Darrell B. Sims, DDS, PC, Oral Surgery & Maxillofacial

In response to your letter dated January 1, the following had procedure occurred.The above patient was referred to my office on March 7, for the "valuation of on impacted canine tooth number and the extraction of tooth letter C.Weproceeded to submit a
pre-authorization to the state Medicaid planThe treatment plan was denied, as a non covered benefit.April 11, 2014, Patient returned to my office for treatment, as a courtesy Dr*** charged her AHCCCS reimbursement prices giving the patient a significant discountI proceeded with the extraction of letter C and uncover/exposure with a chain and bracket to tooth number using a nitrous oxideThe surgery was unremarkable and with no complicationsPatient did not return for any post operative visits.November 12, 2014, the orthodontist emailed our office stating their office had been activating the chain and removing links and had movement since July They also stated the bracket was no longer attached to tooth number 6.Patient's mom phoned our office after eight months of orthodontic activation to reschedule treatment, informed mom that there would be a charge to re-cement the bracket and the use of nitrous gasThere is no guarantee the success for the repositioning of an impacted tooth.Patient was scheduled on February 3, prior to receiving this formal complaintWe phoned patient canceling and dismissing her from our office

In response to your letter dated January 1, 2015 the following had procedure occurred.The above patient was referred to my office on March 7, 2014 for the "valuation of on impacted canine tooth number 6 and the extraction of tooth letter C.We. proceeded to submit a...

pre-authorization to the state Medicaid plan. The treatment plan was denied, as a non covered benefit.April 11, 2014, Patient returned to my office for treatment, as a courtesy Dr. [redacted] charged her AHCCCS reimbursement prices giving the patient a significant discount. I proceeded with the extraction of letter C and uncover/exposure with a chain and bracket to tooth number 6 using a nitrous oxide. The surgery was unremarkable and with no complications. Patient did not return for any post operative visits.November 12, 2014, the orthodontist emailed our office stating their office had been activating the chain and removing links and had movement since July 2014. They also stated the bracket was no longer attached to tooth number 6.Patient's mom phoned our office after eight months of orthodontic activation to reschedule treatment, informed mom that there would be a charge to re-cement the bracket and the use of nitrous gas. There is no guarantee the success for the repositioning of an impacted tooth.Patient was scheduled on February 3, 2015 prior to receiving this formal complaint. We phoned patient canceling and dismissing her from our office.