Dr. Suresh & Associates

This letter is the response in reference to the complaint by [redacted] on behalf of her Mother [redacted] ***[redacted] has been a patient in our office for since In her last visit which had a lapse of almost years , had some progressive issues with her teeth which needed extensive treatmentWe gave her a detailed written treatment plan with the fee as designated by her insurance company and every aspect of treatment and the outcome was discussed with herShe gave acceptance for the recommended treatmentThe total fee went beyond the maximum limit of the insurance for the year, which she was vey well aware and the needed treatment were such that it could not have waited for the next year's Insurance benefits without compromising the integrity of the teeth( we do have a copy of the signed treatment plan with the insurance benefits and the co-pay amount with her signature)She paid all the copay accordingly at every stage of treatment and insurance paid their share of maximum benefit for the year and she expressed happiness about the outcome of the treatment.One fine day our office received a phone call followed by email from [redacted] the daughter of the patient stating that her Mother has paid too much money for the treatment with the impression that insurance had not paid much for the treatment renderedWith the patient consent I sent all the relevant documents to her which included treatment plan with the consent of the patient, copy of the ledger showing the amount we collected from the patient and from the insuranceEvery fee we quoted to her was exactly to the Dentimax fee schedule of her insurance company.She contacted the insurance company about the fee structure and the billingInsurance company requested me to send the relevant documents in regard to the fee I had charged and collected, which I sent themAfter few days when our office called the [redacted] about the outcome of issue, they said that everything looks good from my side Obviously [redacted] was not happy and she questioned the Insurance company again for some clarification and it is unfortunate at this stage they made an error in figuring out the payments and informed [redacted] that I have charged more than I should have and to collect the overpaid money from Us.As I was very sure that have not done anything wrong in my billing, I informed [redacted] that I will be appealing the insurance to correct their mistake and till such time I will not be refunding the money because I had not collected more than the prescribed fee as per to insurance fee schedule Mean time I started getting number of emails from her about the mistrust and my integrity of practice and so on.Meantime, I talked to [redacted] who was the case worker of the patient complaints and I sent all the documents againShe called me last week and told me that they looked into every thing and that I do not owe anything to the patient and I am waiting to get a written information to that effect from [redacted] [redacted] the Mother of the complainant had very good relation with us [redacted] multiple emails with accusations leads to a conclusion that they have total distrust in me and our officeIn such situation I am sure it is hard for [redacted] to accept us for her dental services even though we have not committed anything wrong.This is the extract from my last email addressed to [redacted] about her Mothers present dental issue " If you think that tooth in question is recently done that is # 10, I have no problem to look into that issue as long as your mother is comfortable with me If needed, I can send all the records that I have worked on [redacted] teeth with dates and needed x-raysAll I need is [redacted] permission to release her records either by email or direct mail to the person of her choice."As soon as I get the corrected written explanation of insurance benefits from [redacted] of [redacted] , I will forward a copy of it to youFor any reason, if you need to contact the responsible persons in the insurance company here are their addresses[redacted] ###-###-#### [redacted] ( Insurance carrier) [redacted] ###-###-#### Dentimax Fee Schedule co-coordinator[redacted] RegardsDr [redacted]

This letter is the response in reference to the complaint by [redacted] on behalf of her Mother [redacted].[redacted] has been a patient in our office for since 1996. In her last visit which had a lapse of almost 3 years , had some progressive issues with her teeth which needed extensive...

treatment. We gave her a detailed written treatment plan with the fee as designated by her insurance company and every aspect of treatment and the outcome was discussed with her. She gave  acceptance for the recommended treatment. The total fee went beyond the maximum limit of the insurance for the year, which she was vey well aware and the needed treatment were such that it could not have waited for the next year's Insurance  benefits without compromising the integrity of the teeth. ( we do have a copy of the signed treatment plan with the insurance benefits and the co-pay amount with her signature)She paid all the copay accordingly at every stage of treatment and insurance paid their share of maximum benefit for the year and she expressed happiness about the outcome of the treatment.One fine day our office received a phone call followed by email from [redacted] the daughter of the patient stating that her Mother has paid too  much money for the treatment with the impression that insurance had not paid much for the treatment rendered. With the patient consent I sent all the relevant documents to her which included treatment plan with the consent of the patient, copy of the ledger showing the amount we collected from the patient and from the insurance. Every fee we quoted to her was exactly to the  Dentimax fee schedule of her insurance company.She contacted the insurance company about the fee structure and the billing. Insurance company requested me to send the relevant documents in regard to the fee I had charged and collected, which I sent them. After few days when our office called the [redacted] about the outcome of issue, they said that everything looks good from my side.  Obviously [redacted] was not happy and she questioned the Insurance company again for some clarification and it is unfortunate at this stage they made an error in figuring out the payments and informed [redacted] that I have charged more than I should have and to collect the overpaid money from Us.As I was very sure that have not done anything wrong in my billing, I informed [redacted] that I will be appealing the insurance to correct their mistake and till such time I will not be refunding the money because I had not collected more than the prescribed fee as per to insurance fee schedule.  Mean time I started getting number of emails from her about the mistrust and my integrity of practice and so on.Meantime, I talked to [redacted] who was the case worker of the patient complaints and I sent all the documents again. She called me last week and told me that they looked into every thing and that I do not owe anything to the patient and I am waiting to get a written information to that effect from [redacted].[redacted] the Mother of the complainant had very good relation with us. [redacted] multiple emails with accusations leads to a conclusion that they have total distrust in me and our office. In such situation I am sure it is hard for [redacted] to accept us for her dental services even though we have not committed anything wrong.This is the extract from my last email addressed to [redacted] about her Mothers present dental issue  " If you think that tooth in  question is recently done that is # 10,  I have no problem to look into that issue as long as your mother is comfortable with me.  If needed, I can send all the records that I have worked on [redacted] teeth with dates and needed x-rays. All I need is [redacted] permission to release her records either by email or direct mail to the person of her choice."As soon as I get the corrected written explanation of insurance benefits from [redacted] of [redacted], I will forward a copy of it to you. For any reason, if you need to contact the responsible persons in the insurance company here are their addresses.[redacted] ###-###-#### [redacted] ( Insurance  carrier)[redacted] ###-###-####  Dentimax  Fee Schedule co-coordinator.[redacted] RegardsDr. [redacted]

This letter is the response in reference to the complaint by [redacted] on behalf of her Mother [redacted].[redacted] has been a patient in our office for since 1996. In her last visit which had a lapse of almost 3 years , had some progressive issues with her teeth which needed extensive...

treatment. We gave her a detailed written treatment plan with the fee as designated by her insurance company and every aspect of treatment and the outcome was discussed with her. She gave  acceptance for the recommended treatment. The total fee went beyond the maximum limit of the insurance for the year, which she was vey well aware and the needed treatment were such that it could not have waited for the next year's Insurance  benefits without compromising the integrity of the teeth. ( we do have a copy of the signed treatment plan with the insurance benefits and the co-pay amount with her signature)She paid all the copay accordingly at every stage of treatment and insurance paid their share of maximum benefit for the year and she expressed happiness about the outcome of the treatment.One fine day our office received a phone call followed by email from [redacted] the daughter of the patient stating that her Mother has paid too  much money for the treatment with the impression that insurance had not paid much for the treatment rendered. With the patient consent I sent all the relevant documents to her which included treatment plan with the consent of the patient, copy of the ledger showing the amount we collected from the patient and from the insurance. Every fee we quoted to her was exactly to the  Dentimax fee schedule of her insurance company.She contacted the insurance company about the fee structure and the billing. Insurance company requested me to send the relevant documents in regard to the fee I had charged and collected, which I sent them. After few days when our office called the [redacted] about the outcome of issue, they said that everything looks good from my side.  Obviously [redacted] was not happy and she questioned the Insurance company again for some clarification and it is unfortunate at this stage they made an error in figuring out the payments and informed [redacted] that I have charged more than I should have and to collect the overpaid money from Us.As I was very sure that have not done anything wrong in my billing, I informed [redacted] that I will be appealing the insurance to correct their mistake and till such time I will not be refunding the money because I had not collected more than the prescribed fee as per to insurance fee schedule.  Mean time I started getting number of emails from her about the mistrust and my integrity of practice and so on.Meantime, I talked to [redacted] who was the case worker of the patient complaints and I sent all the documents again. She called me last week and told me that they looked into every thing and that I do not owe anything to the patient and I am waiting to get a written information to that effect from [redacted].[redacted] the Mother of the complainant had very good relation with us. [redacted] multiple emails with accusations leads to a conclusion that they have total distrust in me and our office. In such situation I am sure it is hard for [redacted] to accept us for her dental services even though we have not committed anything wrong.This is the extract from my last email addressed to [redacted] about her Mothers present dental issue  " If you think that tooth in  question is recently done that is # 10,  I have no problem to look into that issue as long as your mother is comfortable with me.  If needed, I can send all the records that I have worked on [redacted] teeth with dates and needed x-rays. All I need is [redacted] permission to release her records either by email or direct mail to the person of her choice."As soon as I get the corrected written explanation of insurance benefits from [redacted] of [redacted], I will forward a copy of it to you. For any reason, if you need to contact the responsible persons in the insurance company here are their addresses.[redacted] ###-###-#### [redacted] ( Insurance  carrier)[redacted] ###-###-####  Dentimax  Fee Schedule co-coordinator.[redacted] RegardsDr. [redacted]