Clark, William E Dds

Dear Revdex.com [redacted]. [redacted], D.D.S., Inc. 5777 N. Fresno, Suite 110 Fresno, CA 93710 (559) 435-3111 I'm responding to complaint ID # 12307968 dated 8/3/2017/. [redacted] has been a patient since 11/2512015 for her first appointment and second and final appointment...

was 6/6/2016. A copy of her account is enclosed. Ms. [redacted] was a patient of Dr. [redacted]'s when he retired and I acquired his practice. I acquired his patient treatment records and if the patients wanted to choose me as a dentist, we accepted them. Dr. [redacted] and I have no contractual agreement to treat his patients or to accept his billing practices as to how and who he charged. Ms. [redacted] contacted our office and we accepted her as a patient. I am a provider for Guardian Insurance and I am not under contractual agreement with them, but I have other patients using Guardian and bill their insurance plans as a courtesy with the understanding that the patient is responsible for their co-payment and deductible. My patients have all made an educated choice concerning their insurance and out of pocket expenses if they remain in my practice. Because I accept Guardian Insurance does not mean I am a provider writing off 50%-80% of the cost. We help patients understand their insurance which can be a difficult task due to all of the variations. We are not responsible for the contractual agreement patients have with their Insurance Company. We never told Ms. [redacted] that I was a provider, only that we accepted Guardian and the patient is responsible for the difference of what the insurance does not cover which includes co-payment. Ms. [redacted] records are correct for the dates and times of her only 2 visits and for the amount charged. I did write off $46,00 as a onetime courtesy at my discretion for being a new patient. Ms. [redacted] lack of understanding for the new patient charge was explained to her. Even though she was a patient of Dr. [redacted]'s for 19 years, I have a moral, legal and professional responsibility to know all medical information deemed necessary to accept and treat her as a new patient. These are my findings as I do not accept second hand medical information. Therefore the justification of the $46.00 charge. Ms. [redacted] questioned the terms of a possible agreement I had with Dr. [redacted]. I acquired Dr. [redacted]'s patient records only. I have no business, finical or fiduciary agreement with Dr. [redacted] as Ms. [redacted] alleges. There was never any assumption that any or all of Dr. [redacted]'s patients would transfer although more than 90% did. Shandon nor I ever said that Dr. [redacted] was not a member of Guardian Insurance due to the fact we retained an EOB statement (Explanation of Benefits) of his from Guardian showing personal responsibility of $70.00 from Guardian Insurance for Ms. [redacted]. Ms. [redacted] was told by Shandon that since the outstanding account was turned over to collections after a year of nonpayment, all financial questions had to be directed to the Collection Agency and I would not be contacting her. In the 12 months prior to being turned over to collections she contacted our office one time in regards to her balance. After receiving approximately the third statement, she inquired why she had a balance due. Shandon then explained to Ms. [redacted] it was due to her deductible of $100.00 that was applied to payment and Dr. [redacted] is not obligated to cover the deductible. As a courtesy again, Shandon took off finance charges and Ms. [redacted] was to mail in payment in full. Ten months went by with no payment and she admitted to receiving statements from us to Shandon prior to the account being sent to collections. Again, as Ms. [redacted] found out correctly from Guardian Insurance that I am not a non-contracted Dentist for her dental plan. I do accept insurance payments from Guardian when patients properly understand their insurance company and agree to any co-payment as stated on their EOB. This contractual agreement is between the patient and the insurance company, not between the patient and a dental office. Ms. [redacted] wrongly assumed our office was an extension of Dr. [redacted]'s and our business practices were the same even though explanations were given to the contrary. Because I agreed to take over Dr. [redacted]'s patients of record, no agreement was ever made or implied to have a business model the same as his. Ms. [redacted] was sent statements every month since June 2016 which she acknowledged receiving. She has not sent in a payment for over 12 months_ There is no dispute over treatment being done, or the validity of her insurance or the correctness of the insurance payment. Ms. [redacted] came to us on her own free will and accord. In closing, I am a member in good standing with the Fresno-Madera Dental Society, The California Dental Association, and the American Dental Association for 42 years. I accept insurance plans if they give the patient a choice as to where they want to have services done. Ms. [redacted] knew from 11/25/2015 that we would bill her insurance as a courtesy to her but we were not a contracted provider for her dental plan and she would be responsible for the deductible and co-payment. Whether she paid her personal responsibility portion with Dr. [redacted]s office or it was written off we don't know. For some reason she decided she was not going to pay any portion of her current balance. As it clearly states on her EOB from 6/6/16, Patient's responsibility is $181.60 and benefits are based on the use of a non-contracted dentist. My office provided Ms. [redacted] with services, If she was not aware the first time my office was non-contracted, it clearly was provided to Ms. [redacted] the second time and once again I offered her the courtesy to take care of her co-payment but would not cover her deductible. She was aware of her balance and choose not to contact our office for 12 months until receiving a letter the from collection agency. It is within the collection agency's jurisdiction to properly collect for nonpayment once it was turned over to them and not my financial responsibility anymore. Sincerely, [redacted]. [redacted] DDS