Bite Dental

BiteDental is charging me for a service I did NOT ask for and they're not willing to reconsider.I had a problem with the services offered by my dentist; Dr. [redacted] at Bite Dental.I recently received two fillings from my dentist (8/12/2013). Before the procedure, I asked the dentist's office to verify whether the charge is covered by my insurance and what is my co-pay portion. They told me my portion is $49.20 and I paid that at time of service. Two weeks later, I received a bill from the office stating that the insurance didn't fully cover the remaining part of the bill.After investigation, it turns out the dentist decided to use a "white" filling and the insurance only pays for a "silver" filling.I feel like I am being charged for something I didn't need or ask for. I had no clue what kind of filling he is putting for me and had no idea what does the insurance cover. I didn't even know about white and silver fillings.I tried explaining that to the dentist but he does not care.I am wondering if you can help me resolve this issue because I feel like the dentist wants to charge me for am upgrade I never asked for.Thank you.Desired SettlementI would like BiteDental to admit they should have informed me of the extra cost prior to the service and let me decide whether I need the upgrade or not. Accordingly I would like them to not charge me for a service I did not ask for.Business Response Contact Name and Title: [redacted]- Office ManagerContact Phone: XXX-XXX-XXXXContact Email: [redacted].comTo Whom It May Concern,Bitedental values every patient. We continually strive to administer quality treatment and personalized care while treating our patients as individuals.In regards to this complaint, our response is as follows:Bitedental is a PPO contracted office with this patient's dental insurance carrier. Therefore, we cannot change the covered cost or out-of-pocket expense; that is dictated by the insurance company. Contractually, we are bound to charge the fee for the administered procedure code. As always, we strive to be as accurate and as forthcoming as possible to inform our patients of the recommended treatment and coinsurance levels. However, as with any provider that files insurance as a courtesy for their patients, we cannot guarantee insurance payment. We are, as is the insured, at the mercy of the insurance company. In addition, it is our policy to have patients review treatment plans* prior to scheduling recommended treatment. This allows ample time to discuss any concerns or questions they may have. In addition, we provide a copy for patients to take home as reference when contacting their insurance company.*Treatment Plan Estimates contain recommended treatment along with tooth number & surface, procedure code, fee for service, insurance estimate, patient estimate and the Financial Disclaimer.This patient signed his Treatment Plan Estimate prior to scheduling his appointment. In addition, if this patient would have questioned "white" (Resin-based) versus "silver" (Amalgam) we would explain that our office does not use the Amalgam fillings. By his scheduling the appointment, and his signature on the Treatment Plan Estimate, it indicated he agreed with the presented treatment and all was well.This patient also signed our Financial Policy. This clearly explains our courtesy to file insurance and provide the best possible estimate for out of pocket expenses- but also emphasizes we are not responsible for the outcome of the transaction.We are sorry for any misunderstanding there may have been concerning out-of-pocket expenses incurred due to plan benefit maximums and disclaimers. All our patients receive the highest of quality of care, treatment and his charges are contractually based and non negotiable.We are confident you will find our practices and policies ethically sound. Furthermore, the dissatisfaction is due to our patient's misunderstanding of his insurance benefits and the role we play in filing claims.Below is a copy of our Financial Policy for your review.In regards to this particular patient, after e-mail and phone correspondences, there is no longer an outstanding balance and we believe the matter to be closed.Dr. [redacted] D.M.D., P.A.FINANCIAL AGREEMENTOf Bite DentalFiling Your Claims: As a courtesy to our patients, we gladly file insurance for you. However, we are not responsible for the outcome of the transaction. Your insurance policy is an agreement between yourself, your employer and the insurance company. We are not party to that agreement.Payment Assignment: We ask you to sign this agreement and/or any other necessary documents that may be required by your insurance company. This instructs your insurance company to pay Bite Dental directly, and gives us your permission to release information to the insurance company. If you decline this assignment or your insurance company does not allow payment to come to us, we ask that payment in full be made day of service.Estimated Copay: Your ESTIMATED COPAY is just that, an estimate. Guarantee of payment is not given by insurance companies until the final bill is received and final determination is made.In the event your insurance company fails to pay the estimated amount for treatment received you will be responsible for the remaining balance due. Missed Appointments: If you arrive more than 10 minutes past your appointed time or fail to appear, you will be charged a $50 MISSED APPOINTMENT FEE that must be paid if you wish to reschedule.Returned Payment Fee: If any check or other payment you have made is returned unpaid, you will be charged a Returned Payment Fee of $35. Future payments must be made with cash or credit card.If you have any questions, or would like further explanation of this agreement, please inform our front office staff for clarification.I AUTHORIZE MY INSURANCE COMPANY TO PAY MY DENTAL BENEFITS DIRECTLY TO BITE DENTAL.BY SIGNING THIS AGREEMENT, I HAVE READ AND ACCEPTED THE TERMS AND CONDITIONS.

Bite Dental confirmed to me that my insurance would cover my procedure, and then billed me directly when my insurance denied the procedure.In early 2014, I had recently moved to Morrisville, North Carolina, and began using Bite Dental as it was closest to my home. At my first visit, Bite Dental recommended that I undergo a procedure requiring three additional visits spread out over several months. When I inquired about cost, Dr. [redacted] staff ensured me, quote "You have great insurance and this will definitely be covered." Based on these statements, I went ahead with the procedure.Later in 2014, I began to get bills for a substantial balance, I inquired with Bite Dental as to why insurance would not cover it. [redacted], a staff member, told me that she remembered our conversation, apologized profusely for the mistake, and told me they had actually not obtained pre-approval, although their comments at the initial visit led me to believe otherwise. Despite the fact that they admitted responsibility and acknowledged their errors, Dr. [redacted] refused to waive the balance.I continued with the recommended procedures based on the assurances provided by Dr. [redacted] staff. Despite the fact they have repeatedly admitted their mistakes, no one in the office will take responsibility for the mistakes. Only I have to shoulder the responsibility. Had Dr. [redacted] staff done their job and determined pre-approval as opposed to making statements leading a reasonable person to believe that approval was guaranteed, I would not have continued with the procedures due to the extremely prohibitive costs.Desired SettlementRefund of any amounts paid, if any, to the collection agency, and for my bill to be marked "paid in full".Business Response To Whom This May Concern and to address this complaint,Bitedental strictly adheres to and stands behind our Financial Policy signed by all our patients- yearly. The following quotes are from our Financial Policy - of which this patient signed and dated at his first appointment: "Estimated Copay: Your ESTIMATED COPAY is just that, an estimate. Guarantee of payment is not given by insurance companies until the final bill is received and final determination is made.In the event your insurance company fails to pay the estimated amount for treatment received you will be responsible for the remaining balance due." and"Filing Your Claims: We are not responsible for the outcome of the transaction. Your insurance policy is an agreement between yourself, your employer and the insurance company. We are not party to that agreement."Even with a Pre-Treatment Estimate, insurance companies always have the disclaimer on the estimate, "Pre-Estimates are not a guarantee of payment." Therefore, even if a patient "has great insurance", our staff will not state that a procedure "will definitely be covered." This patient also signed a Proposed Treatment Plan on his initial appointment which he took home for review. This document also clearly states, "Insurance portion is only an estimate. Please use this as a reference when contacting your insurance carrier to discuss disclaimer, co-pay and remaining benefits."He did not begin treatment immediately, and had ample time to contact his carrier to address any concerns or request a Pretreatment Estimate. In addition, we went far beyond what most professionals would consider a reasonable effort. We called the carrier, spoke with management, sent additional documentation, narratives & escalated the appeals process until all were exhausted and kept this patient abreast of the situation.It is unfortunate insurance companies attempt to dictate a patient's treatment contrary to diagnosis. Dr DeStefano, however, evaluates each and every patient and only recommends necessary treatment to promote oral health and overall wellness.