Arlington Dental Excellence

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed as Answered] Complaint: [redacted] I am rejecting this response because: an "in network" provider has no authority to decide a procedure's final price for a patient and how much a patient's co-pay isHere is my reasoning:It is well known that a "in network" provider should honor the service price set by the relevant insurance companyIn my case, it is [redacted] MOThe positive part of Arlington Dental Excellence's response is that they had confirmed that they told the patient that Arlington Dental Excellence was a "in network" provider before the procedure began Arlington Dental Excellence claimed " The patient portion for all was only from patient and from insurance"This is wrongThe correct way for an "in network" provider billing is to file this "3000" service claim to the [redacted] MO and let this insurance company making service price adjustment (usually the insurance company will apply some kind of discount, called contract price) and decide how much a patient's co-pay isAn "in network" provider has no authority to decide a procedure's final price for a patient and how much a patient's co-pay is Arlington Dental Excellence claimed " We have contacted her insurance company ( [redacted] ) and they have informed us that she is responsible for the entire balance." I would like to see the document that support this acclaim Arlington Dental Excellence claimed " And his daughter signed off on ALL treatment knowing the cost before starting treatment." I would like to see the document to support this acclaim There are many statements in their response and I would like to focus on these three main points so that we can move our case on promptly Regards, [redacted] ***

To whom it may concern:*** *** is the father of a previous patient of oursAt her 1st visit to our office we were in the credentialing process with *** *** *** had informed us that claims would be processed retroactively in network when our practice becomes a in network provider
This is why the patient was told that we area in network providerWe explained all this to the patient and made an attempt to Collect her co-pay based on in network benefitsShe informed us that her father would contact us to make paymentWe informed her that her insurance has a maximum of $The root-canal was done and then followed by crown and a surface filling as wellThe patient portion for all was only from patient and from insurance and the insurance made the payment to the patient directly (He has collected $from the insurance for our services and he wouldn't even pay that to us)so the patient due is total since they received the insurance moneyWe have contacted her insurance company (*** ***) and they have informed us that she is responsible for the entire balance.We have given *** *** many opportunities to take care of this balanceThis issue has been going for over months and has left us no choice to send her to a collection agencyBefore sending her to collection we even offered the patient a 20% discount in order to help her pay the balance.To be honest, the father has given us such trouble and I explained to him that the crown part cost $and based on him stating the national average is between 800-therefore we are IN WITHIN the national average, I don't think he understands that his coverage for the root-canal is 80% which is phenomenal, but it maxed out his insurance so his insurance yearly limit is overAnd his daughter signed off on ALL treatment knowing the cost before starting treatment.If you have any further questions please let us know! And explain to them that we have NEVER had any complaints beforeAnd that there definitely won't be any apology or discount because we did everything right with signed consents and explanation of benefits and also have extended him courtesy of payment plan and he refusedHe has collected $from the insurance for our services and he wouldn't even pay that to usNo matter what we tried to do before they refused to pay and now they have been sent to collection agency they are doing all this fussAnd just so you know they are the first and only patients EVER who have been sent to a collection agencyThis is a 100% owned and operated family dental practice we make business based on trust and the last year alone we have over new patients that have referred a lot of their friend and family because we are very honest and TRUSTFULPlease if you have any further questions don't hesitate to reach out to us,Thank you,Ban A***Office Manager OfArlington Dental Excellence

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
 Complaint: [redacted]
I am rejecting this response because: an "in network" provider has no authority to decide a procedure's final price for a patient and how much a patient's co-pay is. Here is my reasoning:It is well known that a "in network" provider
should honor the service price set by the relevant insurance company. In my
case, it is [redacted] MO. The positive part of Arlington Dental Excellence's
response is that they had confirmed that they told the patient that Arlington
Dental Excellence was a "in network" provider before the procedure
began.
Arlington Dental Excellence claimed " The patient portion for all was only
1000 from patient and 2000 from insurance". This is
wrong. The correct way for an "in network" provider billing is to
file this "3000" service claim to the [redacted] MO and let this
insurance company making service price adjustment (usually the insurance
company will apply some kind of discount, called contract price) and decide how
much a patient's co-pay is. An "in network" provider has no authority
to decide a procedure's final price for a patient and how much a patient's
co-pay is.
Arlington Dental Excellence claimed " We have contacted her insurance company
([redacted]) and they have informed us that she is responsible for the entire
balance." I would like to see the document that support this
acclaim.
Arlington Dental Excellence claimed " And his daughter signed
off on ALL treatment knowing the cost before starting treatment." I
would like to see the document to support this acclaim.
There are many false statements in their response and I would
like to focus on these three main points so that we can move our case on promptly.
Regards,
[redacted]