Bethesda Chevy Chase Dental Care

Sorry for the delay in your reimbursementWe have returned the check that was processed under the incorrect doctorThe fortunate thing is that [redacted] was expedient in processing the first claim so we hope that they can be as efficient on reprocessingWe have sent all information to ***We also made [redacted] aware that you should be reimbursedGenerally, insurances including [redacted] do not reimburse the office for 60-days after the claim is submitted based on those parameters, your case is moving at lightening speedWe're unsure who else can mediate this situation until the paper work is processed by [redacted] You are free to contact the office with further questions or concerns if you see fit.When the claim reprocesses they will reimburse youWe have made certain of thisNo one is being difficult or dishonestIn fact we have been very directAt this point, the money has been refunded to [redacted] and we will resubmit the new claimThank you for your patience.Attached is the insurance claim form for you to submit as you wish, it was resubmitted on our end as well

[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:The proper claim has still yet to be filed. Misinformation was repeatedly given to me and whenever I contacted the office I was disrespected and information was withheld from me. The dental office hasn’t even registered the dentist, Sinclair D[redacted], with [redacted] in order for the proper process to unfold causing more stress on my end as well as my insurance. They are running a scam. 
Regards,
[redacted]

Sorry for the delay in your reimbursement. We have returned the check that was processed under the incorrect doctor. The fortunate thing is that [redacted] was expedient in processing the first claim so we hope that they can be as efficient on reprocessing. We have sent all information to [redacted]. We also...

made [redacted] aware that you should be reimbursed. Generally, insurances including [redacted] do not reimburse the office for 60-90 days after the claim is submitted based on those parameters, your case is moving at lightening speed. We're unsure who else can mediate this situation until the paper work is processed by [redacted]. You are free to contact the office with further questions or concerns if you see fit.When the claim reprocesses they will reimburse you. We have made certain of this. No one is being difficult or dishonest. In fact we have been very direct. At this point, the money has been refunded to [redacted] and we will resubmit the new claim. Thank you for your patience.Attached is the insurance claim form for you to submit as you wish, it was resubmitted on our end as well.

Review: Previously, they held off on billing my insurance for over 6 months, at which point I had a new insurance provider who denied the claim. Recently, I have received 2 blank invoices stating that I owe $100. Each time I called for an explanation and advised that I would not pay without details regarding what it was for. I still have not received a detailed statement and now receive a letter that I will be sent to collections for a $285 balance. I have never received statements for the other $185. I have left numerous messages for the office manager (who only works 1 day per week) and have never received a return call. I verified with our current insurance company, that all services since 9/1/2012 have been paid in full by both our insurance and our patient responsibility. Whatever they are billing for now (December 2013), is from prior to 9/1/12.Desired Settlement: There is an amount of $285.00 the company is indicating is past due. This matter can be resolved by removing that balance and providing me with a copy of all of my family records (me, my husband, and our three children) to enable us to find proper dental care elsewhere.

Business

Response:

Dec. 16, 2013

Dear Sir/ Madam

We are writing in response to a complaint made by [redacted].

Please take into consideration, the patient had signed our financial policy, which is stating: "Your insurance policy is a contract between you and your insurances company and we file your claims as a courtesy. If your account has not been paid within 45 days,

balance will be due in full by you,regardless of insurance status"

The patient has informed you, that our company has held off billing her insurance for 6 month, which is appropriate considering that this particular service is not a covered benefit under patient's insurance. The patient was informed of that fact prior to services. We would like to clarify the situation by providing a brief explanation of why the patient has received the statements in question.

The patient [redacted] daughter) received a service on 9/17/11 in total amount $900, which is not covered service by her insurance, on date of service [redacted] paid $525, leaving a balance of $375 on the account. Our office on 11/3/11 faxed a letter with explanation of her remaining balance; we have a copy of this letter in the patient chart, on 12/30/11 the patient made a payment of $275, leaving a balance $100. Bill and statement regarding the $100 balance was sent one more time on 6/26/12, prior four mouths to patient switching insurance provider.

On 6/11/12 the patient had a panoramic x-ray done, which was a medical necessity, and the bill to the insurance company was sent on the same day, however insurance company did not pay for the x-ray due to similar service was done within three years. We can waive this charge as a courtesy.

On 3/16/13 we have billed the [redacted] a $50 "no show” fee, which company policy is regarding appointments which were not canceled within 48 hours. We can also waive this charge as a courtesy.

However the patient still has a balance of $100, which we are required to receive. Unfortunately, [redacted] did not wish to accept an explanation of her account balance from our assistant manager and continued to request only speak with our office manager, who has not been available at this time.

We hope this clarifies the situation and we apologize for any misunderstanding.

Sincerely,