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Davison Rugs Reviews (1)

Initial Business Response /* (1000, 6, 2016/03/22) */
To Whom Ever It May Concern:
This letter is in reference to the complaint file with your office date March 10, 2016, by the above patient. On her initial visit patient stated that she had been permanently released from her previous dental...

office and that she is unable to return back to that office because she was asking questions about insurance, On July 23, 2015, we accepted her as a new patient in our office. Patient insurance company was then contacted to verify insurance coverage as well as eligibility. since patient had x-rays done at previous dentist and because patient insurance only coverage a [redacted] set of x-rays every three years to date.
On July 29, 2015, patient came in and impression were taken for upper and lower immediate dentures. On August 20, 2015, upper and lower dentures were delivered. Patient was informed that over time the her ridge will continue to shrink and that her dentures may eventually need a reline, tissue conditioning and adjustments as a result of her bone ridge shrinking due to not having any teeth and the patient understood. At this point, patient has paid no money out of pocket to the office. All money had been collected from the patient insurance. On August 31 & October 7, 2015, patient came in for tissue conditioning for her denture, which patient paid [redacted] per visit according to her insurance contracted fees. On October 22, 2015 patient return because of sore spot and at this time tissue conditioning was done at no cost to the patient. Patient stated that she felt comfortable and was satisfied. Patient was then given post-operative instruction and told to contact the office as needed for adjustment.
From this point, patient has not been in contact with the office regarding any adjustments until March 1, 2016, in which she stated that the dentures were loose and she has a few sore spot. At this time patient was given the option to do a chairside reline or a lab reline. With the lab reline patient was told that she would be without the demure for a couple of days. Patient refused the lab reline because she did not want to be without her dentures. Patient then requested a chairside reline. At this point patient insurance was contacted and the office was told by her insurance that

ehairside reline were not covered. but the lab were covered. Patient still declined lab reline and wanted the chairside reline. Patient was given a quote for [redacted] for the cost to do the ehairside reline. The patient accepted the cost and wanted to proceed with treatment, Patient reline was completed and patient was told to contact the office if she needed any additional adjustment,
On March 10, 2016, patient insurance company called and stated that the patient had made a complaint regarding the office performance of her dentures. Patient told insurance company that she had been in pain since that Friday and that no one in the office returned her call. I informed the insurance company that we have an emergency number that is answered 7 days a week in the event of an emergency. Patient also stated to the insurance company that she paid for the dentures and all treatment since becoming a patient and that we had no billed anything to the insurance, I explain to the insurance company that if they check there records that they would see that they have paid the office $1209.28 and patient has paid [redacted] for services that they stated are not covered under her insurance guidelines. The insurance representative verified and confirmed our statement to be correct and then said she will contact the patient. I also explain to her that we were told that chairside reline were not covered, She then stated that she would check into and give me a call back. The representive called me back and stated that chairside reline would be covered and I immediately billed it out to the insurance and told her once we receive payment we would send a refund to the patient.
In light of this situation, the patient has to understand that she had all of her natural teeth removed due to poor oral hygiene. As a result she has to understand that dentures are something that she will need to get used to. Her complaint of soreness is to be expected with dentures, and as time go on with proper adjustment she will get use to them.
As in reference to the patient request for a refund. Our office provided quality services to the patient. We will not be reftinding any payment that the insurance company has made. In additional the payment that the patient made in the amount of [redacted] for the chairside
we will refund half of the amount since we were able to get the insurance company to pay the other half. A phone call was made to the patient and the patient has refuse to speak with us, however, patient husband was not willing to accept the amount of [redacted] the different in what the insurance did not cover. He states he would like to contact his insurance company because that amount is too low.
Patient received an upgraded denture from what her insurance did not pay for in which we did not charge extra for, so that she did not have to walk around without teeth while her denture was being made, Our office has done everything to accommodate this patient in regards to proper fitting of her upper and lower denture.

Respectfully,
Dr. [redacted] Dental bg
Initial Consumer Rebuttal /* (3000, 8, 2016/03/23) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The response provided by Allusion Dental is both a gross distortion of facts and outright fabrications. Allusion signed a contract to be a medicaid provider to eligible patients, as part of this contract they agreed to accept payment set forth in the payment schedule provided by medicaid. Also by the rules of this contract they are prohibited from collecting any fees form the patient that occur from provided services that are covered by medicaid.
Allusion has openly admitted that I am a medicaid eligible patient, furthermore the dental insurance has verified in multiple phone conversations that the services provided by Allusion Dental to include all temporary relines and chair side permanent relines are covered services and no money should have ever been collected by the patient. Allusion openly has admitted to collecting [redacted] which they were never entitled to in violation of medicaid rules.
Allusion Dental has billed the insurance for payment and now refuses to refund the money they never should have collected. They have tried to blame the insurance for their lack of knowledge of covered services and engaged in false statements acting as if the refund of this money is some sort of negotiation.
Allusion has engaged in behavior that violates both state regulations and Hippa laws, to share with a third party the reasons why you required your patients services with out prior written authorization is a crime, and than to phrase it in a personal attack is unacceptable. This behavior is in violation of the Standard of Professional Conduct that every medical professional is to abide by.
I reject Allusion Dental"s response and demand the refund of all monies paid by myself. There has never been a request to refund money paid by the insurance as stated by Allusion, the only claim is to the money paid by myself which they never should have collected.

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Address: 39 Pilgrim Pathway, Ocean Grove, New Jersey, United States, 07756-1536

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