Emerald Crossing Family Dentistry

I am aware of Mrs [redacted] visit and complaint to the OM at H [redacted] but I apologize for her confusionThat office is not our main dental officeWe are two separate dental officesThey do not have our patient records or would not have any authority with Emerald Crossing Family Dentistry's patients or staff Since the first date of service April 15, 2015, [redacted] had proposed a 3-unit bridge as a permanent solution to replace tooth #broken at the gum line as a result of trauma sustained during sports activityI sent a pre-authorization to the [redacted] ***-***, the patient's insurance at the time, on April 24, The pre-authorization was deniedA flipper was then proposed as a temporary esthetic solution and approved by the insurancePrior to the flipper being delivered the patient and father chose to have a splint placed as a temporary solution The splint came off on several occasion due to patient not following home care instructions regarding eating habits and athleticsat every visit a 3-unit bridge was proposed as the permanent restoration, including the following dates: 4/15/15, 4/24/15, 05/06/15, 11/03/15, and 4/18/Mr [redacted] continually stated his concern for not crowning the adjacent teeth since they did not have decayCost was another of Mr [redacted] 's concernsAn Implant on tooth #was also recommended Although the patient never scheduled the complimentary consultation with the periodontist The flipper was returned by the lab to our office on May 13, We attempted to deliver the flipper to the patient when it was delivered to us and on Nov 03, The patient declined the flipperHe was not interested in wearing a removable appliancePatient finally accepted the appliance on April almost one year after it was madeThere was a balance on the patient account from the dates of service where the patient had [redacted] ***- [redacted] or no insurance coverageOn [redacted] ***- [redacted] the patient is responsible for the remaining balance that is not covered by insurance, unlike [redacted] ***-M [redacted] On April 18, 2016, I had given Mr [redacted] , [redacted] a detailed account of the services rendered and account balanceThe date of service 4/15/15, $was due for the extraction on tooth #that was denied by [redacted] ***-***Date of service 4/17/15, $was due for the composite splint that was placed, also denied by [redacted] ***-***On 11/03/15, $was due for the Limited evaluation and re-cementation of the splint was also denied by [redacted] ***-***A total balance at that point had been given of $ Mr [redacted] , **and I made financial arrangement for the balance to be taken care of in 2-paymentsThat same day, April 18, 2016, services were rendered in the amount of $for a limited exam and re-cementationPatient did not have insurance coverage at that timeA payment was given of $The first visit Mrs [redacted] came to was on May 16, At that time the patient had Traditional M [redacted] - [redacted] coverageMrs [redacted] gave a payment of $towards the previous account balanceAt this point the remaining patient balance was $On May 13, we were informed pt had traditional [redacted] when our office verified coverage for an upcoming dental appointment A pre-authorization for the 3-unit bridge was mailed on May 16, and was denied on May 24, Once the patient was assigned a managed care plan ( [redacted] ***-M [redacted] ) on June 01, 2016, a pre-authorization was once again sent out electronicallyI personally was checking the online portal daily to see any immediate approvalJune 8th the portal was checked before noon and was still under reviewThe Pre Authorization was approved the afternoon of June 8thMrs [redacted] came into Emerald Crossing on June 9th visibly upset, demanding to speak to [redacted] , cursing not giving us the opportunity to speak or relay that the bridge had been approve the day beforeDue to the di**espectful outburst in our office made to myself and [redacted] by Mrs [redacted] , I was informed to give her time to clarify her emotions All the claims that have been made are inaccurate and when I last spoke with Mrs [redacted] on the date of June 9, 2016, unfortunately I was not given the chance to clarify and address her concernsWhen Mrs [redacted] was here, she stated she had switched her son to a different dental officeKnowing the rules and regulations of [redacted] ***-M [redacted] , I called them the next day to release the approved pre-authorizationThis would assure that there would be no delays at the patient's new dental office getting the procedure approved We also forwarded the pt's x-rays to the new dental officeOur patients are our priority, whether it is with our office or another The patient's remaining balance has been written-off as a courtesyWe will not be refunding the account considering it was a true balance for services rendered [redacted] *- Office Manager

I am aware of Mrs*** visit and complaint to the OM at H*** *** *** but I apologize for her confusionThat office is not our main dental officeWe are two separate dental officesThey do not have our patient records or would not have any authority with Emerald Crossing
Family Dentistry's patients or staff. Since the first date of service April 15, 2015, *** *** had proposed a 3-unit bridge as a permanent solution to replace tooth #broken at the gum line as a result of trauma sustained during sports activityI sent a pre-authorization to the *** ***-***, the patient's insurance at the time, on April 24, The pre-authorization was deniedA flipper was then proposed as a temporary esthetic solution and approved by the insurancePrior to the flipper being delivered the patient and father chose to have a splint placed as a temporary solution. The splint came off on several occasion due to patient not following home care instructions regarding eating habits and athleticsat every visit a 3-unit bridge was proposed as the permanent restoration, including the following dates: 4/15/15, 4/24/15, 05/06/15, 11/03/15, and 4/18/Mr*** continually stated his concern for not crowning the adjacent teeth since they did not have decayCost was another of Mr***'s concernsAn Implant on tooth #was also recommended. Although the patient never scheduled the complimentary consultation with the periodontist. The flipper was returned by the lab to our office on May 13, We attempted to deliver the flipper to the patient when it was delivered to us and on Nov 03,2015. The patient declined the flipperHe was not interested in wearing a removable appliancePatient finally accepted the appliance on April almost one year after it was madeThere was a balance on the patient account from the dates of service where the patient had *** ***-*** or no insurance coverageOn *** ***-*** the patient is responsible for the remaining balance that is not covered by insurance, unlike *** ***-M***On April 18, 2016, I had given Mr***, ** a detailed account of the services rendered and account balanceThe date of service 4/15/15, $was due for the extraction on tooth #that was denied by *** ***-***Date of service 4/17/15, $was due for the composite splint that was placed, also denied by *** ***-***On 11/03/15, $was due for the Limited evaluation and re-cementation of the splint was also denied by *** ***-***A total balance at that point had been given of $430.79. Mr***, **and I made financial arrangement for the balance to be taken care of in 2-paymentsThat same day, April 18, 2016, services were rendered in the amount of $for a limited exam and re-cementationPatient did not have insurance coverage at that timeA payment was given of $The first visit Mrs*** came to was on May 16, At that time the patient had Traditional M***-*** coverageMrs*** gave a payment of $towards the previous account balanceAt this point the remaining patient balance was $On May 13, we were informed pt had traditional *** when our office verified coverage for an upcoming dental appointment. A pre-authorization for the 3-unit bridge was mailed on May 16, and was denied on May 24, Once the patient was assigned a managed care plan (*** ***-M***) on June 01, 2016, a pre-authorization was once again sent out electronicallyI personally was checking the online portal daily to see any immediate approvalJune 8th the portal was checked before noon and was still under reviewThe Pre Authorization was approved the afternoon of June 8thMrs*** came into Emerald Crossing on June 9th visibly upset, demanding to speak to *** ***, cursing not giving us the opportunity to speak or relay that the bridge had been approve the day beforeDue to the di**espectful outburst in our office made to myself and *** *** by Mrs***, I was informed to give her time to clarify her emotions. All the claims that have been made are inaccurate and when I last spoke with Mrs*** on the date of June 9, 2016, unfortunately I was not given the chance to clarify and address her concernsWhen Mrs*** was here, she stated she had switched her son to a different dental officeKnowing the rules and regulations of *** ***-M***, I called them the next day to release the approved pre-authorizationThis would assure that there would be no delays at the patient's new dental office getting the procedure approved. We also forwarded the pt's x-rays to the new dental officeOur patients are our priority, whether it is with our office or another. The patient's remaining balance has been written-off as a courtesyWe will not be refunding the account considering it was a true balance for services rendered*** *- Office Manager

I am aware of Mrs. [redacted] visit and complaint to the OM at H[redacted] but I apologize for her confusion. That office is not our main dental office. We are two separate dental offices. They do not have our patient records or would not have any authority with Emerald Crossing Family Dentistry's patients or staff.  Since the first date of service April 15, 2015, [redacted] had proposed a 3-unit bridge as a permanent solution to replace tooth #9 broken at the gum line as a result of trauma sustained during sports activity. I sent a pre-authorization to the [redacted], the patient's insurance at the time, on April 24, 2015. The pre-authorization was denied. A flipper was then proposed as a temporary esthetic solution and approved by the insurance. Prior to the flipper being delivered the patient and father chose to have a splint placed as a temporary solution.  The splint came off on several occasion due to patient not following  home care instructions regarding eating habits and athletics. at every visit a 3-unit bridge was proposed as the permanent restoration, including the following dates: 4/15/15, 4/24/15, 05/06/15, 11/03/15, and 4/18/16. Mr. [redacted] continually stated his concern for not crowning the adjacent teeth since they did not have decay. Cost was another of Mr. [redacted]'s  concerns. An Implant on tooth #9 was also recommended.  Although the patient never scheduled the complimentary consultation with the periodontist.  The flipper was returned by the lab to our office on May 13, 2015. We attempted to deliver the flipper to the patient when it was delivered to us and on Nov 03,2015.  The patient declined the flipper. He was not interested in wearing a removable appliance. Patient finally accepted the appliance on April 18 2016 almost one year after it was made. There was a balance on the patient account from the dates of service where the patient had [redacted] or no insurance coverage. On [redacted] the patient is responsible for the remaining balance that is not covered by insurance, unlike [redacted]-M[redacted]. On April 18, 2016, I had given Mr. [redacted], ** a detailed account of the services rendered and account balance. The date of service 4/15/15, $129.35 was due for the extraction on tooth #9 that was denied by [redacted]. Date of service 4/17/15, $179.62 was due for the composite splint that was placed, also denied by [redacted]. On 11/03/15, $121.82 was due for the Limited evaluation and re-cementation of the splint was also denied by [redacted]. A total balance at that point had been given of $430.79.  Mr. [redacted], **. and I made financial arrangement for the balance to be taken care of in 2-3 payments. That same day, April 18, 2016, services were rendered in the amount of $173.40 for a limited exam and re-cementation. Patient did not have insurance coverage at that time. A payment was given of $193.00. The first visit Mrs. [redacted] came to was on May 16, 2016. At that time the patient had Traditional M[redacted] coverage. Mrs. [redacted] gave a payment of $100.00 towards the previous account balance. At this point the remaining patient balance was $311.19 . On May 13, 2016 we were informed pt had traditional [redacted] when our office verified coverage for an upcoming dental appointment.  A pre-authorization for the 3-unit bridge was mailed on May 16, 2016 and was denied on May 24, 2016. Once the patient was assigned a managed care plan ([redacted]-M[redacted]) on June 01, 2016, a pre-authorization was once again sent out electronically. I personally was checking the online portal daily to see any immediate approval. June 8th the portal was checked before noon and was still under review. The Pre Authorization was approved the afternoon of June 8th. Mrs. [redacted] came into Emerald Crossing on June 9th visibly upset, demanding to speak to [redacted], cursing not giving us the opportunity to speak or relay that the bridge had been approve the day before. Due to the di**espectful outburst in our office made to myself and [redacted] by Mrs. [redacted], I was informed to give her time to clarify her emotions.  All the claims that have been made are inaccurate and when I last spoke with Mrs. [redacted] on the date of June 9, 2016, unfortunately I was not given the chance to clarify and address her concerns. When Mrs. [redacted] was here, she stated she had switched her son to a different dental office. Knowing the rules and regulations of [redacted]-M[redacted], I called them the next day to release the approved pre-authorization. This would assure that there would be no delays at the patient's new dental office getting the procedure approved.  We also forwarded the pt's x-rays to the new dental office. Our patients are our priority,  whether it is with our office or another.  The patient's remaining balance has been written-off as a courtesy. We will not be refunding the account considering it was a true balance for services rendered. [redacted]. - Office Manager