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/ [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 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 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 days.” [redacted] acknowledged these statements with her initials on 12/03/ 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, [redacted] failed to contact our office to discuss the matter and/or pay her balance A copy of [redacted] ***’s ledger and day final notice was mailed out on 10/20/ 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 paysAttached, please find a copy of the patient’s EOB sent to [redacted] and our office on 01/19/and a copy of the financial responsibility page of [redacted] ***’s new patient paperwork Sincerely, [redacted]
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/ [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 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 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 days.” [redacted] acknowledged these statements with her initials on 12/03/ 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, [redacted] failed to contact our office to discuss the matter and/or pay her balance A copy of [redacted] ***’s ledger and day final notice was mailed out on 10/20/ 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 paysAttached, please find a copy of the patient’s EOB sent to [redacted] and our office on 01/19/and a copy of the financial responsibility page of [redacted] ***’s new patient paperwork Sincerely, [redacted]