Initial Business Response /* (1000, 5, 2016/11/22) */
Contact Name and Title: *** *** Office Manager
Contact Phone: ***
Contact Email: ***@gmail.com
Unfortunately due to Federal HIPAA regulations, I can NOT respond to the complaint specificallyI can however tell
you that any patient that has private insurance receives a treatment plan showing what we estimate the insurance to coverIt says on the treatment plan "Please note all insurance and patient portions are estimates" When a patient checks out from receiving treatment, we collect what we estimated the patient to oweIf their insurance does not pay for something or pays less than we expected, the insurance company tells the provider what is billable to the patientAdditionally, When A patient contacts the office manager (in this office ME) We always review what the insurance denied and when appropriate, adjustments are madeI would suggest this Patient contact her insurance carrier and find out what was not covered and whyWe are contracted with most major Dental InsuranceBecause we are contracted we can only bill a patient what the insurance company determines is billable to the PatientAgain HIPAA prevents me from responding to the specifics of this complaintThat is very frustrating to me because the patient can make allegations against our clinic and we are legally not allowed to provide a specific responsePlease be aware ALL DENTAL INSURANCE send the Patient an EXPLANATION of BENEFITSIf this patient does NOT have the EOB, She can request oneFurther, All Patients are given the written Financial policy and acceptance of Financial Responsibility for our company when we give them new patient paperworkIn the Paperwork it states the patient agrees to pay any part their insurance deniesStill Our company makes every effort to be as accurate as possible with the estimatesWe do not want our patient's to be unhappy, but we can NOT control what the insurance paysThank YOU
Initial Consumer Rebuttal /* (3000, 7, 2016/11/29) */
(The consumer indicated he/she DID NOT accept the response from the business.)
First of all, I tried to contact *** *** starting November 14, I called at 8:am and was told to try back in an hour or so as she was not in yetI called back hrs later and was told she was not in that day to try again tomorrowI called again the following day and was told she was not available and to leave a messageShe called back at pm and I asked if I could call back in minutes when I got homecalled back in minutes and she was going out the door to lunchThis continued on to WednesdayShe called me and I asked for an explanation of the chargesShe told me that she could not access my files to give me an explanationShe said she would find the files and call me backTo date I have had not recieved any phone calls from the Dental Office with an explanationI phoned my insurance company and spoke to *** who could find that the only charges they denied were for a periodontal cleaning, which I did not authorizeI was under the understanding that I was going to receive a dental cleaning which was covered by my insuranceI went into the office for my cleaning and received x rays and minutes of scraping on my teeth and sent on my wayI had a periodontal cleaning done months earlier, which is done in two visits and takes 1/hrsOne side of the mouth per visit***, which is the umbrella carrier for my dental insurance is filing a grievance with *** Dental on my behalf
Final Consumer Response /* (4200, 21, 2016/12/15) */
(The consumer indicated he/she DID NOT accept the response from the business.)
This is a copy of the letter I emailed to *** on December 8, To date I have not received a response from her
This message contains blocked images
When we spoke on November 15, 2016, you did adjust and remove the periodontal cleaning chargeBut you did not adjust the x rays or explain why I received the x raysI am not trying to get free services from your officeI only want an explanation as to the charges that I am being billed for nowI was under the impression that I paid the balances as services were renderedI was under the impression that I had a general cleaning done, as a periodontal cleaning is done in two visitsThis visit, I was in and out in less than thirty minutesThis is to my knowledge not a periodontal treatmentPerhaps this matter would have been explained and done with already had you followed up and returned a call to me which to date you have not done despite many attempts to get in touch with youEither you are not in or not available and cannot access my files to give me an explanation of the chargesSo while you are talking dollars and cents, I am clarifying proceduresIt seems you are doing one procedure yet charging for anotherIf you say I owe $***, please send me an email stating that and I will get the payment to your office
*** ***
Final Business Response /* (4000, 19, 2016/12/15) */
I have contacted this Patient directlyAlthough I know the Revdex.com serves a unique and vital service to our community, I am frustrated by this situationAs I said before, I am legally Bound by FederAL hipaa LAWS that restrict my ability to defend myself and my companyThis Patient DID NOT provide you with the entire truthThe patient failed to mention several things, and slanted the facts to his/her favorIt is unfair that a person can say anything they want on this forum, AND BECAUSE OF hipaa, I CANNOT adequately represent myself or my businessPlease be advised MY company does try to resolve patient complaintsSometimes even when we compromise and make concessions, we still get a Revdex.com letter because there is little WE can say on Public Forum
Initial Business Response /* (1000, 5, 2016/11/22) */
Contact Name and Title: *** *** Office Manager
Contact Phone: ***
Contact Email: ***@gmail.com
Unfortunately due to Federal HIPAA regulations, I can NOT respond to the complaint specificallyI can however tell
you that any patient that has private insurance receives a treatment plan showing what we estimate the insurance to coverIt says on the treatment plan "Please note all insurance and patient portions are estimates" When a patient checks out from receiving treatment, we collect what we estimated the patient to oweIf their insurance does not pay for something or pays less than we expected, the insurance company tells the provider what is billable to the patientAdditionally, When A patient contacts the office manager (in this office ME) We always review what the insurance denied and when appropriate, adjustments are madeI would suggest this Patient contact her insurance carrier and find out what was not covered and whyWe are contracted with most major Dental InsuranceBecause we are contracted we can only bill a patient what the insurance company determines is billable to the PatientAgain HIPAA prevents me from responding to the specifics of this complaintThat is very frustrating to me because the patient can make allegations against our clinic and we are legally not allowed to provide a specific responsePlease be aware ALL DENTAL INSURANCE send the Patient an EXPLANATION of BENEFITSIf this patient does NOT have the EOB, She can request oneFurther, All Patients are given the written Financial policy and acceptance of Financial Responsibility for our company when we give them new patient paperworkIn the Paperwork it states the patient agrees to pay any part their insurance deniesStill Our company makes every effort to be as accurate as possible with the estimatesWe do not want our patient's to be unhappy, but we can NOT control what the insurance paysThank YOU
Initial Consumer Rebuttal /* (3000, 7, 2016/11/29) */
(The consumer indicated he/she DID NOT accept the response from the business.)
First of all, I tried to contact *** *** starting November 14, I called at 8:am and was told to try back in an hour or so as she was not in yetI called back hrs later and was told she was not in that day to try again tomorrowI called again the following day and was told she was not available and to leave a messageShe called back at pm and I asked if I could call back in minutes when I got homecalled back in minutes and she was going out the door to lunchThis continued on to WednesdayShe called me and I asked for an explanation of the chargesShe told me that she could not access my files to give me an explanationShe said she would find the files and call me backTo date I have had not recieved any phone calls from the Dental Office with an explanationI phoned my insurance company and spoke to *** who could find that the only charges they denied were for a periodontal cleaning, which I did not authorizeI was under the understanding that I was going to receive a dental cleaning which was covered by my insuranceI went into the office for my cleaning and received x rays and minutes of scraping on my teeth and sent on my wayI had a periodontal cleaning done months earlier, which is done in two visits and takes 1/hrsOne side of the mouth per visit***, which is the umbrella carrier for my dental insurance is filing a grievance with *** Dental on my behalf
Final Consumer Response /* (4200, 21, 2016/12/15) */
(The consumer indicated he/she DID NOT accept the response from the business.)
This is a copy of the letter I emailed to *** on December 8, To date I have not received a response from her
This message contains blocked images
When we spoke on November 15, 2016, you did adjust and remove the periodontal cleaning chargeBut you did not adjust the x rays or explain why I received the x raysI am not trying to get free services from your officeI only want an explanation as to the charges that I am being billed for nowI was under the impression that I paid the balances as services were renderedI was under the impression that I had a general cleaning done, as a periodontal cleaning is done in two visitsThis visit, I was in and out in less than thirty minutesThis is to my knowledge not a periodontal treatmentPerhaps this matter would have been explained and done with already had you followed up and returned a call to me which to date you have not done despite many attempts to get in touch with youEither you are not in or not available and cannot access my files to give me an explanation of the chargesSo while you are talking dollars and cents, I am clarifying proceduresIt seems you are doing one procedure yet charging for anotherIf you say I owe $***, please send me an email stating that and I will get the payment to your office
*** ***
Final Business Response /* (4000, 19, 2016/12/15) */
I have contacted this Patient directlyAlthough I know the Revdex.com serves a unique and vital service to our community, I am frustrated by this situationAs I said before, I am legally Bound by FederAL hipaa LAWS that restrict my ability to defend myself and my companyThis Patient DID NOT provide you with the entire truthThe patient failed to mention several things, and slanted the facts to his/her favorIt is unfair that a person can say anything they want on this forum, AND BECAUSE OF hipaa, I CANNOT adequately represent myself or my businessPlease be advised MY company does try to resolve patient complaintsSometimes even when we compromise and make concessions, we still get a Revdex.com letter because there is little WE can say on Public Forum