear ***, This is a response into complaint # [redacted] , regarding patient [redacted] Elder Roger came into Hylan Dental Care on 6/25/to have an implant placed on tooth number &We took an impression for a flipper (temporary teeth) that was seated on that day After that day, Roger never returned We have a signed treatment plan from Roger stating that he understood he was responsible for his portion It is protocol for a patient to come back in for a heal check weeks after implants [redacted] NEVER came back to the office If he would have come back for his heal check, we would have been able to evaluate his implantsWhen implants are placed, healing caps are placed on the implant They are screwed on and placed in a temporary fashion until healing is complete It is possible that the healing cap came off and the implant did not fall out Regardless, Roger never came back for his heal check It is possible that his implant is still in his mouth and everything is fine We would like it if Roger could come back for his heal check so that we can determine the state of his implants Out of the goodwill of our hearts, we refunded [redacted] $2,because he claims he was not satisfied If we were able to check his condition, it would make it a lot easier to evaluate this situation Please let me know how you would like to proceed Thank you, Lauren Hylan Dental Care
Revdex.com: II called [redacted] dental and they said that the statement of not excepting a refund is falseThat they excepted the first refund why not a secondHyland is dancing around this refundI have given a letter from Hyland clearly stating a full refund for and I have given letters showing explanation of benefitsI have shown my burden of proofWheres Hylands proof? I had to get letters from [redacted] dentalWheres Hylands proof of denial from [redacted] dental that they wont except a refund? 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 Regards, [redacted]
Company responded via phone as follows: The consumer came in with her son March 6, Her son need a root canal on tooth #15, a root canal was done and completedShe returned on March for a root canal on tooth # DrF
* had an emergency so it took longer to
* wanted to fix it at that time, but she demanded they leave since her son had been sitting for so long Her copay for both visits was fully refunded as well as the insurance portion for tooth #which was an incomplete root canal Tooth #can not be refunded due to the root canal on the tooth being completed The insurance cannot be refunded since the work was completed There are no further refunds we can issue to the consumer
see her son Before the root canal could be finisheda temporary filing was placed due to the file being short DrF
Business Response:We saw consumerWe wanted to help her get out of pain, as she was in tearsKnowing that we do not accept her insurance, we told her this and that she had the option to payShe did not want to pay so we placed sedative filling in her mouth for free in the hopes that her tooth
would calm downWe then followed up and called her later to see how she was feelingShe said she was feeling betterA few days later she went on our *** page and complained about us not getting people numbNot only did we place numbing gel on her, we also gave her an injectionWe contacted her after the Facebook post and she explained that she thought everything was fine but she still didn't think that we got her numbWe are a good dental facility trying to give everyone the best care, even if they can not pay we were able to do this as volunteer work
Our dental office contacted *** dental and they told us in order to possibly refund the money we need to start an appeal process. After that, specialists will need to review the case to see if the patient should receive the refund. The dental office is not allowed to randomly send the money back, as *** will not cash the check.If you want us to appeal the process, we are more than happy to. I am not sure of the results that will come.We want to make the patient happy, we are only given certain limitations with insurance companies
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***
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.Hylan Dental,This response is not accurate. There was not a numbing gel or injection given. This is completely false. This did not happen. I was very willing to pay for a numbing injection and had begged to do so. The employee that placed the filling was a dental assistant that to my knowledge is not qualified to give an injection and the dentist had only came into the room briefly to state that I needed a filling. The dentist looked at the x-ray however the dentist at no point examined the tooth first hand. Had I of been numb I would of been able to have the filling placed. After the several attempts and being told if I could just bare with the pain to allow this filling placed it would be over. It is true that I was in tears, as this happened after the several attempts to place the filling with it causing agonizing pain. The filling was also composed of only cotton that the employee had torn off and attempted to place in the tooth. I gladly paid for the x-ray ($40) and was not charged for the filling that was unable to be placed. I was completely capable of paying for the filling as well as any numbing techniques that would go with the minor procedure. Even though my insurance was not accepted I was under full understanding with this and at no point was 'volunteer' work done or was it an expectation. It is truly disheartening that the response was dishonest. An apology for what happened and recognizing the truth and problem is much more honorable.My resolution remains the same, either please be upfront and honest with patients or please change your practices. The goal is not to cause defamation of this business. In fact I have referred many people to this business in the past (my mother had dentures here as well as my significant other had paid more than $20,in crowns.) This experience took me by utter surprise. This business needs to be aware of what had happened. I would not want this to happen to anyone else. This could have been fixed with a simple apology for not numbing a patient before a procedure on the day I was at the appointment. There was no need to rush a patient in agonizing pain out of the office. This was a wrong doing that I would of hoped would of been brought to attention and recognized so that this would not happen to a patient in the future
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
*** ***
[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 [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]
Company responded via phone:Company will call and request the item be removed from collections and will be sending a check to the consumer.
This business response was received by Revdex.com via email and is a copy/paste by staff member [redacted] Hello [redacted]! Thank you for your help today. Here is our response: Our patient, [redacted] was seen in the summer of 2015 to begin the process for upper and lower partial...
dentures. Though we do accept managed care plans (such as Caresource, United Healthcare, Paramount, etc)- we are not/ we have never been in network with straight Medicare or Medicaid. We make a point of making this very clear to each and every patient because we understand that it is sometimes confusing that we accept some plans but not all. Per our standard procedure, we began the process with sending a pre-authorization (or prior-authorization) to Mr. [redacted] insurance on file, United Healthcare Community Plan/ Dentaquest. This is always the first step as the managed care plans always require authorization for prosthetics.We received a response from United Healthcare/ Dentaquest approving Mr. [redacted] upper and lower partials. I have included this determination in the attachments to this email. Typically at this point, we begin the process for making the partials. In this case however, Mr. [redacted] did not come back to us to get started until the end of July of 2015. When a patient comes into our office and we check them in, we always ask them to please update us on any changes to their information- especially any changes in insurance information. Mr. [redacted] did not provide us with any such updates. Though we were still in network with United Healthcare Community Plan, we received a denial for Date Of Service 7/28/2015 for Mr. [redacted] partials with denial code: "2035- Patient is not eligible for services: coverage is not active". I have attached that denial to the email as well. Mr. [redacted] claims that we stopped accepting his insurance in the middle of his procedure. This is not the truth. You can see on the included EOB that we were paid for two other unrelated patient's work on 7/22/15 and 8/4/15. They would have been denied as well if we had not been in network. I feel that we followed the proper procedures for such a situation. Before beginning treatment, we submitted a pre-determination that was approved and at the time of treatment, we asked the patient to update us with any changes to his information. We can only work off of the information we are given. When a patient's insurance denies a claim, in most situations the responsibility for payment falls on the patient. In this case, Mr. [redacted] is responsible for the cost of his treatment. If you have any other questions, please feel free to reach out to me! I will help in any way I can. Thank you and have a great day! Anna M[redacted]Hylan Dental Care ([redacted]
we are refunding her money. I was out f town and thought it was already done. It is being taken care of immediately.
[redacted]This note is to inform you that we took Patient [redacted] out of collections. Although, she did have services rendered at the office, we didn't want to make this patient angry. We wrote her balance off of our books, and the patient no longer has a remaining balance.It is...
our goal to give patients the best care in every way possible. We don't want to make anyone angry.Please let me know if you have any other questions or concerns.Thank you,LaurenHylan Dental Care216.835.4567
Revdex.com:
II called [redacted] dental and they said that the statement of not excepting a refund is false. That they excepted the first refund why not a second. Hyland is dancing around this refund. I have given a letter from Hyland clearly stating a full refund for 14 and 15. I have given letters showing explanation of benefits. I have shown my burden of proof. Wheres Hylands proof? I had to get letters from [redacted] dental. Wheres Hylands proof of denial from [redacted] dental that they wont except a refund?
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.
Regards,
[redacted]
From: Lauren H[redacted] <lh[redacted]@gmail.com>Date: Mon, Feb 29, 2016 at 2:58 PMSubject: ID [redacted]To: [redacted][email protected]
Dear [redacted],
This is a response into complaint # [redacted], regarding patient [redacted] Elder.
Roger came into Hylan Dental Care on 6/25/2015 to have an implant...
placed on tooth number 8 &9. We took an impression for a flipper (temporary teeth) that was seated on that day. After that day, Roger never returned. We have a signed treatment plan from Roger stating that he understood he was responsible for his portion.
It is normal protocol for a patient to come back in for a heal check 2 weeks after implants. [redacted] NEVER came back to the office. If he would have come back for his heal check, we would have been able to evaluate his implants. When implants are placed, healing caps are placed on the implant. They are screwed on and placed in a temporary fashion until healing is complete. It is possible that the healing cap came off and the implant did not fall out. Regardless, Roger never came back for his heal check. It is possible that his implant is still in his mouth and everything is fine.
We would like it if Roger could come back for his heal check so that we can determine the state of his implants.
Out of the goodwill of our hearts, we refunded [redacted] $2,500.00 because he claims he was not satisfied. If we were able to check his condition, it would make it a lot easier to evaluate this situation.
Please let me know how you would like to proceed.
Thank you,
Lauren
Hylan Dental Care
216.835.4567