Ballwin Dental Care

This complaint is due to processing errors on the part of Mr [redacted]'s insurance company. All claims have been filed correctly by our office, and resubmitted several times.For one of the dates of service, the insurance company issued the payment directly to the patient, rather than sending...

the payment to us as requested on the claim. When we did not receive payment from the insurance company within a reasonable amount of time, we called the insurance company to follow up. At which time we were informed by the insurance co service rep, "the payment has been sent to the patient, and I cannot give you any information." We did bill the patient multiple times for the payment. We did threaten to send the account to a collection agency when the patient was unwilling to pay us. We have had multiple issues with claims being "keyed in" incorrectly by this insurance company. When a paper claim is received, someone has to manually key it into the insurance companies' computer system. We have seen several data entry errors on the part of this insurance company. Our claims are computer generated, taking the services and dates of services information directly off the patients' account information. The patients' wife, [redacted], contacted us and stated we had filed another claim incorrectly, stating the claim was filed with a service date of 2014. The claim was denied by the insurance company, with the insurance company stating the patient did not have coverage with them in 2014. We explained to [redacted], there is no way our computer would be able to generate a claim with a date of service of 2014 for [redacted], especially since he was not a patient here in 2014. The date of service was 4-14-17. Therefore, the insurance company must have keyed the date in incorrectly when entering the claim into their system 2014 instead of  4-14-17. We did resubmit the claim with the correct date of service. We have filed all claims correctly. The errors and denials are due to claims and claim information being processed improperly by the insurance company.ALL CLAIMS HAVE BEEN SUBMITTED CORRECTLY.I have attached copies of our email correspondence with [redacted].Please feel free to contact me if you have any further questions.Sincerely[redacted]Office ManagerBallwin Dental Care