Central Connecticut Oral Maxillofacial & Implant Surgery, PC

Prior to *** our office calls our patient's insurance company to get an estimate of how much the patient is going to pay for ***, and how much the insurance company is going to pay For this patient we called twice because they changed their insurance prior to the procedure We
explain verbally and in writing to all of our patients this is an estimate and not a guarantee of payment In this case the issue is between the patient and their insurance company, not our practise
I have attached our financial agreement that clearly states "It is your responsibility to pay any deductible amount, co-insurance or any other balance not paid for by your insurance company." And our treatment plan that says how much the procedure costs if insurance covers nothing and states "This is not a guarantee of payment you are ultimately responsible for all charges Insurance is a contract between the patient and the insurance company and there is no guarantee of payment." Both of these agreements were signed by the patient prior to the procedure
In this case the insurance company told us prior to the procedure the patient portion of the bill was $ This is what we told the patient and this is what the patient paid the day of the procedure After the procedure was completed the insurance company said the patient portion was $and the patient owed an additional $1101! This was not a clerical error made by my staff, it was a decision made by the insurance company.
Our practise employs a nationally recognized dental billing company They handle all of our insurance claims and accounts receivables Their business is to hold insurance companies accountable for the amounts they are supposed to pay and specialize in dental insurance On this patients behalf, they have made multiple calls, filled multiple appeals and spent the last months dealing with this patient's dental and medical insurance companies trying to obtain payment They have been unable to do so
When I was made aware of this issue I personally (Dr***) called this patient twice to try and resolve the issue and did not receive a call back I am very understanding in these situations and am usually able to work with the patient and obtain a mutually agreeable outcome In this case the practise and I have done everything possible to try and remedy the situation.
Sincerely,
*** *** DDS, MD