Dentistry With TLC

[redacted] states that he was charged $in addition to his original estimate This simply is not true He was given a form and signed the form that clearly shows his deep cleaning was $ It shows that the addition $was for the exam and xrays completed at the visit He choses to have these completed and he was informed of the cost before the exam and xrays were taken This is clearly listed on the form and signed by [redacted] on 2/15/before his treatment At the end of his appointment he stated he only wanted to pay $and that left him with a remaining balance of $ The late fee he is referring to is a finance charge from not paying the $balance on time There was no mistake on our part and no one ever told [redacted] that a mistake was made [redacted] was made aware of the treatment fees before he began treatment I will be happy to provide a copy of this form with his signature[redacted] requested his xrays be sent to another dentist and we sent the xrays on 3/7/to the email he provided He had provided an incorrect email on his signed release form We called the other dentists office and received the correct email and reset the xrays If [redacted] had provided the correct email on his release forms then there would have been no issue No one has ever told him we can't release his records This is a very standard procedure for any office and is quickly and easily fulfilled when we are provided with correct information I contacted the dentists office today after reading this complaint and they stated they have received the xrays I asked them to tell me when they received the xrays and the receptionist said she couldn't tell me because the email is only checked by the doctor and he won't be checking it today It is possible they had the xrays for days before the doctor checked his email Our notes and our sent box show we emailed the xrays on 3/7/16, 3/8/and 3/9/to each email address we were provided We will be happy to release ***'s xrays to his new dentist In fact, today his receptionist stated that [redacted] has already been in to see them As far as refunding him $for an exam and xrays he agreed to and signed for before they were completed, we simply can not refund This was not an incorrect estimate as he is claiming [redacted] chose to have these services completed, was informed of the fee, signed consent and then chose to have the balance remain long enough that it incurred a fee I will be happy to remove this finance charge (not the entire balance of his account) that he incurred due to leaving a balance on his accountTell us why here

I was informed on Wednesday, May 10th that C.Swould like to me to return his call about his billing complaints I returned his call on Thursday, May 11th, less than hours after his request He proceeded to tell me that his son didn’t have any dental problems and that we told him the insurance would completely cover the cost of his fillings His son’s xrays clearly show there were cavities in his teeth and the cavities required fillings There was a financial form prepared and signed showing he had been informed he would be responsible for the cost of the fillings His insurance gave us an estimate and we passed on that estimate to [redacted] and his son We informed him that it was just an estimate, not a guarantee He chose to proceed with treatment His insurance did not pay what they estimated they would pay He is responsible for the balance as he agreed before treatment began It appears C.Sthinks we make an error when giving him the insurance estimate This is not true We have supplied him with copies of the estimate provided to us by his insurance We have spent time explaining to him and showing him the estimates from his insurance company At a face-to-face meeting [redacted] became so heated and aggressive that an employee was concerned he may even become physically dangerous C.Sinsurance company is the one in error They did not pay what they estimated They paid less Before treatment was begun we informed C.She would be responsible if something like this would occur When I called C.Stoday I asked him if he would like me explain what had happened He said “no” I do not know how to proceed in a relationship with someone when they are unwilling to collaborate or move forward C.Sthen told me he has decided to go to another dentist I told him I respect his decision and I think that would be best I wish him and his family all the best

Initial Business Response / [redacted] (1000, 7, 2015/09/17) */ Mrs [redacted] was fully informed of the four week holding policy on her insurance reimbursementShe signed a payment policy form that states, "...the check will be endorsed over to you after the four week holding period." This is a policy that protects patients should the insurance company make a mistake and demand the insurance payment be returned to the insurance companyWe have seen insurance companies make mistakes on payment many times and wish to shelter our patients from the hassle created by insurance mistakesWe received reimbursement from the insurance company on 8-6-Mrs [redacted] was forwarded her reimbursement on 9-3-All of this was explained to Mrs [redacted] at her consultation and she signed papers confirming she was fully informed on4-23-When Mr [redacted] became involved in the process we explained the same to him and he referred to the paperwork as " [redacted] "We offered to send him copies of the policy and meet with him to explainHe refused to collaborate and said he would report us to the Revdex.com if we did not meet his demandsHe said he did not care about the paperwork or anything his wife signedIt is my impression that the matter has been taken care of, just as we informed Mr [redacted] it would be and just as our payment policy outlinesI will be happy to meet with Mrand Mrs [redacted] to discuss this matter further if they feel things have not been reconciled

***’s mother suggests [redacted] was charged $for his cleaning This simply is not true ***’s cleaning, x-rays and comprehensive doctor’s exam were covered by insurance [redacted] has incurred no personal charge for those services His only personal charges were $for the oral appliance therapy consultation, $for the Velscope cancer screening and $for a filling [redacted] has been billed correctly It appears that [redacted] may not have told his mother that he had a cavity and chose to have the filling completed while she was spending time with a friend This would explain why she thinks he has been overcharged for services [redacted] gave consent for the filling and he was informed of his estimated cost before the filling was performed (see more details below) After the intense reaction our office encountered with ***’s mother, it has been noted in his chart that she is now the responsible party for all work There was absolutely no way for us to know ***’s mother was the responsible party before his appointment because neither [redacted] nor his mother listed her as the responsible party on his paperwork She was not present for his appointment and did not tell anyone that we should call her before doing any type of treatment for *** He stated he would be using a Visa card to pay for his treatment and gave written and verbal consent for the $cancer screening, $oral appliance therapy consultation and $fillingIn an effort to collaborate we are willing to waive half of the oral cancer screening fee ($27), even though [redacted] gave full consent for the $charge This gesture is done to illustrate our willingness to reach a happy endingHere is further explanation of the situation: On December 19, [redacted] presented as a new patient at Dentistry With TLC [redacted] is a year old student at the [redacted] [redacted] completed all of his own paperwork He did not list his mother, ***, as the responsible party for his account His mother was not at the appointment with him She simply dropped him off ***’s chart notes report that his mother said she was going to meet a friend during ***’s appointmentThis patient’s mother states she was denied access to speak with Dr [redacted] *** This simply isn’t true Dr [redacted] left a message at [redacted] — the evening after this patient’s appointment Dr [redacted] left her personal cell phone number and asked that the patient or his mother return her call to discuss what was upsetting them Instead of calling Dr [redacted] chose to rant on Facebook Later Dr [redacted] called [redacted] —and was unable to leave a message at that number A recording stated the phone number was “not accepting calls at this time”***’s mother states we practice“deceitful, blatant and purposeful omission” tactics to obtain consent for treatment This simply isn’t true [redacted] was asked if he wanted an oral cancer screening with a Velscope light He was told insurance will NOT pay for the screening and he would be responsible for $ He was given the option to check “Yes” or “No” on the consent form He chose to check “Yes”, then printed his name, signed the consent and dated the consent before the Velscope cancer screening was performed ***’s mother states “scare tactics and deception” were used to obtain consent This simply isn’t true She was not present at his appointment to witness any conversations She states we did not obtain “payer permission” That simply is not true [redacted] was the “payer” and he gave permission before the screening was performed For the past years we have offered the screening to all patients ages and older Not offering this screening to one patient would potentially fall below the standard of care***’s mother fails to mention in her complaint that [redacted] had a cavity and he asked us if our schedule would allow for him to have his cavity filled after his cleaning was complete It was explained to him before the cavity was filled that the cost of the filing was $ It was estimated that his insurance would adjust off $for the cost of the filling It is clearly written that his insurance benefit was $and his estimated investment was $for the filling [redacted] signed and dated the financial explanation and chose to wait for an opening in the scheduled and have his filling completed after his cleaning ***’s chart notes state when Tommy asked [redacted] how he was going to pay and [redacted] asked if we accepted credit cards Tommy said we did and [redacted] stated he would be paying with a Visa At no time did [redacted] state that his mother would be paying for his filling, cancer screening or oral appliance therapy consultation [redacted] had an Oral Appliance Therapy Consultation completed on the same day He was only charged $for the consultation after using our advertised discount ***’s mother states in her complain we perform “purposeful intention to commit insurance fraud” by “prospective insurance overcharge of $6,for an $1,800-$2,oral sleep appliance” This simply isn’t true We follow all medical insurance guidelines and rules involving coding and billing for oral sleep appliances We have been providing this service since without incident

[redacted] states that he was charged $175 in addition to his original estimate.  This simply is not true.  He was given a form and signed the form that clearly shows his deep cleaning was $1293.  It shows that the addition $175 was for the exam and xrays completed at the visit.  He...

choses to have these completed and he was informed of the cost before the exam and xrays were taken.  This is clearly listed on the form and signed by [redacted] on 2/15/16 before his treatment.  At the end of his appointment he stated he only wanted to pay $1293 and that left him with a remaining balance of $175.  The late fee he is referring to is a finance charge from not paying the $175 balance on time.  There was no mistake on our part and no one ever told [redacted] that a mistake was made.  [redacted] was made aware of the treatment fees before he began treatment.  I will be happy to provide a copy of this form with his signature.[redacted] requested his xrays be sent to another dentist and we sent the xrays on 3/7/16 to the email he provided.  He had provided an incorrect email on his signed release form.  We called the other dentists office and received the correct email and reset the xrays.  If [redacted] had provided the correct email on his release forms then there would have been no issue.  No one has ever told him we can't release his records.  This is a very standard procedure for any office and is quickly and easily fulfilled when we are provided with correct information.  I contacted the dentists office today after reading this complaint and they stated they have received the xrays.  I asked them to tell me when they received the xrays and the receptionist said she couldn't tell me because the email is only checked by the doctor and he won't be checking it today.  It is possible they had the xrays for days before the doctor checked his email.  Our notes and our sent box show we emailed the xrays on 3/7/16, 3/8/16 and 3/9/16 to each email address we were provided.  We will be happy to release [redacted]'s xrays to his new dentist.  In fact, today his receptionist stated that [redacted] has already been in to see them.  As far as refunding him $175 for an exam and xrays he agreed to and signed for before they were completed, we simply can not refund.  This was not an incorrect estimate as he is claiming.  [redacted] chose to have these services completed, was informed of the fee, signed consent and then chose to have the balance remain long enough that it incurred a fee.  I will be happy to remove this finance charge (not the entire balance of his account) that he incurred due to leaving a balance on his account. Tell us why here...

Initial Business Response /* (1000, 7, 2015/09/17) */
Mrs. [redacted] was fully informed of the four week holding policy on her insurance reimbursement. She signed a payment policy form that states, "...the check will be endorsed over to you after the four week holding period." This is a policy that...

protects patients should the insurance company make a mistake and demand the insurance payment be returned to the insurance company. We have seen insurance companies make mistakes on payment many times and wish to shelter our patients from the hassle created by insurance mistakes. We received reimbursement from the insurance company on 8-6-15. Mrs. [redacted] was forwarded her reimbursement on 9-3-15. All of this was explained to Mrs. [redacted] at her consultation and she signed papers confirming she was fully informed on4-23-15. When Mr. [redacted] became involved in the process we explained the same to him and he referred to the paperwork as "[redacted]". We offered to send him copies of the policy and meet with him to explain. He refused to collaborate and said he would report us to the Revdex.com if we did not meet his demands. He said he did not care about the paperwork or anything his wife signed. It is my impression that the matter has been taken care of, just as we informed Mr. [redacted] it would be and just as our payment policy outlines. I will be happy to meet with Mr. and Mrs. [redacted] to discuss this matter further if they feel things have not been reconciled.

Initial Business Response /* (1000, 5, 2016/01/21) */
Before this patient had her treatment begun on December 12, 2014 she signed a paper acknowledging the total cost of her services was $3,166. Based upon the information provided to us by her and her insurance company it was ESTIMATED that her...

insurance adjustment would be $1,346. Her ESTIMATED cost of services was $1,820. The ESTIMATED insurance benefit was $956.70, leaving her ESTIMATED investment $863.30. This form clearly states "This estimate is based on the information you and your insurance company have provided for our review. Please remember that you are ultimately responsible for the entire amount of the services rendered. If the insurance pays more than estimated, you may either use this credit towards future services, or you may have the overpayment returned to you. If the insurance pays less than estimated, you will be responsible for the remaining balance." She completed and signed a similar paper on December 15, 2014 stating the total cost of services was $2204. Her ESTIMATED insurance adjustment is $1070 taking her ESTIMATED cost of services down to $1134. The ESTIMATED insurance benefit was $458.50. This left her ESTIMATED investment $675.50.
We are very generous at Dentistry With TLC and only require that our patients pay their estimated investment portion while we are waiting for the insurance company to send the insurance's estimated portion. We did submit her claims three separate times, December 15, 2014, January 21, 2015 and September 10, 2015. Her insurance company finally sent an EOB on October 15, 2015 stating her yearly maximum had been reached. She had only used $1050.12 at our office and her yearly maximum was $1500. Her insurance company told us that the most obvious explanation of this issue is that the patient went to another office and did not disclose this information to us when she returned to our office. In her complaint she states "The 12/12 visit exhausted my benefits. Therefore, nothing on the 12/15 visit would have been covered. I did not know any of this at the time the services were provided which is why I agreed to the new payment." This statement does not make sense. Her insurance company is refuting the December 12, 2015 appointment and is actually paying towards the work completed on December 15, 2015. The insurance company is stating their lack of payment is most likely due to her using her benefits in another office and not reporting that to us when she returned to our office.
When we received the EOB from her insurance company on October 15, 2015 her balance was updated showing that she owed $1041.50. She was sent two statements on October 26, 2015 and November 25, 2015 reflecting the new balance. From December 2014 until October 2015 she did not owe this balance because the insurance company was still processing her claim. We were very generous to provide her dental work without requiring she make any payments on her possible insurance portion while her insurance was pending. Some dental offices require patients pay in full before treatment and then they receive the insurance portion as a reimbursement later. As soon as we received the EOB and insurance refused to pay their estimated part we sent the patient a statement to inform her of her balance.
She states we did not inform her of the new balance as "an error on their part for not notifying me of the ins. issue". There was no error on our part. We were very kind to allow her pending insurance balance to remain and not require her to make any payments from December 2014 until October 2015. As soon as her insurance company sent the EOB in October of 2015 we sent her two statements informing her of the new balance.
We have discussed this situation with the patient and her husband. These are notes made by our financial coordinator on December 3, 2015: [redacted] called in wanting to know why he is still receiving a bill for his wife [redacted]. He stated that he made a final payment in July of $123.81 and that should have paid the balance in full. I explained to [redacted] that when that payment was made it left a balance of $1041.50 and that statements have been going out monthly. He stated yes he has been receiving the statements and that he called in Oct to see why the ins had not been paying and was told he was going to be called back but never received a return call. I read to him the note from 10/15/15 from SRB that stated ins did not pay for services on 12/12/15 because they are stating that she had reached her yearly max of $1500 and that combined with the balance from 12/15/15 is where the current balance is from. He again asked but why didnt they pay. I again let him know that the ins is claiming yearly max has been met and that ins is just an est and never a guarantee. He stated that he was going to have his wife call the office because he doesnt think we are being truthful. He then said good bye and hung up.
These are notes made by our financial coordinator on January 8, 2016: PT called on 01/07/16 to discuss a bill for services that ins did not pay for from 12/12/14. PT said that she had not been receiving statements for these services. I explained to her that the statements have been going out to her on a monthly basis. I then confirmed her address. She agreed that it was correct. It was explained to her that ins had explained to us that the reason the claim was not paid was because her yearly max had been reached. She then voiced her concern that she was not informed of this for a year and that she feels a "statute of limitations" on the bill should apply and she should not have to pay for it. I explained that we were more than happy to work with setting up a pp for her and she continued to argue repeatedly and use vulgar language. I offered to send her a new statement and explained that we did everything in our power to try to collect from insurance. After approx 20 minutes of the same arguments, she hung up the phone.
On January 12, 2016 our financial coordinator made this note: On 1/7/16, I also spoke with [redacted] and she told me that we had terrible customer service and that she was going to report us to the Revdex.com for not making her aware of an issue. I explained to her that we were doing our part and trying everything we could to get insurance to pay. She explained that she also did not get a statement so I offered to check her address and she said no the other person she talked to already confirmed it was correct. I then told her I would be happy to email her a copy of the statement so that way she had one for her records. [redacted] was very hostile and angry throughout the conversation and it sounded as if she was talking through gritted teeth. She then told me that she had received everything we had ever sent her and she was just mad at our terrible customer service because it took so long for us to tell her her insurance wasn`t paying. I told her that our intent was not to have bad customer service, but we wanted to make sure that we made every effort we could to collect insurance payment before sending her a bill. She said that we should have made her aware of the problem ahead of time and that makes it bad customer service and she was going to tell the Revdex.com all about it. I told her again that I was sorry she felt that way but we really were doing everything we could to get her insurance to pay, and she hung up.
In summary, the patient was fully informed before she began her treatment that she was responsible for the full cost of treatment if her insurance did not pay what was estimated. Her insurance company is implying the reason they did not pay what was estimated is because she used those benefits at another dental office and did not inform us of this fact. We have bent over backwards by resubmitting her claim an additional two times. We were also very generous and did not require she pay any of the estimated insurance benefits while we were waiting for her EOB for ten months.
She states in her complaint, "If I would have known there was an issue, I would have taken care of the issue." We informed her insurance was not going to pay what they estimated by sending her a statement on October 26, 2015. We have not received a payment (not even $5) since that statement was sent.
We will be happy to set up a payment plan with the patient for her balance.

I was informed on Wednesday, May 10th that C.S. would like to me to return his call about his billing complaints.  I returned his call on Thursday, May 11th, less than 24 hours after his request.  He proceeded to tell me that his son didn’t have any dental problems and that we told him...

the insurance would completely cover the cost of his fillings.  His son’s xrays clearly show there were cavities in his teeth and the cavities required fillings.  There was a financial form prepared and signed showing he had been informed he would be responsible for the cost of the fillings.  His insurance gave us an estimate and we passed on that estimate to [redacted] and his son.  We informed him that it was just an estimate, not a guarantee.  He chose to proceed with treatment.  His insurance did not pay what they estimated they would pay.  He is responsible for the balance as he agreed before treatment began.  It appears C.S. thinks we make an error when giving him the insurance estimate.  This is not true.  We have supplied him with copies of the estimate provided to us by his insurance.  We have spent time explaining to him and showing him the estimates from his insurance company.  At a face-to-face meeting [redacted] became so heated and aggressive that an employee was concerned he may even become physically dangerous.  C.S. insurance company is the one in error.  They did not pay what they estimated.  They paid less.  Before treatment was begun we informed C.S. he would be responsible if something like this would occur.  When I called C.S. today I asked him if he would like me explain what had happened.  He said “no”.  I do not know how to proceed in a relationship with someone when they are unwilling to collaborate or move forward.  C.S. then told me he has decided to go to another dentist.  I told him I respect his decision and I think that would be best.  I wish him and his family all the best.

[redacted]’s mother suggests [redacted] was charged $204 for his cleaning.  This simply is not true.  [redacted]’s cleaning, x-rays and comprehensive doctor’s exam were covered by insurance.   [redacted] has incurred no personal charge for those services.  His only personal charges were $49 for...

the oral appliance therapy consultation, $54 for the Velscope cancer screening and $112 for a filling. [redacted] has been billed correctly.  It appears that [redacted] may not have told his mother that he had a cavity and chose to have the filling completed while she was spending time with a friend.  This would explain why she thinks he has been overcharged for services.  [redacted] gave consent for the filling and he was informed of his estimated cost before the filling was performed (see more details below).  After the intense reaction our office encountered with [redacted]’s mother, it has been noted in his chart that she is now the responsible party for all work.  There was absolutely no way for us to know [redacted]’s mother was the responsible party before his appointment because neither [redacted] nor his mother listed her as the responsible party on his paperwork.  She was not present for his appointment and did not tell anyone that we should call her before doing any type of treatment for [redacted]  He stated he would be using a Visa card to pay for his treatment and gave written and verbal consent for the $54 cancer screening, $49 oral appliance therapy consultation and $112 filling. In an effort to collaborate we are willing to waive half of the oral cancer screening fee ($27), even though [redacted] gave full consent for the $54 charge.  This gesture is done to illustrate our willingness to reach a happy ending. Here is further explanation of the situation: On December 19, 2016 [redacted] presented as a new patient at Dentistry With TLC.  [redacted] is a 21 year old student at the [redacted].  [redacted] completed all of his own paperwork.  He did not list his mother, [redacted], as the responsible party for his account.  His mother was not at the appointment with him.  She simply dropped him off.  [redacted]’s chart notes report that his mother said she was going to meet a friend during [redacted]’s appointment. This patient’s mother states she was denied access to speak with Dr. [redacted].  This simply isn’t true.  Dr. [redacted] left a message at [redacted]— the evening after this patient’s appointment.  Dr. [redacted] left her personal cell phone number and asked that the patient or his mother return her call to discuss what was upsetting them.  Instead of calling Dr. [redacted] chose to rant on Facebook.  Later Dr. [redacted] called [redacted]—and was unable to leave a message at that number.  A recording stated the phone number was “not accepting calls at this time”. [redacted]’s mother states we practice“deceitful, blatant and purposeful omission” tactics to obtain consent for treatment.  This simply isn’t true.  [redacted] was asked if he wanted an oral cancer screening with a Velscope light.  He was told insurance will NOT pay for the screening and he would be responsible for $54.00.  He was given the option to check “Yes” or “No” on the consent form.  He chose to check “Yes”, then printed his name, signed the consent and dated the consent before the Velscope cancer screening was performed.  [redacted]’s mother states “scare tactics and deception” were used to obtain consent.  This simply isn’t true.  She was not present at his appointment to witness any conversations.  She states we did not obtain “payer permission”.  That simply is not true.  [redacted] was the “payer” and he gave permission before the screening was performed.  For the past 8 years we have offered the screening to all patients ages 18 and older.  Not offering this screening to one patient would potentially fall below the standard of care. [redacted]’s mother fails to mention in her complaint that [redacted] had a cavity and he asked us if our schedule would allow for him to have his cavity filled after his cleaning was complete.  It was explained to him before the cavity was filled that the cost of the filing was $219.  It was estimated that his insurance would adjust off $107 for the cost of the filling.  It is clearly written that his insurance benefit was $0 and his estimated investment was $112 for the filling.  [redacted] signed and dated the financial explanation and chose to wait for an opening in the scheduled and have his filling completed after his cleaning.  [redacted]’s chart notes state when Tommy asked [redacted] how he was going to pay and [redacted] asked if we accepted credit cards.  Tommy said we did and [redacted] stated he would be paying with a Visa.  At no time did [redacted] state that his mother would be paying for his filling, cancer screening or oral appliance therapy consultation. [redacted] had an Oral Appliance Therapy Consultation completed on the same day.  He was only charged $49 for the consultation after using our advertised discount.  [redacted]’s mother states in her complain we perform “purposeful intention to commit insurance fraud” by “prospective insurance overcharge of $6,000 for an $1,800-$2,000 oral sleep appliance”.  This simply isn’t true.  We follow all medical insurance guidelines and rules involving coding and billing for oral sleep appliances.  We have been providing this service since 2009 without incident.