Cellar Door

My original response to [redacted] ***'s claim continues to be my response and explanation of the codes filed by our Practice.We are a specialty dental firm, our specialty is endodontic treatment/therapy All of our doctors have completed dental school and their endodontic specialty program We use similar codes as dentists and we work with the patient's insurer to provide payment for services rendered The codes used were not fabricated and as specialists we provide a full description of the care provided with the use of coding.In closing I do not appreciate [redacted] ***'s accusations about our practice and question his reasoning for bringing this complaint public, several years after treatment We treat our patients in a respectful and sensitive manner and regret that [redacted] does not understand the complexity of the treatment and care provided on his behalf by our staff and doctor

I understand [redacted] **'s frustration, we have tried to work with her over these last months There is a form all patients complete which refers to payment, this form is signed by the patient before the patient sees the dracknowledging he or she is responsible for payment In today's health care environment the patient must be an advocate for their care thus I can't imagine the doctor did not explain the procedure in detail knowing the extent of the treatment and [redacted] **, at that time did not ask questions This was a rather detailed treatment that no doubt was explained to [redacted] and also her General Dentist, if she had one at that timeThe Business Office is the administrative end of the practice and is responsible for receiving payments and applying such to treatment received It appears to me [redacted] has an issue with the doctor and this matter should be forwarded to him, which we have done on several occasions for her At this time we can do little else Payment is still expected, at this time the patient, [redacted] **, is in arrears

Tell us why here.. I have reviewed the complaint from [redacted].  His allegations that the wrong codes were used and that we used these codes for profit is simply wrong.  Upon checking with our Insurance Specialist, the code [redacted] is used by [redacted] for an evaluation limited to oral health...

problems on a focused area.  Specifically, in this case, tooth #4.   We could have used the code [redacted], however [redacted] prefers we use code [redacted] for such examinations.  Additionally, the code [redacted] is a calcification code and it is not covered under [redacted]’s [redacted] PPO.  This code was explained in his treatment plan which he signed and is can be sent to you upon request.  Finally, in response to [redacted]’s allegation that [redacted] is a duplicate code, it is not.  This code represents a pulp vitality test which our doctors do to determine the need for root canal therapy/treatment.  In this case, [redacted] received such treatment, the cost was $58.00 and the patient, [redacted], was responsible for this payment according to [redacted], his insurance provider.I noticed [redacted] had his root canal treatment in December of 2014.  This was quite sometime ago.  We do maintain records of all our patients and it was these records I referred to for [redacted]’s complaint.  The doctor who performed his root canal treatment has since left our practice.  Additionally, something to keep in mind is that we are specialty practice.  Many times patients confuse our services with those of their general dentists.  Our practice only specializes in endodontic treatment.  We do use similar and at times the same codes of the general dentist for certain aspects of the patient's visit and treatment.  Nevertheless, our treatment is specialized to endodontic care.Please let me know if you have any further questions regarding this case.

My original response to [redacted]'s claim continues to be my response and explanation of the codes filed by our Practice.We are a specialty dental firm, our specialty is endodontic treatment/therapy.  All of our doctors have completed dental school and their endodontic specialty program.  We use similar codes as dentists and we work with the patient's insurer to provide payment for services rendered.  The codes used were not fabricated and as specialists we provide a full description of the care provided with the use of coding.In closing I do not appreciate [redacted]'s accusations about our practice and question his reasoning for bringing this complaint public, several years after treatment.  We treat our patients in a respectful and sensitive manner and regret that [redacted] does not understand the complexity of the treatment and care provided on his behalf by our staff and doctor.

To Whom It May Concern,Regarding this former patient and her complaint.  Her treatment took place in the summer of 2015. We tried to work with this patient regarding payment and researched the complaint several times which resulted in a response that she found unfavorable.  Prior to...

treatment, she agreed to the work recommended by the doctor and signed all pertinent forms which included the form to provide payment.  It is our understanding the doctor provided a detailed explanation of her dental needs.  This resulted in a detailed description of the areas needing dental work within her mouth.  She agreed with the doctor regarding treatment and treatment thus commenced.Regarding my action in this case I was out of the office for a period of 4 plus weeks from January till late February due to medical leave.  Upon my return I did contact [redacted] and proceeded to let her know I would further research her case and questions.  This research included a call to the dr. who performed her surgery.  Upon talking to Dr. [redacted]'s doctor, he refused to further negotiate her balance and commented she understood the detailed description of the treatment and agreed to such treatment and costs before treatment began.  Dr. [redacted] is no longer with our practice and this too was told to [redacted]. After our Business Office spoke with the Dr. I then suggested that [redacted], speak to the Dr. herself and proceeded to give her his new contact number.  At this time I do not know if this took place.  (As added information please note I did explain to [redacted] that all billing issues should be directed to our Billing Office and I would assist as best as possible. I recall leaving two messages for her to explain the issue further.) I explained at length, as did our business office, that we did the best we could to resolve her issues but payment was still needed for her surgery per the Doctor's insistence.  The only person who can adjust this payment would be the doctor, he is no longer with our practice and appears to hold firm on his decision.  At this time there is little else we can do to assist in this matter.

[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 Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:Assuming I signed the form saying I am responsible for payment, I am in compliance as I completed payment for the amount quoted to me in writing on 27 April 2015.  I understand the business office position but they cannot collect the fees over and above what was quoted to me on 27 April 2015.  The establishment cannot tell me one cost for the treatment and then trying to collect a different and higher cost. I am still asking for the documentation that shows the quote that resulted in the higher fees that the business is trying to collect.  BACGROUND:  On the 27 April 2015, I came to their office for a consultation and the Doctor explained to me what I needed and I was given a printout with the amount that I am responsible to pay.  At that time, I also double-checked with the Doctor, in front of the office clerk, on the amount to make sure it included everything we had discussed.  The doctor confirmed that it is all included and I agreed with the amount that was on the printout which was $1650.80.    We proceed with the treatment and two thirds of the treatment their office raised the prices and told me what was given to me is only 1/2 of the procedures. This is not proper business conduct.  Making me responsible for the amount much higher than what I was given as a quote is unacceptable.  When I asked for proof that I signed or agreed to the amount they are trying to collect now that office ignored me and kept claiming I did sign and agree to the cost but in reality I didn't? Something is very fishy and appears to be bad business practice from this establishment.  They tried to bill me more than what they quoted me and what I agreed to.  It is frustrating when I took the initiative to solve the problem when their office made the mistake since July of 2015 which is almost one year ago.  I have been waiting patiently and they ignored my request for proof they claim they provided me and I signed which I never did.  So, saying they try to work with me is not accurate. Additionally, this mistake was made by either the Doctor or the desk clerk and neither of them is currently employed at this office.   The billing office and the office manager are part of the company.  They can’t claim they are only on the administrative end and only collect--even the amount is erroneous!  They can’t keep on quoting office policy and what was supposedly done but have not been able to help me with the proof that I signed and agreed to the cost. Regards,
[redacted]

I understand [redacted]'s frustration, we have tried to work with her over these last months.  There is a form all patients complete which refers to payment, this form is signed by the patient before the patient sees the dr. acknowledging he or she is responsible for payment.  In today's health care environment the patient must be an advocate for their care thus I can't imagine the doctor did not explain the procedure in detail knowing the extent of the treatment and [redacted], at that time did not ask questions.  This was a rather detailed treatment that no doubt was explained to [redacted] and also her General Dentist, if she had one at that time. The Business Office is the administrative end of the practice and is responsible for receiving payments and applying such to treatment received.  It appears to me [redacted] has an issue with the doctor and this matter should be forwarded to him, which we have done on several occasions for her.  At this time we can do little else.   Payment is still expected, at this time the patient, [redacted], is in arrears.

[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:Dear Revdex.com,  re: VS Greater Washington Endodontics, the response from the business is again absolutely not acceptable and NON responsive.Its reply reads “several years after treatment”, I am stating here again, I have attempted to contact this business, in person, by phone, by email, time and again more than 20 times, with absolutely NO response for months. You can verify with Ms. Katie (and other ladies) that works at the front reception and receiver of my emails.The complaint is the dentist used the wrong code, the business previous reply was [redacted] Insurance told them or suggested to them to use the wrong code. I have shown you after checking with [redacted] that [redacted] does not suggest or in any way tell the dentist what codes to use. This business just does not admit it make the mistake.The complaint is the dentist charged me for procedures that according to [redacted]’s determination is part of the main procedure that is already paid. Just in case this point is not clear. This dentist is IN-Network with [redacted] Dental Insurance, and thus this dentist has agreed to the terms of [redacted] or is under contract to [redacted], the dentist cannot pick which [redacted] claim determination to accept and which one to reject. The dentist accepted [redacted]’s claim pay out for [redacted] (root canal), he cannot reject [redacted]’s determination that the claims [redacted] and [redacted] are part of the root canal procedures and thus already been covered and paid, I should not be charged for these. [redacted]’s determination of the claims were shown in previous reply and attached below.The complaint is this business may have “fabricated” or “created” my signature on the procedures approval listing or approval form that this business produced. I have shown you a copy that does not have any signature and I state this again, I was NOT consulted or discussed by anyone or I have approved any of the procedures shown.The complaint is this business charged my credit account, for the said 3 procedure claims after [redacted]’s determination some time later, without consulting me or ask for my approval, is this a violation of some consumer law or is it a “crime”? Hope this makes sense.
Regards,
[redacted]