Dr. Denise J. Unterbrink, DDS

Review: I moved here in 2013 and called her office because I was looking for a dentist in this area. When I called, I told [redacted] what dental insurance I had & told her I needed to confirm that my insurance was in-network with them before I made an appt. She did confirm that I was in-network so I chose Dr. Unterbrink as my dentist. December 2014 I went for my 6 month cleaning & was told that I needed dental work. I made the appt. for January of 2015 & @ the same time informed [redacted] that I would have different dental insurance beginning January 1st 2015-that it would still be with [redacted] but it would be a different policy. She said that's fine, just bring your new card when you come. I did. Then I receive a bill for $224.00 for my portion & my insurance only paid $148.00. I called my insurance to see why I was responsible for the larger amount & I called [redacted]. That's when they both informed me that I was out-of-network. I was never told by [redacted] that I was only in-network @ this office with certain [redacted] policies & for me to blame it on [redacted]. I think this was wrong so I wrote Dr. Unterbrink a letter explaining what had happened & that the only way to make this right was for her to accept what I would have paid if I had been in-network which would have been $108.75. I asked her in the letter to contact me. She never did. Instead I received another bill for the same amount.Desired Settlement: I've already paid the $224.00 but feel she should reimburse me $115.25. This treatment is very unprofessional & I've never experienced this at any other dental or physician's office.

Business

Response:

I received your letter today regarding case #[redacted]. This patient was seen in our office on 7/1/14 and 12/11/14. On both of those occasions we were a provider for her insurance. She had insurance through [redacted] at that time. At the 12/11/14 appointment she was told that she needed 2 restorations and she scheduled that appointment for 1/13/15. Her insurance changed to a different [redacted] policy on 1/1/15 and we did not know until we filed that insurance claim that we were not a provider. She had the option to check with her insurance to see if we were a provider. She could have obtained that information by phone or on line. We knew that we had been a provider for her insurance in 2014 and we thought that because it was an [redacted] policy that we were a provider. The Affordable Care Act has changed insurance dramatically and it becomes impossible for us to know the specifics on each patients insurance policy. All patients sign an Authorization for us to file their insurance claim. Along with the authorization there is a statement that says: I understand that my dental insurance carrier may pay less than the actual bill for services. I agree to be responsible for payment of all services rendered on my behalf or my dependents.If necessary I can send you a copy of the patients signed authorization. I hope this better explains what happened with this patient. I will gladly send any further information that you may need.I appreciate your help with this matter.Best wishesDenise Unterbrink DDS

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I do not agree with her reply. When I originally called the office [redacted] told me my insurance with them would be in-network if it was with [redacted]. I informed her in December that my insurance would be changing January 1 2015 & that it would still be with [redacted] but that it would be a different policy. [redacted] took the insurance card to make a copy of it. Apparently they no longer participate with all [redacted] policies but she didn't inform me of this information so that I could find another dentist that I would be in-network with. She should have told me. I did sign the standard forms that a new patient signs at any office, but this doesn't give them permission to mislead me and make me think that I'm still in-network when I'm not.

Regards,

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Business

Response:

Our original response stands. We were not aware that we are no longer an in-network provide under her new [redacted] plan due to the Affordable Care Act.Dr. Unterbrink

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

Claiming they were not aware that I was out-of -network is no excuse after I was clearly told by [redacted] that as long as I had [redacted] that I would be in-network. You don't give a patient that kind of information and then not honor it. That is dishonest. I gave Dr. Unterbrink credit for having more character than this-she has clearly proven me wrong. She knows that she owes me $115.25 and the fact that she has not reimbursed me is nothing less and nothing more than stealing. I do get some satisfaction that the Revdex.com will publicly post all of this information on their website. Also it is within my right to publicly post this information on her website page so that others will be aware and hopefully choose an honest dentist who has a better moral and professional character.

Regards,