Center for Oral Surgery

January 20, Dear [redacted] ***,I am writing in regards to [redacted] ’s complaintAttached will be a documents from ***’s Health FileThis information should not be shared with the publicI am sending it to you to show the account has not been forwarded to our collection agency, [redacted] ’s was told she could make monthly payments and if she does not it will be forwarded to our collection agencyThe services were performed and the patient was notified that our office was not par with her Insurance companyIt is also the patient’s responsibility to know what offices are par and not just the providers.Please contact our office if there is any additional information needed.Sincerely, Sherry G Billing Supervisor

This is in response to a letter our office received today from the Revdex.com with I.D. [redacted].  A copy of this letter is attached.The facts of this account are as follows:This patient's account has a balance of $992.00.  This office has actively been pursuing benefit...

payments from the patient's insurance company.  The insurance company incorrectly processed this claim after the first filing.  we are now in the process of following through to have the claim reprocessed with the complete and correct benefit.  Once we receive the benefit payment from the patient's insurance company we will bill the account's responsible party for any balance or return any over payment that was made by the same.Please contact our office with any further questions.

January 20, 2015
Dear [redacted],I am writing in regards to [redacted]’s complaint. Attached will be a documents from [redacted]’s Health File. This information should not be shared with the public. I am sending it to you to show the account has not been forwarded to our collection...

agency, [redacted]’s was told she could make monthly payments and if she does not it will be forwarded to our collection agency. The services were performed and the patient was notified that our office was not par with her Insurance company. It is also the patient’s responsibility to know what offices are par and not just the providers.Please contact our office if there is any additional information needed.Sincerely,
Sherry G
Billing Supervisor

Review: On 11/7/2013 my daughter [redacted] signed a Treatment Plan with this business agreeing to pay their estimation for services of extraction of widsom teeth to be performed on 12/2/2013. The amount of their estimation was $405.00. I am the insurance holder, I have medical insurance with [redacted], ###-###-####, and dental insurance with [redacted], ###-###-####. From the day we agreed to pay their estimation, I believed the amount owed for services should be less. I was given a very hard time by the staff handling the matter on the day we signed the agreement. On 11/7/2013, we paid $15.00 for the co-pay & $405.00 for their estimation of the total cost owed by the patient. My daughter received the services on 12/2/2013, I called my dental insurance company to find out what my cost should be. They initially told me $200.00 total, then on 12/16/2013 I was told according to the pre-determination they received, they may have to pay $864.00 & I would have to pay $355.00, however, since they had not received a finanalized bill, they could not provide me with an exact amount. I phoned Center for Oral on 12/11/2013 and was told they mailed her claim on 12/2/2013, that same day, [redacted] told me to date they had not received a claim, only a predetermination IVR # [redacted] is the claim number. Today 12/22/2013, I contacted [redacted] and was informed to date they still have not received a finalized bill from Center for Oral. I called Center for Oral, spoke with someone by the name of [redacted], I asked her when they sent the finalized bill to my insurance company, she replied 12/11/2013, I informed her that to date my dental insurance had no received anything stating this was a final bill. [redacted] repeated they had sent an explanation of benefits from my medical insurance provider, which she told me is called a Coordination of Benefits. I asked [redacted] what the amount was they are charging my dental insurance company, [redacted] refused to answer and transferred me to a voicemail.Desired Settlement: I would like to be refunded the entire overpayment that was obviously paid to the provider on 11/7/2013, along with copies of the statements sent to both my medical insurance carrier & my dental insurance carrier. I would also appreciate an apology letter for the inconvenience this caused financially, along with an apology for the treatment my daughter received when she attempted to call to schedule her consultation & was treated very poorly by staff.

Business

Response:

December 30, 2013

Dear [redacted],

1 am writing in regards to **. [redacted]’s complaint. Attached will be documents from [redacted]’s Health File. This information should not be shared with the public. I am sending it to you with information blacked to prove the dates in service are correct and incorrect in her statement.

The patient was seen in our office on November 7, 2013 for a consult. We only collected $15.00 for the medical co-pay due at the time of office visit. They were given a treatment plan asking for $405.00 down. The treatment plan clearly states it is an estimate, not a guarantee of coverage. It is done as a courtesy for our patients. We explain to them if we collected to much then after ALL insurances pay we will refund, as well if the patient uses more than there maximums and if deductibles were not met then they may be billed an additional amount. The monies in question were paid on December 2, 2013, the day the services were performed. The Medical Insurance was billed that day. Claims are sent on paper. We received payment from them on December 11, 2013. The dental Insurance was then billed. When we send a dental claim as secondary to any dental Insurance Company we have to send it paper. We are not allowed to bill both dental and medical at the same time. That is against Insurance regulations and our contract with both medical and dental carriers. Once the dental Carrier pays on this claim we will be happy to refund **. [redacted]’s daughter who is over 18 for her payment that was received in our office on December 2, 2013 not November 7, 2013 as [redacted]. [redacted] claimed was her date of payment.

Please contact our office if there is any additional information needed.

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because:

I called [redacted] on January 2, 2014 after receiving the response from Revdex.com. I was told [redacted] did not receive a FINAL determination until December 26, 2013. I believe they put off submitting the claim because they were well aware they overcharged. As far as the comment regarding my daughter being over 18 years old, it is MY insurance they are dealing with, not hers. I have had nothing but runarounds from this so called place of business and had I read their reviews online, I never would have used their service a 2nd time. I want my refund immediately, I am truly tired of waiting around for these people.

Regards,