Daniela A. Zambon, DDS, MS, PC

The information that follows is in response to Ms***'s complaint: On August 15th, Chase *** did come in for surgery The patient paid in full what we estimated to be their portion of the procedure based upon what we estimated primary insurance to pay We do accept
secondary insurance but do not factor that into our estimate, only primary and we fully explain that to the patient We also explain that after filing all claims to both primary and secondary, that if there is a credit we will refund the patient to reflect a $balance on the patient's account After Ms***'s secondary paid she did indeed have a credit Shortly thereafter the secondary insurance (Ameritas) requested a refund due to an over payment mistake based upon what primary insurance (Delta Dental) paid We honored the request for the exact amount that they were requesting After the refund to the secondary it left the patient account with a $balance so there was nothing to refund to the patient The patient received their EOB's thinking they had money coming back to them We explained to the patient what happened and at this time there was not a credit on the account She was not happy and felt we should have sent the money to her instead of the sending it back to the secondary insurance We tried to very delicately explain in many ways that it was not her money for us to refund it to Since that time we have refilled her claim to her primary insurance requesting reprocess of the claim with additional information explaining to the insurance that the initial claim was processed incorrectly and they should have paid more We recently got an insurance check back from her primary (Delta Dental) and it has left her with a $credit We have called the patients mother twice to let her know this and that we have also submitted this new information on to her secondary to which there may be additional funds coming from them to give to her We have not had any response to our calls to her regarding this new good information We have been working diligently with the insurance to get this matter resolved and with a satisfactory outcome for the patient We are more than happy to issue a refund for the current credit on her account or wait till more money arrives from secondary Again, we are waiting on a response from the patient's mother as to what course of action she would prefer us to take so that we can again make her happy with the situation and it is resolved to her satisfaction