Doc Bressler's Cavity Busters

Review: I scheduled an initial visit with Doc Bresslers as a new patient. My wife and daughters currently receive dental care there as well. Upon the completion of my visit I was informed my visit was covered by insurance company. Several weeks later I was asked to pay approximately $190.00 for x-rays that were not covered. I was told the x-rays were not covered because they were not within the timeframe of my plan, had they been done at a different time they would be fully covered. This was a scheduled service that could have easily been preauthorized to determine coverage. Had this been done I could have scheduled my visit for another date. In the haste of the office to obviously get me in for an appointment, due diligence was not done and resulted in my charges. Additionally this account is now listed as a collection account on my credit report.Desired Settlement: I would like the charges to be absorbed by the business and the account removed from my credit report.

Business

Response:

To Whom It May Concern,This letter is in response to complaint ID: [redacted]. After further review, we have decided to settle with the patient and adjust the charges to $0.00. The patient will be made aware of this adjustment via a phone call.If you have any other questions, please contact me.

Consumer

Response:

[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.]

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,

Review: My daughter was experiencing issues with her teeth 2/6/13 and weeks prior she had a dental exam through another dentist office to confirm she was in need of dental work (fillings and caps). I was afraid one of her teeth might have been infected so I called Cavity Busters to schedule an exam. When I called I advised the office I had recently become unemployed 1/28/13 and stated I believed I still have a few weeks remaining on my CIGNA dental insurance ( I was paid weekly and insurance was deducted every week so I was under the impression I should still be covered since I still had two paychecks coming to me from previous employer, but again I ADVISED Cavity Busters of this and they insisted I come in and would be assisted with all that I need and help me).We arrived and the dentist came in and I once more explained she already was seen by another dentist (different dentist/ location) and already aware what was needed for her treatment and the fact of insurance issues looming. The dentist asked my daughter to smile and said "ok well nothing I can do she needs to be seen by our Surgie Center once you figure out if you have insurance or not"He performed NOTHING! He didn't look in her mouth or perform an actual exam. The bill was sent to CIGNA and denied because of coverage ending 1/31/13. Which is fine. I was advised through [redacted] that if my child received any service Medical/Dental I would be able to claim it through the state to absorb the cost of the bill. But yet again why am I charged with a bill for $95 dollars when the dentist didn't even do anything?!?And on top of that my daughter still went through with the surgery which cost more then $3500+ and this billing office is constantly calling and harassing my husband and I. And to make things worse sending me pamphlets for [redacted] for a $95 bill with 28%interest to people who stated over and over again it needs to be submitted through the state. Let alone don't have the means to pay for it since I am unemployed!Desired Settlement: I would like this bill to be removed and waived due to the fact of the incompetents of this office. They already received $3500+ from the state for Dental Surgery for my daughter and trying to draw blood from a stone. Once the bill is removed and waived I will withdraw my story from credited search sites with my current negative reviews. I want my bill to be $0 and a copy sent to my house and the harassing phone calls to end!

Business

Response:

August 23, 2013

Dear **. [redacted],

This is in response to your letter dated August 14, 2013 in which a customer has indicated that they are not responsible for the $95.00 balance on their account due to non-payment by the insurance company. The child presented to the office on February 26, 2013 with all information indicating coverage was through [redacted] insurance Company. Our office verified eligibility on-line which did indicate that coverage through [redacted] was active. A copy of all information is attached for your review.

An exam was done and the claim was submitted to the insurance company for payment By the time [redacted] processed the claim the coverage had been backdated with a termination date of January 31,

2013, therefore a bill was generated for the service rendered.

The parent then called to notify us that the child was covered through [redacted] at the time of service but our verification of eligibility indicated coverage did not become effective until April 15, 2013. Upon denial from [redacted] the mother advised that coverage was active through the Department of Public Welfare on February 6, 2013 but once again verification showed no active coverage. Copy of all eligibility information is included.

As you can see we attempted to work with the parent in getting the exam covered but were unsuccessful as coverage was not showing as eligible under any plan the mother supplied us with. Although we are in no way at fault for the denial of service, as a gesture of good faith, we will write off the current balance of $95.00 for the exam rendered on February 6, 2013.

If you should have any questions regarding this matter please feel free to contact me.

Sincerely,