Dr. Ed Monroe Dentist

Initial Business Response /* (1000, 5, 2014/10/01) */
This patient was seen on 9/3/for cleaning,exam and full set of xraysFee amt $We received an insurance check on 3/21/for part of this visit in amount of $The other portion of this claim is still pending as of TODAY
with the State of IllinoisWe then saw the patient on 10/28/for root canal, core build up, crown and a fillingFee amt $We received an insurance check on 5/23/in the amount of $
We did make a mistake on 11/5/charging Care Credit a total of $We should have charged Care Credit $This mistake was brought to our attention by the patientA refund check was issued to the patient on 11/7/in the amount of $that he could have applied to his care credit accountTransactions are as follows:
CHARGE BALANCE
Cleaning
exam
x rays
crown
root canal
core buildup
filling
CARE CREDIT PAYMENT
REFUND CK TO PATIENT
INSURANCE CK PAYMENT
INSURANCE CK PAYMENT -
Typically we will refund the patient when there is a credit on the account, but since there was still a pending claim, we were waiting until that claim paid to send one check rather than two separate checks
The patient came to our office on 6/9/to discuss the refund owed him that we had not issued to himHe spoke with one of our receptionistShe was comparing the Explanation of Benefits that the patient brought in to what we had receivedPatient was stating he had a refund of $owed to him, but we were only showing a credit of $on the accountShe was trying to figure out where the discrepancy was when the patient then brought up the fact we had made a mistake with his Care Credit and proceeded to carry on about the fact it was costing him $a month for his balance and he would be paying on that for almost monthsThe other receptionist that was sitting up front was looking at his account as well,and noticed we had refunded him $and then said she was confusedHe said why, and she mentioned the refundHe said yes he had received the refundShe asked him if he had applied it to his Care Credit balance and he said NO he had notHad he done this, he would have only been paying on the Care Credit account for months rather than Pointing this out to him made him extremely angryHe grabbed the explanation of benefits from the first receptionist and started to storm out of the office, stating while he was leaving, he was going to contact his lawyer
The first receptionist called the patient shortly after he left and said she was willing to try to help him figure out the credit he had coming and why his numbers weren't coinciding with oursShe also explained to him that there was a pending claim yet and this is why we had not yet refunded him any money ($42.00)Again, we were waiting for the second insurance check so we could issue one refund check instead of two and YES he would be receiving his refundHe said he was willing to speak with her but he did not want to speak with the second receptionistI am ASSUMING it was because she is the one who pointed out he could have applied the refund check to his care credit and that angered himThe first receptionist made an appointment with the patient for later in the week but then he called to cancel the appointment due to a work conflictHe said he would call back to reschedule but he never didRoughly weeks later, the patient came into our office and spoke with the first receptionistShe presented to the patient a list of the transactions exactly as the ones listed above explaining to the patient that a claim was still pending with insurance and as soon as we received payment a refund check would be issued for the full credit amountPatient said he understood and accepted these terms
We have called on the outstanding claim TODAY and it is still pending with the insurance
Had the patient called our office and requested the credit that was on his account now, we would have been more than happy to refund that, but we were under the impression he was willing to wait for the outstanding claim to be paid and one check issued
I would like to address that the patient has stated he has given us almost a year to pay him back, when in all actuality we only received insurance payments on 3/21/AND 5/23/and today is 10/1/
As far as pointing out our mistake with Care Credit and the lady he spoke with being very condescending and rude and upset we caught her mistake???? On the rare occasion that a mistake has been made in our office, (but it has happened) we are more than willing and happy to rectify that mistake and take full responsibility for said mistakeI do not believe anyone from this office treated this patient in the way he described
In summation, our records indicate he has a credit balance of $I am happy to refund this amount immediately
Initial Consumer Rebuttal /* (3000, 8, 2014/10/11) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The anonymous response is so childish and insulting and laughable that I don't really have time for their nonsenseThey obviously are not taking this seriously and would prefer to act shocked that someone would accuse one of their receptionists of being rude and condescending right after that receptionist just overcharged a customer by over a $1,000!
Instead, I will just lay out the FACTS as simply and clearly as I can so that they can even be understood by this businessRemember, numbers that are not manipulated do not lieAnd the facts of this case are quite incriminating, as you will see
The $charge from the cleaning, x-rays, and exam on 9/3/is separate from the $1,charge for the root canal, crown and buildup of 10/28/that was paid for with the loan from Care CreditAfter subtracting the $1,overcharge, the amount I was charged for the 10/28/procedures was $The Patient Payment portion from Delta Dental on its Explanation of Benefits dated 5/18/was $704, an overcharge of $I did not receive and Explanation of Benefits for the $even though I got a bill from Dr*** Dated October 28, for $62, which was my portion of the $after the estimated insurance payment of $
I called Delta Dental on 10/6/and spoke with ***, and we figured out what Dr*** office had done with the billing, which even *** agreed is quite suspiciousWhen I went in on 6/9/and tried to explain the situation to the or receptionists in there, I noticed that the $had not been turned in to Delta Dental even though the dentist office had sent an estimate (from the insurance company) and a bill to me for my portionI asked why, and they claimed they had "forgot"WHAT? Does anyone really believe that a business would just HAPPEN to "forget" to get reimbursed for almost the EXACT same amount (vs 262) that they overcharged me for the crown? What a coincidence!! *** said that they finally turned in the bill for x-rays on 8/6/14, almost a YEAR after they were taken! By not turning in the bill to the insurance company and overcharging me instead, the only *** in the transaction was the customer, because the lender was able to lend more than they should have, the insurance company saved money, and what the dentist gained will probably be one of the questions that the authorities and regulators will be investigating when they see if this type of billing irregularity has been a pattern for this businessI'll leave that speculation for others, although the evidence is quite incriminating if you ask me
When I mentioned that Dr*** has been unwilling to pay me back what I am owed, she emphatically replied "Well, they HAVE to." I said "I know they HAVE to, but it's been a year and they still haven't." She said there are regulations in place to make sure they do, so I hope she's right
I really don't care what the office's response is, because I don't even know for sure who is responding, and they obviously just want to play some sort of game of deception that I simply don't want to play with themAll I want is my money and to make sure they aren't doing this to other customers
*** ***
Final Business Response /* (4000, 10, 2014/10/22) */
To resolve this issue, I have called the insurance to find out what they will eventually be paying on the outstanding claimThey will be paying $for the cleaning and $for the X-rays, but we won't be receiving funds for a minimum of days as the insurance pays as the state releases fundsThis total amount though, plus the credit on the account totals $I will have Dr***'s wife issue Mr*** a check in this amount and we will then wait for insurance to pay usMrs*** won't be back in the office until Monday October 27thThe check will be issued then and mailed out on the 28thI hope this is satisfactory to Mr***