Denville Oral & Maxillofacial Surgeons

I was having an issue with recurring, multiple mouth sores. My dentist advised me to see an Oral Surgeon. I called my dental office and was referred to Dr. [redacted] in Denville, New Jersey. I asked if Dr. [redacted] participated in my insurance and was told yes. I was informed that he accepted [redacted] Dental, and they refer many patients to him. I called his office to make an appointment. I advised them that I had multiple, recurring mouth sores & that I was referred by my dentist. I told them Who I was insured with, and asked if they participated in my plan. I was told yes. The woman took my information and also asked who my regular insurance was with. I advised her who I was insured with, and she proceeded to make my appointment. My appointment was on November 3rd. When I arrived at the office, I was given a clipboard with a bunch of paperwork to fill out. While filling out the paperwork, it asked for both my Dental & Medical insurance information. When I completed the paperwork, the receptionist asked for both my Dental and Medical insurance cards. I asked again if they were a participating provider and was told yes. A few minutes later I was called in to see the Dentist. He verified the fact that I had mouth sores and told me that since they were in the process of healing, I had to wait until a new one started. He told me when I saw a new sore starting, to call and come in right away. He said they would biopsy it, to see if it was a viral or an autoimmune issue. He told me to follow up with him in three weeks. I went out to make my follow up appointment and was handed a piece of paper by the receptionist. It was an estimate for surgery, and I was told I needed to sign it. She told me that if I came back for a biopsy it was $500.00 and they did not accept any insurance. I was totally caught off guard. I was very confused and stated that I asked three times if they accepted my insurance and was told yes. She told me they don't accept any insurance and today's visit was also $200.00. I was completely blind sighted. I asked if my next appointment was going to cost another $200.00 and she looked at me exasperated. She told me that my next appointment was a follow up and was included with today's $200.00 fee. If I came back for a biopsy, it would cost $500.00 and I would be responsible because they don't accept insurance. I was very confused and asked for an explanation. I told her that I asked three different times if they accepted my insurance and was told yes. She advised me that they accept [redacted] Dental, but my issue was a medical nature. She told me as a courtesy, they file the medical claim on my behalf, but do not accept any medical insurance. I had to pay the bill and get reimbursed by my insurance. Frustrated, I paid the bill and left. The next day, I called My dental office and advised them what occurred. They told me they would call and speak to the office manager and get back to me. A few days later, they called me back saying they were also confused. Dr. [redacted]'s office said it was a medical
issue not dental, and that is why it was not covered. They didn't understand how they arrived at a $200.00 fee, because that wasn't an amount on the fee schedule. I decided to call Dr. [redacted]'s office myself on November 12th. I asked to speak to
the office manager in regard to my bill. A woman claiming to be the Office Manager came on the phone. I proceeded to explain everything to her. She was insistent that I was charged the $200.00 correctly and I was responsible for the bill. I asked repeatedly, why I was not informed of this BEFORE I went in to see the doctor. She told me that they don't know if its a dental or medical issue until after I'm seen. They have to wait for the diagnosis from the doctor. At that time it was determined that it was medical and they do not take insurance. I told her that I advised them exactly what I was coming in for when I made the appointment. I also asked at that time if they accepted my insurance and was told yes. She told me she was the one who made my appointment and didn't recall any of that. I was not happy that she was insinuating that I was lying. We kept going around in circles. I told her to cancel my follow up appointment. She told me that the follow up was included in my initial visit. I advised her that that I felt the office was shady in their business practices and I didn't want to return. She put me on hold for a bit and came back on the line. She tried to explain again about the whole dental/medical issue. I advised her that the same way they informed me after the fact, that a biopsy would cost $500.00. They should have notified me that they do not accept insurance for my issue. I was referred to this Dental Office, by my Dental Office. I advised at that time exactly why I was being referred there and what insurance I had. I should have been told, we accept dental insurance, but if the doctor determines your diagnosis is a medical issue, we do not accept any medical insurance, and you will be fully responsible. At no time was I advised of this. Had I known this upfront, I would not have made this appointment. It was my understanding, that I was referred to a dental specialist by my dentist, and he was a participant in my insurance. Now I was duped with a $200.00 consultation fee. The claim was denied by my medical insurance, because Dr. [redacted] is not an in network provider. I had no idea this would be considered a medical issue, nor was I advised by anyone that it may be. The receptionist handed me an estimate for surgery AFTER the fact and then hand wrote Today's Visit $200.00 under the estimate. I was told I had to sign it after I was already seen by Dr. [redacted]. I feel this office has unethical business practices.
I have attempted to work this out with Doctor [redacted]'s office, but my attempts have proved fruitless. I have filed appeals with both [redacted] & [redacted]. I also filed a complaint with the American Dental Association & Consumer Affairs. I disputed the charge twice with [redacted]. The dispute was closed in favor of the dental office, because they submitted the form that I was forced to sign, AFTER the fact. It basically came down to my word against theirs. Since they had my signature, it was considered a signed contract. The Office Manager is a blatant liar and wouldn't know how to tell the truth if her life depended on it. She submitted lies to [redacted] stating I was I was aware of all fees in advance and was told they do not participate in any insurance. I was advised of this, and made to sign the form after seeing the dentist and on my way out the door.
Do not do business with Denville Oral & Maxillofacial Surgeons. They are unethical and not honest. NEVER sign anything after the fact, it will come back to haunt you.