Awnie Amman DDS

In regards to item #of the patients concern from your letter dated 3/24/2014, we bill the UCR (usual and customary fee) which is the higher fee listedThe patient is mentioning ($90)The lower fee $is the lower negotiated fee between us and the insurance if the insurance will cover this service, in the case were the insurance does not cover it then the UCR fees are in effectThe patient was quoted the PPO fees (the negotiated fees) because the insurance said they cover $but they covered only $I think the patient should not be complaining about us they should call the insurance company and ask to have the insurance listen to the conversation between us and them since most calls are recordedWe are not the problemThe fees that I send the patient a statement for is clearly marked as patient responsibility $on the explanation of benefits that came from the patient's own insuranceThis amount is what legally we can charge the patientAgain, we are not the problem In regards to item #2, the patients wife was talking to the person in charge of handling these issuesThe Doctor is above her but does not handle issues like this with the patientsAlthough my staff and I discussed patients concern and we came to a compromise to give the patient a discount to keep them happy in our officeWhy would I give discount if the patient is going to destroy my reputation online? We offered a compromise solution but the patient had ill intention and that is why the decision was made not to grant the discount As far as finishing the treatment on her husband, shows the level of care our office deliversThe crown had suboptimal fit and we know the lab can do better so we decided to make a new one that we feel the patient should getI do not really see where is the crime in delivering the best we can!! In regard to item #4, again the patient is trying to taint us no matter howYes the bill she received reflects the family balance with some pending charges which was explained to [redacted] and that the insurance will payIf the insurance does not pay then it is patients responsibility As of today the patient owes us $and is overdue and the account will go to collections or even to court if the patient refuses to pay Thank you for your cooperation in this matter and please do not hesitate to call on me if you need any assistance to resolve this dispute

I am rejecting this response on the following; The first original quote fees were much lower and increased when they billed Blue Shield the prices were much higher When looking at Explanation of Dental Plan Reimbursement Awnie [redacted] billed for the most part double the prices in comparison to what we were original quotedI feel that is unethical business standards and did not receive billing from my Dentist or Dental plan that have such a difference in pricesFor example on the item comprehensive dental exam my insurance was billed $dollars and my fee was $please see attached files and compare billings When speaking to one of his office staff I questioned such a major difference and extended a discount but yet still a difference between the two qutoes were a major differenceI asked to speak to someone else of higher position and she refused that I was only to speak to her in regards to the matterI did inform her that I would be writing a review on yelp based on my situationShe had no response and called me the next day to let me know that I was unprofessional and she would take away the professional discountAt no time was I ever unprofessional and angry with office staff and offer to sit down and go through each item charged and she refused and asked that my children not return to the follow up schedule appointment because Mr [redacted] did not feel comfortable working with the childrenMr [redacted] would finish [redacted] pending workAnd yet he went in on March 11, and did not finish the work because it was the incorrect size or fit and schedule for another appointment in April I notice on the letter that I gone to another I informed Mr [redacted] with a certified letter making him aware of the discrepancies in amounts billed and the adjustments done without explanationsmy intent was never to After [redacted] left the office they gave him final notice billing my year old for pending charges for the familyPlease see attachment # First Quote see attachment # [redacted] fees $-750= $ Blue Shield Billing see attachment # [redacted] fees $ 3975.00-750= $ These are the two different billing to me and to Blue ShieldThere is $dollar difference? Why did they add to my account when given a different quote and yes I did sign off that I would be responsible for the first quote and not the second quoteI would like for Mr [redacted] to honor his contract liked we agree on February 25, Sincerely, [redacted]

On Feb 04/Mr*** *** visited our officeA full exam was done along with some dental treatmentMr*** *** was giving a good faith estimate for the treatment he receivedMr***'s portion was $1,This portion is an estimate an just and estimateMr***
signed a financial statement stating that he is responsible for all the balance regardless if insurance pay or not, (copy of which is attached)
The insurance was billed and they paid much less than expected, the explanation of benefits is attachedThe explanation of the benefits states that the patient portion is $3,When the patient wife received this explanation of benefits she called our office on 02/25/and we explained to her that she need to address this issue with her insuranceThe patient's wife was very angry and we wanted to help herShe was asked if 50% discount would keep them happy in this office and that we are willing to work with herShe accepted that and we tried to work with her on 02/25/
The patient accepted the good grace discount but had ill intentionOn the same day 02/25/she send us a fax to refer her husband to a different office thus she is leaving usAlso she acted unprofessionally and posted a slander comment on Yelp to hurt our good standing in the community
Her ill behavior and ill intention forced us to extend no discount and charge the full amount dueShe has the right to express her feelings on Yelp and we have the right to charge the full fees
Thank you for your cooperation in this matter and if I could be of any help please let me know

In regards to item #1 of the patients concern from your letter dated 3/24/2014, we bill the UCR (usual and customary fee) which is the higher fee listed. The patient is mentioning ($90). The lower fee $55 is the lower negotiated fee between us and the insurance if the insurance will cover this service, in the case were the insurance does not cover it then the UCR fees are in effect. The patient was quoted the PPO fees (the negotiated fees) because the insurance said they cover $1500 but they covered only $750. I think the patient should not be complaining about us they should call the insurance company and ask to have the insurance listen to the conversation between us and them since most calls are recorded. We are not the problem. The fees that I send the patient a statement for is clearly marked as patient responsibility $3225 on the explanation of benefits that came from the patient's own insurance. This amount is what legally we can charge the patient. Again, we are not the problem.
In regards to item #2, the patients wife was talking to the person in charge of handling these issues. The Doctor is above her but does not handle issues like this with the patients. Although my staff and I discussed patients concern and we came to a compromise to give the patient a discount to keep them happy in our office. Why would I give discount if the patient is going to destroy my reputation online? We offered a compromise solution but the patient had ill intention and that is why the decision was made not to grant the discount.
As far as finishing the treatment on her husband, shows the level of care our office delivers. The crown had suboptimal fit and we know the lab can do better so we decided to make a new one that we feel the patient should get. I do not really see where is the crime in delivering the best we can!!
In regard to item #4, again the patient is trying to taint us no matter how. Yes the bill she received reflects the family balance with some pending charges which was explained to [redacted] and that the insurance will pay. If the insurance does not pay then it is patients responsibility.  
As of today the patient owes us $1325 and is overdue and the account will go to collections or even to court if the patient refuses to pay.
Thank you for your cooperation in this matter and please do not hesitate to call on me if you need any assistance to resolve this dispute.

I am rejecting this
response on the following; 
 1. The first original
quote fees were much lower and increased when they billed Blue Shield the
prices were much higher.  When looking at Explanation of Dental Plan
Reimbursement Awnie [redacted] billed for the most part double the prices in
comparison to what we were original quoted. I feel that is unethical business
standards and did not receive billing from my Dentist or Dental plan that have
such a difference in prices. For example on the item comprehensive dental exam
my insurance was billed $90.00 dollars and my fee was $55.00 please see
attached files and compare billings. 
 
2.  When speaking
to one of his office staff I questioned such a major difference and extended a
discount but yet still a difference between the two qutoes were a major
difference. I asked to speak to someone else of higher position and she refused
that I was only to speak to her in regards to the matter. I did inform her that
I would be writing a review on yelp based on my situation. She had no response
and called me the next day to let me know that I was unprofessional and she
would take away the professional discount. At no time was I ever unprofessional
and angry with office staff and offer to sit down and go through each item
charged and she refused and asked that my children not return to the follow up
schedule appointment because Mr. [redacted] did not feel comfortable working with
the children. Mr. [redacted] would finish [redacted] pending work. And yet he went in
on March 11, 2014 and did not finish the work because it was the incorrect size
or fit and schedule for another appointment in April. 
 
3. I notice on the
letter that I gone to another I informed Mr. [redacted] with a certified letter
making him aware of the discrepancies in amounts billed and the adjustments
done without explanations. my intent was never to 
 
 4. After [redacted]
left the office they gave him final notice billing my 8 year old for pending
charges for the family. Please see attachment #6.
 
First Quote see attachment
# 1 
[redacted] fees $2732 -750= $
1982.00 
 
Blue Shield Billing see
attachment # 2 
[redacted] fees $
3975.00-750= $3225.00
These are the two
different billing to me and to Blue Shield. There is  $1243.00 dollar difference? Why
did they add to my account when given a different quote and yes I did sign off that I would be responsible for the first quote and not the second quote. I would like for Mr. [redacted] to honor his contract liked we agree on February 25, 2014. 
 
Sincerely,
[redacted]

Review: I called the office and asked if they accepted my insurance. I gave them all of my insurance information, and they told me that they were a network provider. It turns out they were not a network provider. I was not able to maximize the insurance benefits. On February 04, 2014 the day of appoint and x-rays were done and advice on work that needed to be done and the cost. The staff advice the cost and what the insurance would pay and I signed off that I agree. Staff broke down there price and what the insurance would pay and our responsibility portion. They gave us the estimate of how much it would cost us to continue the work. They quoted me the cost of my husbands procedures, and we accepted terms and made payment of $800.00 dollars that day and would have a remaining balance of $412 dollars in our second visit. The second visit the staff advised us that the cost was three times the amount than what was originally quoted. The office staff told me that the office would reduce it by 50 percent but not off the entire procedure. The staff first deducts the $800.00 before giving me the 50 percent. I insiste that they should honor the original given amount that we had originally agreed on. Or the discount should be the total amount and not after the $800.00 given down as a down payment.Desired Settlement: I would like for the company to honor the quoted amount..

Business

Response:

On Feb 04/2014 Mr. [redacted] visited our office. A full exam was done along with some dental treatment. Mr. [redacted] was giving a good faith estimate for the treatment he received. Mr. [redacted]'s portion was $1,232. This portion is an estimate an just and estimate. Mr. [redacted] signed a financial statement stating that he is responsible for all the balance regardless if insurance pay or not, (copy of which is attached).

The insurance was billed and they paid much less than expected, the explanation of benefits is attached. The explanation of the benefits states that the patient portion is $3,225. When the patient wife received this explanation of benefits she called our office on 02/25/14 and we explained to her that she need to address this issue with her insurance. The patient's wife was very angry and we wanted to help her. She was asked if 50% discount would keep them happy in this office and that we are willing to work with her. She accepted that and we tried to work with her on 02/25/2014.

The patient accepted the good grace discount but had ill intention. On the same day 02/25/14 she send us a fax to refer her husband to a different office thus she is leaving us. Also she acted unprofessionally and posted a slander comment on Yelp to hurt our good standing in the community.

Her ill behavior and ill intention forced us to extend no discount and charge the full amount due. She has the right to express her feelings on Yelp and we have the right to charge the full fees.

Thank you for your cooperation in this matter and if I could be of any help please let me know.

Consumer

Response:

I am rejecting this

response on the following;

1. The first original

quote fees were much lower and increased when they billed Blue Shield the

prices were much higher. When looking at Explanation of Dental Plan

Reimbursement Awnie [redacted] billed for the most part double the prices in

comparison to what we were original quoted. I feel that is unethical business

standards and did not receive billing from my Dentist or Dental plan that have

such a difference in prices. For example on the item comprehensive dental exam

my insurance was billed $90.00 dollars and my fee was $55.00 please see

attached files and compare billings.

2. When speaking

to one of his office staff I questioned such a major difference and extended a

discount but yet still a difference between the two qutoes were a major

difference. I asked to speak to someone else of higher position and she refused

that I was only to speak to her in regards to the matter. I did inform her that

I would be writing a review on yelp based on my situation. She had no response

and called me the next day to let me know that I was unprofessional and she

would take away the professional discount. At no time was I ever unprofessional

and angry with office staff and offer to sit down and go through each item

charged and she refused and asked that my children not return to the follow up

schedule appointment because Mr. [redacted] did not feel comfortable working with

the children. Mr. [redacted] would finish [redacted] pending work. And yet he went in

on March 11, 2014 and did not finish the work because it was the incorrect size

or fit and schedule for another appointment in April.

3. I notice on the

letter that I gone to another I informed Mr. [redacted] with a certified letter

making him aware of the discrepancies in amounts billed and the adjustments

done without explanations. my intent was never to

4. After [redacted]

left the office they gave him final notice billing my 8 year old for pending

charges for the family. Please see attachment #6.

First Quote see attachment

# 1

[redacted] fees $2732 -750= $

1982.00

Blue Shield Billing see

attachment # 2

[redacted] fees $

3975.00-750= $3225.00

These are the two

different billing to me and to Blue Shield. There is $1243.00 dollar difference? Why

did they add to my account when given a different quote and yes I did sign off that I would be responsible for the first quote and not the second quote. I would like for Mr. [redacted] to honor his contract liked we agree on February 25, 2014.