5 Star Dental

Review: I WENT TO 5 START DENTAL SUMMER 2013 THEIR OFFICE WAS DOWN FROM MY WORK. I CALLED TO MAKE AN APPOINTMENT AND ASK IF THEY TOOK MY INS [redacted] THE OFFICE MANAGER THEY HAD OTHERS FROM [redacted] WHERE I WORKED COME THERE AND THEY WOULD FILE IT. ON MY FIRST VIST THEY HAD ME PAY 75.00 I HAD SEVEAL VIST AFTER THAT EACH TIME SHE WOULD WANT ME TO PAY IN FULL OR 100.-200 DOLLARS I ALWAYS PAID SOME AT LEAST $50. THEN I TOLD THAT THESE THING WHERE COVERS I ONLY WANT TO PAY MY DEDUCTABLE. THERE WAS OTHER WORK THEY WANTED TO DO BUT I STOP GOING THE BILL WAS 1800. AND I COULD GET HER TO FILE IT. SHE SAIS ADREES WAS WRONG I GOT HER ANOTHER ADDRESS STILL WENT ON. I KEEP CALLING AND ASKING ABOUT THE INS IT TOOK HER MONTHS TO FILE . THEY TURN IN A JUDGEMENT FOR 1800.00 WITHOUT ME KNOWING TILL I WENT TO GET A LOAN. THAT WAS ABOUT 3 WEEKS AGO. I CALLED AND ASKED WHAT WAS GOING ON. [redacted] SAID SHE DIDNT TURN IT THAT MUCH IT WAS FOR 800 BUT I ONLY OWED 650.SO I CALLED MY INS CO. THEY SAID THEY DIDNT PAY THE FULLY TAKE MY INS. AND THE HAD SENT THEM A CODE IN FOR A ROOT CANEL. I NEVER HAD A ROOT CANEL. BUT I HAD RECIVED A LETTER FROM MY INS A YEAR AFO AND CALLED THE DR. OFFICE AND SHE SAID SHE WOULD FIX IT BUT DIDNT. NOW SHE IS BUT ACCORDING TO MY INS MY TOTAL OUT OF POCKET SHOULD OF ONLY BEEN $574. DOLLARS AND I HAD PAID 399. I CALLED AND ASK WHAT WAS GOING ON WHY THEY CHARGED MR OVER $1000.PLUS ALMOST DOUBLE. AT TIME [redacted] SAID THEY DONT PAR TAKE IN [redacted] INS FULLY. I TOLD HER YOU SAID YOU DID HER REPLY WAS NO I SAID I HAD CO WORKERS THAT USED THEM. I TOLD HER THAT WAS UNFARE PRACTICE I WOULD NOT OF CAME THERE AND PAID DOUBLE IF SHE HAD TOD ME THAT I WORK WITH DIFFERENTS INS IN MY FEILD AND I HAVE TO TELL THEM IF THERE WILL BE A DIFFERENCE IF IN PRICE IF THEY DONT PAY OUR PRICES. BUT THE REFUSE TO DO ANYTHING. EVEN THOUGH THEY LIED ABOUT TAKEING MY INS AND I NEVER GOT A BILL FROM THEM THAT REFECTED [redacted] INS THAT WAS PAID. AND I CANT GET MY HOUSE LOAN TILL THIS IS FIXED THANK YOU [redacted]Desired Settlement: BILL ADJUSTMENT TO THE RIGHT PRICE SO I CAN PAY IT OFF AND THEY TAKE THE JUGEMNT OFF THAT SHOULD OF NEVER BEEN. THEY INFLATED WHAT I OWED TURN CODES IN TO MY INS FOR WORK I DIDNT DO AND MESS MY CREDIT UP.

Business

Response:

I will try to address each statement in this patient's letter although it was difficult to decipher. Thispatient first came to us in September of 2013. When she called to make the appointment, she statedshe was referred by other employees from [redacted] who are patients of ours. While it is true we saidwe would file her insurance, we would never tell a patient we were a participating provider if we werenot. At the time we were a participant of only one dental plan and it was not her plan. The employeesfrom [redacted] that come to our office know that we are not a participating provider. It is our policy togive patients a copy of their treatment plan with fees. It is also our policy, as it is for most offices, forpatients to pay their deductible and co-pays at the time of appointment. Typically these charges do notapply to preventive, which was patient's first appointment, so contrary to her statement, she did notpay anything the first appointment. Her second appointment totaled 800.00, her co-pay and deductiblewould have been approximately 300.00 for that day but she only paid 100.00. Her third appointment copayshould have been approximately 350.00 but again she only paid 100.00. It was at this appointmentthat our office made an error in a code. But contrary to what patient has stated we did not charge for aroot canal, as she did not have one done. The discrepancy lay in the fact that we inadvertently selectedthe code for a procedure that involves 4 or more teeth when it should have been the code that involves1- 3 teeth. This error only reduced bill by 50.00. We did not know of this error for a very long timebecause patient had given us incorrect insurance information and the claims were going to wrongaddress. We were not paid for first claim until June of 2014, almost a year later. In the meantime, thispatient had a large outstanding balance, which we explained would not be covered 100% by insurance.Even if we had been in network, patient would still have had a portion to pay out of pocket but shemade only one more payment in September 2014 before we sent her a delinquent account letter andthen ultimately sent her account to collections. Patient called our office on 6/3/2015 to complain aboutbill, was very argumentative and kept saying that [redacted] told her we were wrong, I tried asking herwho she spoke with at [redacted] that gave her this information but she wouldn't let me get a word in,then hung up on me. I then called [redacted] and spoke to [redacted], explained the situation to her, and shesaid there were no notes regarding patient's conversation but that she would look at claims to seewhere the problem was, this is when l found out about discrepancy in code. She said other than this,everything is correct and has been paid and that information that patient received saying that sheshould only have had to pay 500.00 out of pocket is not correct. I refiled claim with correct code anddeducted the 50.00 difference from patient's account. I then called and left message for patient,explaining what had transpired. I told her since this corrected claim is 2 years old, insurance may not payon it, and if that was the case, we would write off amount of that procedure (200.00). Patient calledback and wanted me to talk to Dr. [redacted] and have him write off more of remaining balance because wewere too expensive and had scammed her and lied, etc. I told her we did none of those things but that Iwould talk to Dr. [redacted]. Per Dr. [redacted], I called patient back and told her that after we received aresponse from insurance company for this one charge we would adjust her account accordingly, but theremaining balance would stand as is. Patient also claims that she did not know we had referred heraccount to collection until 3 weeks ago, but her account was turned over in November 2014, and thiswas after she had received numerous statements and a delinquent letter from our office.Sincerely,[redacted], Office Manager