Dr. Althea Eggleston DDS

Dear [redacted] , This letter serves as our response to [redacted] ***'s most recent correspondence with the Revdex.com [redacted] states that our office has not provided proof that she was advised that she would incur a cost for x-rays taken if insurance did not cover them Proof is never provided at our office that a patient will or will not incur a cost for services renderedBecause we are 3rd party to the patient's insurance, everything quoted is always an estimate Our office is not responsible for any patient's insurance And, as stated in our previous reply, eligibility/benefits are verified either by phone or through the insurance website In the instance of online verification, there would not be a confirmation number received All new patients to our office are seen for a prophylaxis, comprehensive exam and a full mouth series of x-rays Had x-rays been sent to us from [redacted] ***'s previous dentist, they would not have been taken in our office No fraud has been committed All services submitted to insurance were rendered Per [redacted] ***'s request and to avoid any further back and forth banter regarding this situation, we will be removing [redacted] ***'s balance from collection and dismissing her from our practice Sincerely, [redacted] ***

Complaint: ***
I am rejecting this response because: ***r has provided documents that I was there for a basic cleaningI never denied that and that's not the dispute***r has not provided proof that I was advised that I would incur the cost for the x-rays if my insurance did not cover themInstead I was told that my insurance covered the costHow could you say that when you never contacted them? I provided a reference number from my insurance provider that will indicate my telephone call to them regarding that visit in Basic cleanings do not require x-rays, which I am now aware ofYour office advised me that my insurance would cover the cost for x-rays per a phone call that you claimed you all made to them, but never didYou all were going to do my cleaning and perform x-rays on me whether I had insurance or notIt would be more money in your pocket if I did not have insurance, which means I would be expected to pay out of pocket for the full serviceIf not, you would forward the account over to the collection agencyThat was your plan!!! My insurance company does not have any record of you all contacting them at allYou said that you all contacted my insurance company to inquire about coverage, but that's not documented with my insurance companyAlso, why would you only inquire about coverage for cleaning and not the panoramic x-rays that could cost the patient out of pocket if it's not covered? The burden falls on you to inform the patient that signed an agreement to pay when you offer a service that I did not ask forI did advise you all that I had x-rays done at a different dental office prior to my visit with you allI advised you all that I was not aware of what type of x-rays they performed, but that you all could retrieve those from them and you all agreed to do thatThat is what dental and dentist offices do for their patientsI also have not received any correspondence by mail, text, email, or phone that I had a balance due to the insurance not covering the panoramic x-raysYou all are deceptive and are not telling the truthHow do I know that you all even took panoramic x-rays? Why did you all not contact me by phone about the insurance not covering the x-rays? Why are you not being truthful about calling the insurance provider? Why would you put your patient in an inconvenient situation that could have been prevented if you had told me that you could not confirm if the insurance would cover those particular x-rays? I signed an agreement to pay for basic cleaning and you all took advantage of me due to me not knowing that those particular x-rays are not always coveredHow am I suppose to know off hand that panoramic x-rays would be done and are only paid for every so often? You're the experienced professionals in this fieldYou all did not do your job and I trusted your office to be honest and professional despite the reviews I had readAlso please stop sending me reminders to visit your office for a cleaningYou have my number and seem to be real selective on how you choose to use itThat was terrible of you to send that account to collections without calling me immediately to tell me my insurance did not cover those x-raysPlease close the account with Capital AccountsI do not have a problem with reporting to the office of *** *** ** *** *** *** *** regarding my complaint.
Regards,
*** ***

Dear *** ***,
This letter serves as our response to *** ***'s most recent correspondence with the Revdex.com. *** *** states that our office has not provided proof that she was advised that she would incur a cost for x-rays taken if insurance did not cover them. Proof is never provided at our office that a patient will or will not incur a cost for services renderedBecause we are 3rd party to the patient's insurance, everything quoted is always an estimate. Our office is not responsible for any patient's insurance. And, as stated in our previous reply, eligibility/benefits are verified either by phone or through the insurance website. In the instance of online verification, there would not be a confirmation number received. All new patients to our office are seen for a prophylaxis, comprehensive exam and a full mouth series of x-rays. Had x-rays been sent to us from *** ***'s previous dentist, they would not have been taken in our office. No fraud has been committed. All services submitted to insurance were rendered. Per *** ***'s request and to avoid any further back and forth banter regarding this situation, we will be removing *** ***'s balance from collection and dismissing her from our practice.
Sincerely,
*** **
*** *** *** ***

It was brought to our attention that on 12/07/2016, our patient *** *** submitted a complaint to the Revdex.com regarding Billing/Collection/Fraudulent issues. This complaint stems from a visit *** *** made to our office on 12/03/2015. *** *** was seen in our office
for an exam, full series of x-rays and a dental cleaning as a new patient. *** *** claims that information was given to her at the time of her visit regarding coverage of x-rays, leading to an outstanding balance billed to the patient after insurance did not cover/pay for the x-rays. When a call is placed and/or benefits are looked up online regarding a patient’s insurance, our office verifies that a patient’s insurance plan is active and they are eligible to receive benefits. We offer no guarantees of coverage because we are 3rd party to the patient’s insurance. *** *** also stated in her complaint that she had x-rays previously taken at another dental office in July of 2015. At no point in time did *** *** disclose this information to us. She stated in her complaint that “*** ***’s office could have called the other dental office to obtain the same x-rays”. Unfortunately, if we are not informed by the patient of prior treatments, there is no way for us to know treatment was done. It is up to the patient to disclose to us that x-rays were taken and to coordinate with the other office to have them sent over. Additionally, when a patient is seen in our office for the first time, they complete a health history questionnaire and sign a document regarding financial responsibility. The financial responsibility section states: “Insurance Claims: While we do our best to determine your out of pocket expenses at the time of service, we cannot be certain until your insurer pays your claim. At that time, we will bill you for any unpaid balance or refund any overpayments. An interest rate charge of 10% plus collection fees will be assessed for balances not paid within days.” *** *** acknowledged these statements with her initials on 12/03/2015. Furthermore, on 01/19/2015, our office received a check from the patient’s insurance company for date of service 12/03/(ck#: 0001263456). The patient also received a copy of this EOB. The EOB clearly indicates the patient’s responsibility. Upon receiving this EOB, *** *** failed to contact our office to discuss the matter and/or pay her balance. A copy of *** ***’s ledger and day final notice was mailed out on 10/20/2016. When our office did not hear from the patient or receive a payment, the patient’s account was sent to collection. *** *** claims that the bill our office submitted is fraudulent. *** *** received all services submitted to her insurance on 12/03/2015, rendering the outstanding balance valid. All quotes given to patients are always just estimates, we file insurance claims as a courtesy to the patient and the patient is ultimately responsible for his/her insurance and any balance remaining after insurance paysAttached, please find a copy of the patient’s EOB sent to *** *** and our office on 01/19/and a copy of the financial responsibility page of *** ***’s new patient paperwork. Sincerely, *** **
*** ***
*** *** *** ***
***

It was brought to our attention that on 12/07/2016, our patient [redacted] submitted a complaint to the Revdex.com regarding Billing/Collection/Fraudulent issues.  This complaint stems from a visit [redacted] made to our office on...

12/03/2015.  [redacted] was seen in our office for an exam, full series of x-rays and a dental cleaning as a new patient.  [redacted] claims that false information was given to her at the time of her visit regarding coverage of x-rays, leading to an outstanding balance billed to the patient after insurance did not cover/pay for the x-rays.  When a call is placed and/or benefits are looked up online regarding a patient’s insurance, our office verifies that a patient’s insurance plan is active and they are eligible to receive benefits.  We offer no guarantees of coverage because we are 3rd party to the patient’s insurance.  [redacted] also stated in her complaint that she had x-rays previously taken at another dental office in July of 2015.  At no point in time did [redacted] disclose this information to us.  She stated in her complaint that “[redacted]’s office could have called the other dental office to obtain the same x-rays”.  Unfortunately, if we are not informed by the patient of prior treatments, there is no way for us to know treatment was done.  It is up to the patient to disclose to us that x-rays were taken and to coordinate with the other office to have them sent over.  Additionally, when a patient is seen in our office for the first time, they complete a health history questionnaire and sign a document regarding financial responsibility.  The financial responsibility section states: “Insurance Claims: While we do our best to determine your out of pocket expenses at the time of service, we cannot be certain until your insurer pays your claim.  At that time, we will bill you for any unpaid balance or refund any overpayments.  An interest rate charge of 10% plus collection fees will be assessed for balances not paid within 30 days.”  [redacted] acknowledged these statements with her initials on 12/03/2015.  Furthermore, on 01/19/2015, our office received a check from the patient’s insurance company for date of service 12/03/2015 (ck#: 0001263456).  The patient also received a copy of this EOB.  The EOB clearly indicates the patient’s responsibility.  Upon receiving this EOB, [redacted] failed to contact our office to discuss the matter and/or pay her balance.  A copy of [redacted]’s ledger and 30 day final notice was mailed out on 10/20/2016.   When our office did not hear from the patient or receive a payment, the patient’s account was sent to collection.  [redacted] claims that the bill our office submitted is fraudulent.   [redacted] received all services submitted to her insurance on 12/03/2015, rendering the outstanding balance valid.   All quotes given to patients are always just estimates, we file insurance claims as a courtesy to the patient and the patient is ultimately responsible for his/her insurance and any balance remaining after insurance pays. Attached, please find a copy of the patient’s EOB sent to [redacted] and our office on 01/19/2015 and a copy of the financial responsibility page of [redacted]’s new patient paperwork.  Sincerely, [redacted]
[redacted]
[redacted]
[redacted]

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]

Dear [redacted], This letter serves as our response to [redacted]'s most recent correspondence with the Revdex.com.  [redacted] states that our office has not provided proof that she was advised that she would incur a cost for x-rays taken if insurance did not cover them.  Proof is never provided at our office that a patient will or will not incur a cost for services rendered. Because we are 3rd party to the patient's insurance, everything quoted is always an estimate.  Our office is not responsible for any patient's insurance.  And, as stated in our previous reply, eligibility/benefits are verified either by phone or through the insurance website.  In the instance of online verification, there would not be a confirmation number received.  All new patients to our office are seen for a prophylaxis, comprehensive exam and a full mouth series of x-rays.  Had x-rays been sent to us from [redacted]'s previous dentist, they would not have been taken in our office.  No fraud has been committed.  All services submitted to insurance were rendered.  Per [redacted]'s request and to avoid any further back and forth banter regarding this situation, we will be removing [redacted]'s balance from collection and dismissing her from our practice.  Sincerely, [redacted]