Apex Dental

Within the policies and procedures of our company we in good faith have addressed the concerns with the patient directly, and feel we have reached a satisfactory solution with all concerns that have been brought to our attention.

Mr. [redacted]'s wife received treatment that is performed is phases. His wife provided a card and requested to make payment in full, as to not have multiple payments due on the same procedure as Care Credit issues a separate bill for each run made on the card. . Upon the request of Mr. [redacted] the card...

was refunded today for the treatment not yet finalized. The balance due will be run upon completion. Our goal is to provide payment structures requested by the patient, in compliance with our protocol. Either process is acceptable.

Mr. [redacted] mentioned a 25% discount that he heard when he called on hold, there is no other special percentage discount offered that month he could have heard as we have them all recorded. He may have just picked up a piece of the recording. We are more than happy to "do the right thing" if a different Apex ad or recorded message is provided.  He was also told that the OL in Murray would discuss it with him, as she did when he arrived.  There is a base sign up and a monthly fee, usually much less than other insurances. The response Utah wide has been extremely positive. We hope this clarity helps Mr. [redacted].

Complaint: [redacted]
I am rejecting this response because:Only part of the money I paid in good faith was returned.  I am still left with a piece of a file in my tooth and the expense that goes with fixing their mistake.  This is not a satisfactory solution to me.
Sincerely,
[redacted]

As a preferred provider for this insurance the quoted cost is an estimate of the patient portion provided the insurance pays for anticipated coverage. It is an estimate as ultimately the insurance company has the right to deny or add provisions to any claim not previously disclosed. Apex...

strives to not overcharge patients for treatment rendered,  we received notice that the crown build up is not allowed the same day as a crown prep. acceptable by some insurance plans and common practice in dentistry. Listed below the attempts and communications with the patient regarding the insurance response.  We strive to provide the best dental care as we serve our patients. We also put extreme efforts into collecting all monies owed by insurances. Unpaid portions by the dental "benefit" is the patients responsibility.  Connects to proceed and understanding of payment and insurance responsibilities were also signed by the patient.  Unfortunately the insurance companies are not responsible for providing all business plans that are created in their system, only the patient has that information and as a company we work with the patients insurance to get the max benefits possible. All dental charges are billed to insurance with the companies UCR fees and write-offs are made post insurance payments as our process for clarification on the fluoride billing.  - Wed - Jul 6,2016 -left msg regarding acct, put on aging status tab of tracker because we just rec'd ins denial on buildup. mlb- Mon - Jun 6,2016 -called pt to collect he 85 and the pt sent in a check on Friday/cs- Tue - May 24,2016 -lm to collect the balance of the 83.00/cs- Thu - May 12,2016 -pt was called about the balance- Tue - Apr 19,2016 -pt came in upset about the bill she was under the impression that what we charge is a exact amount, I told her that we call her insurance as a courtesy and do our best to verify coverage and benefits but we are not always exact and sometimes we don't get it to the dollar . she said she did not have the money to cover the 80 something right now and would have to cover that next week on her paycheck/cs

Patient contacted, understanding with full resolution is satisfied.

BCBS revived fax showing proof that Apex did timely filing with EOB's attached on 12/14/16.Apex will follow up on 1/16/17 allowing for the 30 days to process. We will notify patient upon response from BCBS.

All documented  policies and procedures are complete.   Due to HIPAA compliance Apex is unable to comment further on the details of this complaint.  The patient has been contacted and no return call has been made.

Apex shares the frustrations of Mr. [redacted] with his primary insurance BCBS coordinating benefits on all family members except [redacted]. The insurance company requested Mr. [redacted] as the insured to provide coordination of benefits to resolve and pay the claim. Apex had already responded, however this...

was not provided upon several requests from the patient. This primary claim was resolved by Apex finally in August 2016. The secondary insurance placed an exceeded timeline on the claim, Apex is now unable to pursue. The patient can go before the insurance commissioner with all correspondence and peruse payment. Apex stands in full support of this claim and will provide and help Mr. [redacted] with anything we can. Without his action to resolve with insurance the balance of the account remains due.

Apex has an on hold ad we are happy to forward that clearly states that there is a 25% discount when signing up for the Apex membership. The notes in the patient chart for the appointment were made by Michelle from our Sandy office stating that with the Membership there is a 25% discount. The Murray...

Office Leader, Mimi  explained the special further, when Mr. [redacted] did not want to sign up for the Apex Membership she did offer him a new patient special reducing his bill by $57.00. Apex is more than happy to honor the on hold ad of 25% off treatment that Mr. [redacted] originally heard after signing up Mr. [redacted] up on the Membership plan and further more providing uncustomary credit of the additional $50.00 totaling 25% off the original bill.We hope this clarifies any misunderstanding and  anticipate a positive resolve with Mr. [redacted]. Lori P[redacted] COO Apex Plus

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sincerely,
[redacted]

They broke the payment agreement cost me additional money and refused to adjust my bill to reflect the maximum allowed by my insurance company.I went to Apex Dental on August 15th with a broken tooth and in a lot of pain. I was told that I would need a root canal and cap for the tooth. I knew that I couldn't afford to come up with the $854.10 for a couple of months but the office manager, Donna, said that she would set up a payment plan of two payments for me. We set up an appointment for August 22nd. Unfortunately I wasn't able to come up with the money in time for the procedure so I had to call to cancel. When I called Donna was the one to answer. I felt comfortable with her because I thought that we had built a great rapport. I explained that I would have to push the appointment out until at least the last day of the month because that was when I would be paid again. I still had to figure out my finances to see if that would work. Donna suggested that I keep the appointment and she would split the payment plan into three payments. She also told me that she would take the payment on the last day of the following three months but it couldn't be later because it had to go onto the current month's payments. I knew that this was a very nice thing for her to do and I was surprised that there was someone there that was willing to help me when I needed it, something that is more and more rare these days. I kept the appointment and I had the procedure done on August 22nd. I gave the girl that was working that day three checks written for $284.70 each, postdated for the last day of the month for August, September, and October.I went online a couple days later to see if an unrelated check that I had sent had been cashed. I could see that the first payment to Apex Dental was cashed on the day of procedure, which overdrew my account. I tried to call Donna immediately but she was out of the office until the following Monday, so I left a message asking her to call me back. I also went to the bank to see if they would be able to refund any of the money because the check was cashed before the date on the check. They informed me that it was illegal to postdate a check and they weren't able to do anything.When Donna called me back the following Monday she told me that she would call her bank to see if anything could be done and told me that they wouldn't cash the remaining checks until the last day of the month. She told me that she would call me back. I still haven't heard back from her.In the beginning of October an explanation of benefits became available to me which reduced the total bill for the procedure from $854.10 to $740.80. I knew that Apex Dental received the same document, which reduced the maximum amount that they were able to charge me. I figured that I would get a final bill for the amount that I owed to Apex Dental because I didn't think that a check for more than what was owed would be cashed. I wanted to be safe from them accidently cashing both a final check, and one they already had, I decided to cancel the last check that Apex Dental still had in their possession. I honestly kind of forgot about the final bill until I was out of the country attending a training and the last day of October went by. I planned on calling Apex Dental when I returned home, but instead of a final bill with the money I owed according to my insurance company, I received a bill for over double what I owed. Believing that there had been an error, and that Apex Dental might not have received the explanation of benefits, I sent a copy with a note which explained the situation and I asked for a final bill that reflected the adjustments that should have been made because of the agreement that they have with my insurance company. I told them that I would make the payment in full when I received the corrected bill. What I received back was a bill back with none of the adjustments made, a $35 charge because they were not able to cash the check that would have been for more than I owed them, and $37.70 for being more than 90 days late with my final payment.Desired SettlementI would like a correct final bill, which reflects the amount that is owed, as I have already requested. I can call the insurance company and ask them to call you to figure out the whole situation if you would like. I figured you have had to deal with the insurance company's before and would already know how to apply the maximums allowed. Their number is X XXX-XXX-XXXX.I would like the $35.70 fee taken off the bill because I have yet to even receive a correct final bill. I didn't even receive an incorrect final bill until November 11th, not over 90 days ago.I should not be expected to pay a returned check fee of $30 when it was a check that Apex Dental should not have tried to cash in the first place.I would also like the $70 in charges that I received due to Apex Dental depositing my check into their account before the agreed payment refunded. The check that was cashed also caused several other checks to bounce. I won't ask to be refunded for this amount, I just want you to be aware that I also had to pay $105.Lastly I would like the $30, which I had to pay to cancel the check that you had, refunded. This is because you were willing to cash a check that you knew was for more than what I owed you. On top of that, you included a returned check fee to the bill for a check that you had no right cashing in the first place. An apology would be nice, but not expected. I tried to contact you to work something out after you cashed my first check early but you didn't want to even call me back or apologize. I tried to contact you and give you the benefit of the doubt about overcharging me. You refused to fix the error nor apologize for making it. I had to go through the Revdex.com instead of being able talk to you and figuring things out. Please make this right with me, with all of your customers. I was very happy with the dentist and the procedure however no customer should have to go through this in order to not be overcharged.Business Response Thank you for bringing this situation to my attention. This is Dr. Gauthier, the owner of Apex Dental, and I am grateful that you took the time to write such a well crafted letter. I want to start out with a sincere apology on behalf of my team. We normally strive to provide exemplary customer service, and I'm sorry that we fell short with you. I can assure you that the issues you experienced have been addressed. With all that being said, I am also proud of my team for servicing you clinically in a very professional and efficient manner. They were able to save your tooth and the treatment was delivered with a positive outcome. I have taken this opportunity to review your account. The pre-adjusted balance that you received a bill for was $350.40. This was indeed an error. Your final bill should have been $201.40 after insurance adjustments. Your are asking for further adjustments of $165.70 for fees incurred by you. This would leave you with an account balance of $35.70. I have made an account adjustment for you to reflect a $0.00 (Zero dollar) balance as a gesture of good will. We value you as a patient and a customer and look forward to caring for you in the future.