Anna A Danieli DDS PLLC

Complaint: [redacted] I am rejecting this response because: Yes, they did send me a statement, but I had asked for a statement for the year with charges and insurance payments There is an out standing balance from more then day ago and I do not know what it is for and the Flex plan will not pay until they know if that amount is from this current year and not covered by insurance or if it is something that will be paid out by the insurance company Also I had no confirmation that any of the current work was sent in to both Dental insurance company's to see if either would cover any of the work I have contacted both insurance companies and they have both told me that there has nothing submitted for the implant work.Sincerely, [redacted]

Dear ***,
I apologize you feel you are not receiving the standard of care we strive for I do show you have been contacted, and yes you have been sent a bill for an outstanding amount from some time agoFor the procedure you mention that took place more recently, no there has not been a
statement sent just yet because one has not and can not be generated just yetThe insurance company(s) have yet to complete both submissions for these dental servicesYou have what we refer to as Dual InsuranceFirst, we cannot submit anything to insurance until the dental procedure is complete which would have been your very last appointment out of the seriesWe would only be able to submit to your Primary insurance, wait for them to complete, then submit to your Secondary insurance and wait for them to completeIt is only then would we be able to generate a bill to youSince you have two insurance companies we do not anticipate any monies owed on your part at this time therefore collecting payment from you is not a concern for usIn regards to your insurance "not having claims", my only guess would be that when implant crowns are submitted to insurance they have to be submitted with a series of documentation through NEA (National Electronic Attachment) and this provides its own number very similar to what could be referenced as a Claim number If the insurance representative did not know to be looking for an NEA number, no, she/he would not have found anything in relation to this procedure If you were contacting your secondary insurance and the primary was not at completion, then they would not have one due to not having received it at all yet I always estimate for each insurance carrier to take a minimum of two months for each processing
Again, we greatly apologize for any frustration experienced on your partYou are always welcome to email us as well as call if that is more convenient for you If you were calling for a bill, I apologize if there was a miscommunication about the fact that there simply is not one being charged to you at this time and we do not expect one as of now however when processing is complete we are happy to go over it extensively with you A good way of knowing is when your insurance carriers mail you what is referred to as an Explanation of Benefits One will be received for each insurance carrier
Thank you kindly, Kristen, Office Manager

I am unsure for the denial in response Our office is working diligently with the patient to help as much as possible Dental insurance and claims are not an easy task not only to work through but also to understand Other than when the patient is in the office and we verbally notify them we are happy to bill their insurance, no we do not call the patient every time there is an update with Insurance Doing so and for every patient would not allow us to get anything done Processing insurance for patients is a courtesy for any office as the insurance is a contract between the patient and the carrier At any time the patient feels it is not being done up to par they are welcome to process the claims themselves and be reimbursed directly As far as billing and statements go, this patient has already received the answer to her questions I am happy to post her account statements right here if they have not been received as there is an upload option

Complaint: [redacted]I am rejecting this response because:  Yes, they did send me a statement, but I had asked for a statement for the year with charges and insurance payments.  There is an out standing balance from more then 90 day ago and I do not know what it is for and the Flex plan will not pay until they know if that amount is from this current year and not covered by insurance or if it is something that will be paid out by the insurance company.  Also I had no confirmation that any of the current work was sent in to both Dental insurance company's to see if either would cover any of the work.
I have contacted both insurance companies and they have both told me that there has nothing submitted for the implant work.Sincerely,[redacted]