Dental Associates of Northern Virginia

RE: ) ***Dear *** ***:The patient had a change of insurance and did not provide her new insurance until she arrived at her appointment, By the time, insurance verification was completed, patiënt was already on the chair, receiving treatmentPatient was upset to later find that her new
dental insurance Was Out of networkAt that point, we had honored the patient with IN network fees, even though we were OUT of networkWe charged patient her estimated portion for the procedure and then billed her insurance for the remaining portion at the in network feesInsurance came up short with their payment and it was thenthat we billed patient for the remaining balance that her insurance failed to cover.Patient's husband became upset because he believed we were billing her twice for the same procedure after they had made their initial estimated paymentHowever, due to patient's financial difficulties, the doctor has decided to write off patient's balance of $as of today.Regards,Sherry H

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

April 24, 2014
To Whom It May Concern:**. [redacted] came to our office for periodontal services, which according to **. [redacted]’s insurance company [redacted] are covered at 80%.Procedures performed totaled $2,275.00.  Including the deductible, it was estimated by our office that...

**. [redacted]’s out of pocket would be $495.00, which he paid at the time of service.The formula for his insurance payment is as follows: Charges ($2,275.00) - Deductible ($50.00) X 80% = $1,780.00, therefore his responsibility is $495.00.Our Surgeon performed the following procedures:[redacted]#21, [redacted] #22, [redacted] #22, which [redacted] for benefit purposes took the liberty of changing procedure code [redacted]65 to [redacted]73 for reimbursement purposes. Please know that a consultant that has never seen nor examined **. [redacted] makes this decision.The $900 statement is actually $866.40 to be exact. **., [redacted] received the statement with charges of $2,275.00 — patient payment of $495.00 — insurance payment of $913.60 = $866.40.After **. [redacted]'s phone call to our office, our billing department was contacted immediately. There was an error on our part, and **. [redacted] was not given the adjustment he was entitled to. Upon receiving payment from **. [redacted], we were under the impression that our communication was understood and the situation was resolved.I will also be sending **. [redacted] a copy of his account ledger, explanation of benefits as well as his insurance benefits break down. In instances like these where an insurance company has downgraded a patients benefits, we always encourage our patients to discuss discrepancies with their insurance carrier.Please let me know if you shall have any farther questions.
Sincerely,

Review: [redacted] Associates’ attempt to collected more money by claiming I have received a service which I didn’t or misrepresenting procedures.

In 2011, I changed a dentist and went to [redacted] Associates located on [redacted], Suite [redacted] because they are too close to where I work, and requested a deep cleaning service. [redacted] was my new dentist and he told me he had to take a full-mouth x-ray. I told him that my insurance won’t cover for it because I recently took a full-mouth x-ray with my previous dentist. Then he asked me to request a copy of the full-mouth x-ray from my previous dentist and I did. My previous dentist emailed **. [redacted] the digital file of the full-mouth x-ray. Therefore, **. [redacted] took only a bitewing x-ray and gave me a deep cleaning on October 18 and 25, 2011 and I paid my deductions at front. However, few weeks later I have received a balance bill, and when I asked what it was for, they said that I took a full-mouth x-ray and my insurance didn’t pay the whole bill. After three phone calls and explanations that the full-mouth x-ray they have in their system was what was emailed from my previous dentist, they remove the charge from their system.

Because of this, I was disappointed and hesitated to go back to them. However, after they contacted me multiple times, by phone and email, to make appointment for the regular cleaning service (Please see the attached screen-shots), I decided to go back but requested to see a different dentist because I thought **. [redacted] was responsible for what happened. I made appointment for October 18, 2012 to see **. [redacted] for regular cleaning. Since I already had a completed deep cleaning on October 2011, I had no need for another special treatment or did not request any other treatment except for the regular cleaning. I also made that clear to **. [redacted]’s assistance that performed the cleaning in the beginning. We had no discussions about the need for any other treatment other than regular cleaning at all. The only thing she said to me regarding the procedure was that she is **. [redacted]’s assistance and will do the cleaning and **. [redacted] will come at the end to check my tooth. And as she said, he came after the cleaning was done and briefly looked at my tooth and suggested I should floss more often, which I already know. That was the end of the service.

Just like before, few weeks letter I have received a bill for unpaid balance. When I asked what it was for, they said I have received a periodontal maintenance and my insurance did not pay the full amount. I called the office as well as the billing department and explained that neither I have requested nor received any special treatment other than the regular cleaning. The response I got from the billing department was that the computer shows I have received a periodontal maintenance and I have to pay the balance, and the response I got from the dental office was that **. [redacted] is not a regular doctor and he does not do a regular cleaning therefore the treatment I have received was not a regular cleaning.

This is the second time when [redacted] Associates tried to collect more money by claiming I have received a service which I didn’t or misrepresenting procedures. I asked them to correct error and remove the charge three times, but instead of correcting error and apologizing, they send me a threatening letter to give my account to collection agency because they simply thought this time I cannot bring a proof to support my claim. They couldn't deny the first error because the x-ray was emailed to them and that is undeniable proof. What they don't know is that I do have a copy of the reminding note they emailed me for regular cleaning and confirmation of my appointment that shows I have requested for a check-up/cleaning service, not Periodontal Maintenance or any special treatment. I refer this as fraudulent charge instead of error because both issues are similar and both happened within a 12 months.Desired Settlement: They have to correct the error and apologize by mail. I don't wish to talk to them anymore.

Business

Response:

To Whom It May Concern: