Emmert Dental Associates

Review: I am writing about my experience at Emmert Dental on June 10, 2016. (Phone: ###-###-#### Address: [redacted]).

I had an appointment for a cleaning and a consultation at 2pm. I checked in and waited about 10 minutes until the Dental Hygienist, Rachel was ready for me. We got to the first room on the left and she asked if anything changed with my health since my last visit. I said I have a new insurance card and she asked to see it. Rachel took a look at my card and said will give it to the front desk so it can be put it in. One secretary worked the front desk. Her name was either Cindy or Cheri. Seconds later, Rachel came back to the room, apologized and said they didn’t cover my insurance but glad we figured this out before we started.

As we were walking back to the lobby, Rachel recommended the $98 Preventative Plan that they have. I had this plan in the past but respectfully declined and mentioned “I’d rather go to a dentist that my insurance covers.” Cindy/Cheri just got off the phone, came into our conversation by stating “We cover cleaning and x-rays for [redacted].” Rachel and I both heard her comment and went ahead with the cleaning. After the cleaning, Cindy/Cheri came in the room and said I still needed to fill out paperwork once the dentist is finished examining my teeth.

I came back into the lobby and while I was filling the first page, she asked to see my insurance card so she can put it in. This is the second time she saw my card. She then said this card is from the state, we don’t cover this and I have to make a payment of $98. I was confused why she didn’t tell me this before. My card is from [redacted] but now I was told they accept [redacted] through employers only, not state. I was upset because this was the third time I was told something different.

After I finished my consultation with the orthodontist, I came out front and asked Cindy/Cheri who I can talk to about my insurance. She replied “I guess me, what can I help you with?” I told her I felt I was given false information. First I wasn’t covered, then I was, then I wasn’t. She mentioned the manager is on vacation and won’t be back until the following week, but she can have the manager call me. Unfortunately she never did. I asked for the manager’s name (Michelle) and a work phone number with an extension where I can reach her to talk about my issue. Cindy/Cheri told me they just have the main number and said I am still going to have to pay for my cleaning.

Couple days later on June 17th, I got a bill in the mail with Michelle stating “Please remit payment. You paid $98.00 4/16/2015 for the same treatment. Same treatment, same fee, same pricing. Discount applied. Please pay $98.00. Thank you, Michelle.” I want to add; I never signed or agreed to do the $98 Preventative Plan for THIS year. The forms I filled out on June 10th did not include that plan. The following day, June 18th, I received a call from Emmert Dental from Cindy/Cheri giving me a reminder about my bill. I asked to talk to the manager and she answered by stating the doctor actually wanted her to call me about the payment and I should’ve checked where I was covered. I asked again to talk to the manager and was told Michelle was not in. Before the conversation ended, I let her know I was planning on filling out a complaint.

Some things I want to point out; I didn’t fill out paperwork prior to cleaning. I thought this was an important protocol that was required beforehand so they can view my current medical history, any pain I’m suffering from, prescriptions I am taking, emergency contact information, etc. When I arrived for my appointment, I waited 10mins and could’ve filled out forms from the beginning. Instead, it was given to me afterwards. Another issue I came across, I was told three separate times that I was either covered or not covered. I did feel I was given false information and was led to believe they accepted my insurance. Had I had known, I would NOT have gone through with the cleaning and x-rays. I did show my insurance card twice, once prior to the cleaning and a second time after the cleaning when I was filling out forms. One last issue I would like to comment is I never signed or agreed to do the $98 Preventative Plan. I never renewed that plan and I wasn’t given an option to just pay for the one time visit. After doing my research, the information I found would be $69 for current patients.Desired Settlement: I have not paid this bill. I would like this business to retract $98.00 I got billed for.

Business

Response:

I am writing to you concerning complaint # [redacted] -[redacted]. I have read hercomplaint and have spoken to my staff.1. My staff agreed that there was some confusion as to the type of plan that she had. They didtry to verify before hand, but they were unsuccessful in doing so.2. The patient has a state funded dental insurance plan that we do not participate with. We cannot even bill them for out of network benefits,3. It sounds to me that the patient was diligent in trying to make sure we took her insurance,however services were provided before the confirmation had occurred.4.1 never received a message from her concerning this matter, I certainly would have addressedit at that time.5. As a courtesy to this patient, I have adjusted her account balance and gave her a new patientcleaning exam and x-rays at no charge. Her balance Is zero in our system at Settler Ridge,6. If she wishes to come back in the future, I can offer her the Preventive Plan at that time,1Please do not hesitate to call me with any questions.

Consumer

Response:

I have read the

business’ response in reference to complaint # [redacted]. I find her response satisfactory, except for

her fourth comment. The manager said she

never received a message from me concerning this matter and would have

addressed it at the time. I wasn’t given

a direct number so I couldn’t reach her directly. They only have the dental office’s main

number which I’ve tried asking to get in touch with her through her secretary,

since that was the only option. Either her

secretary failed to relay my messages to her or the manager chose to ignore

that I wanted to speak with her and explain what happened.

My reasonings are:

1. * On the day of my appointment, June 10th,

I asked who I can talk to about my insurance.

The secretary said she will have the manager call me when she’s back

from her vacation. I never received a

call.

2. *

After a week had passed, on June 17th,

I received a bill in the mail from Emmert Dental with the manager’s handwritten

note stating that I have to remit a payment of $98. There was no statement in the note that she

wanted to talk about this matter.

3. *The following day on June 18th, I

didn’t receive a call from the manager but from her secretary reminding me of

my payment. I asked twice to talk to the

manager but was unsuccessful in doing so. Due to not being able to get ahold of Michelle, I decided to file a complaint through the Revdex.com. She called me after the fact, but never before. Michelle had two weeks to contact me before I filed. I no longer wish to go back to this business and would not recommend this place to anyone.

Regards,

[redacted]

Review: On July 9, 2016, my daughter went for her six month dental exam with Emmert Dental. She had been there for previous exam but a different dentist examined her from her normal dentist. I was not allowed in the exam room with her. Upon completion of her examination, the hygienist informed me that my daughter had six cavities that needed to be filled. She had an exam 6 months prior with no cavities apparent and sees her orthodontist on a monthly basis who never noticed cavities.

The dentist wanted to fill all six cavities at that time but I would not allow it. He filled two and I made a follow up appointment for two weeks later. I was not allowed in the exam with her during the fillings nor did the dentist speak to me about how she had developed six cavities in a six month time span.

As the two weeks passed, I became very uncomfortable with the situation. Kendal is nine and has had one other cavity in her life. I did not understand how she could develop six cavities in six months. She cleans her teeth after meals, morning and evening, uses dental floss and mouthwash.

When I went to the follow up appointment, I asked to have the dentist show me the exact location of the cavities. This time, she was seeing yet another dentist at Emmert. He examined her teeth and said "I have no idea what the other dentist saw because there are no cavities that I can see." He asked the name of the dentist and I explained that I had never met the dentist who examined her that he was not her normal dentist. Based on Kendal's description, the dentist determined what dentist examined her. He gave his assistant a concerned look when he figured out which dentist she described. He explained that the other dentist left no notes, there were no x-rays taken and he could not determine what teeth he meant to be filled. I stated that I was taking her home then and the dentist replied something along the lines of "you got off easy this time but take care of your teeth" to Kendal. I questioned whether the two teeth the original dentist filled actually had cavities and the dentist could not give a definitive answer.

I have since received a bill from Emmert for almost $500 for a variety of charges none of which were clearly explained in the bill. I have United [redacted] Dental insurance and they stated that the only charge the didn't cover in full was the white fillings for the teeth which came to over $300. I never authorized white fillings for baby teeth nor did they offer me white or any alternatives to white. I did authorize any services beyond the six month exam and cleaning. I have filed a fraud complaint with my insurance company to initiate an investigation of their dental practice including false billing. I have tried to speak to someone from any of their offices to no avail. When I pressed them about the issues with my daughter's exam, their response was "every dentist is different."

This is completely unacceptable. If I did not state that she could not have all six teeth filled in one sitting, my child would have four unnecessary fillings to go with the two fillings to healthy teeth that they had filled on the 9th. I realize that these are baby teeth, but no child should have to undergo unnecessary procedures and pain and suffering in order for a dental office to bill outrageous amounts to insurance companies and patients.Desired Settlement: I would like my account completely cleared as Emmert is charging outrageous amounts for procedures normally fully-covered by my insurance with no written authorization from me or no true explanations of amounts owed

Business

Response:

Emmert Dental Associates2404 Oxford Drive Bethel Park, PA 15102 ###-###-#### 8-31-2016 Dear [redacted]I have received a copy of your complaint dated 8-10-2016 with the ID of [redacted]. I read [redacted]’s complaint and I do agree with her issues.I had talked to her last week and resolved her complaint. She does have a zero balance in our office.I felt that everything was resolved and that she was satisfied, if that is not the case, please let me know if there is anything else t can do for her. Emmert Dental Associates

Review: I went to Emmert dental in March of 2015 because of my tooth bothering me and my regular dentist was on vacation for the week . I went there thinking I had an abscess and wanting antibiotics to treat it . When I got there I was told I needed X-rays which was fine, I assumed I would need them just because I never was seen there before . After the X-ray was completed I was told I needed to have a root canal done because I had a very bad infection in my root . I told them I couldn't afford that nor did I want to have a root canal done (it was right in my front tooth, and I would have preferred my regular dentist to do it if I really needed it ) a few minutes later a lady came from the front desk and had all my insurance break downs and told me the out of pocket cost and such. I still told her I couldn't afford the cost she was telling me it would be so she told me I needed to have this done because it could possibly kill me . I then agreed to allow them to run my credit for a credit line to finance it . That night they started the process of the root canal and crowne. After that I had to go back a couple more times . At one point I received an explaination or benefits from my insurance and I called them and questioned why my explaination from the insurance was a lot less then what they told me it was going to be and what they ran to finance (I was told at the first appt it had to all be ran at once from start to finish ). After showing my EOB's I received to them proving they over charged me they told me they would call leading club (the place where my dental work was financed through ) I was then told that the credit place had a $499 financing minimum or I wouldn't be able to finance with them . They told me that if I let them run the $499 they would refund me a check of the remaining $76 dollars . Still not being able to pay for my dental work out of pocket I agreed not thinking in a million years a practice wouldn't refund my money. Since then I have called numerous times and have gotten the run around with excuses every time such as "we only mail our checks on the 1st of the month " "we mailed it, I guess it got lost in the mail, we will cancel and issue a new check". Now, this week I have called both June 23rd and 24th with both times someone answering telling me I needed to speak to a Joan Marie I believe her name is and she will call me right back and never does . When I call back they put me on hold for 10-20 min before I hang up. I decided to look up reviews on this place and all reviews are absolutely horrible and say the same thing . This place is a bunch of crooks, they don't do refunds, preform dental work that is by far not necessary and refuse to give your records . I went there today after speaking to my regular dentist with them requesting for my records and they got the run around with Emmert dental saying I needed to sign a paper to have them released . Understanding that I went with the signed paper to them and as soon as I walked in I was told that they put my records in the mail right before I got there . Not believing them I asked for it to be printed off again so I can take it to my regular dentist so they can see the original "infected tooth" x Ray . Not knowing what I was looking at I took the x Rays back to my dentist and they told me they have me a side view and a front view from after my proceedure . I immediately went back telling them I wanted all of my records and was told that I didn't have a right to them even though my insurance told me I did because everything was already paid for in full. After bickering about it with them for how long I was finally given one more x Ray and I questioned what part of it shows a infection so bad I needed to have it done right then and there . The lady then got snippy saying she wasn't a dentist . I made the statement saying that all three teeth on the X-ray looked the same and I still wanted to know where this horrible infection was in my root . She kept being snippy and rude so I decided to leave and just take the X-ray and drop it off at my dentist . I still am having pain in the tooth and when I have previously called and questioned about it I was told I needed to give it a good 6 months to be normal . I don't think it should still be a horrible shooting pain in my tooth when I wake up, drink something cold or eat something sweet. Defiantly think there is something more wrong then this joke of a money hungry business wants to admit . I don't believe that I needed a root canal especially with the lady at the desk being so shady with my records and giving me such a hard time to see them. And on top of that I don't believe getting a refund should take this long . At this point I believe it all should just be refunded to me that I have to pay out of pocket for the fact I'm going to have to pay to have someone fix their mess and the fact it's going on 4 months and still no refund on the money that shouldn't have been charged in the first place .Desired Settlement: Listed above

Business

Response:

I have received the complaint reference #[redacted]I have contacted the patient directly. She did overpayfor dental services. We issued a refund check toheron 5-4-2015 and again on 6-20-2015. According to our bank records neither check has been cashed.I have re-issued the check again today and have instructed her to call my personal cell if she does notreceive it by this Friday,[redacted]Emmert Dental Associates

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. However, I would like to make it known that by no means I would never refer this place to anyone . Even though they refunded me the money the overcharged me back. I still am currently doing to another dentist to have everything fixed that was wrong with the procedure they did. When the manager called me to tell me she was putting a third check in the mail for it to hopefully get to me I even told her I have been still having problems with my tooth and she chose to ignore the fact I said anything .

Regards,

Review: I used this dental provider from 7/9/12 through 7/11/13. During this time I had the Aetna Dental Access discount plan through UPMC for Life. Emmert Dental Associates (Emmert) confirmed both on 7/9/12 and on 3/13/13 that they participated in the Aetna discount plan. I had 4 root canals and crowns plus other dental services from Aetna during the service period. During 2012, they applied the Aetna discount (between 43% and 50%). However, they failed to apply the Aetna discount in 2013, applying instead a "Senior Citizen Courtesy" discount of 12.5%. They now deny that they participate in the Aetna discount program. They made me pay at the end of each visit and did not give me a statement until 7/31/13, after I twice demanded same. The statement shows the above plus the following: (1) they failed to credit $98 that I paid them on 3/13/13 for a cleaning/exam on that date and a future cleaning/exam on 9/11/13 (which I have now canceled); (2) they charged $35 on 5/28/13 for a nonexistent service; (3) they charged me $38.80 on 5/31/13 for "ObamaAffordableHealthCareAct." I have copies of extensive written communication between Emmert and me regarding these matters as well as documentation of the statements and my payments. I have attempted to attach all such documentation to this complaint, but it appears that only one document can be attached. I can provide further documentation upon request.Desired Settlement: I paid $7,601 to Emmert in 2012 and 2013. I do not dispute 2012 charges. In 2013, I paid $98 for 2 cleanings/inspections (of which I received only 1 due to their failure to confirm entitlement to 2d cleaning/exam) and $2,417.10 for other dental services. I request following refund: $1,219.82 for difference between 43% and 12.5% discount in 2013; $49 for unused portion of $98 for 2 cleanings/exams; $35 for nonexistent service; $38.80 for Obamacare charge. TOTAL REFUND REQUESTED: $1,342.62

Business

Response:

Dear Mr. [redacted],

l have received the complaint you have forwarded to me from Mr, [redacted], Mr. [redacted] has been a patient in our office for the last 2 years. He has had extensive dental work done in our office in this time frame. I have enclosed a copy of his dental history, including the charges and the discounts that he has received. We did apply the Aetna discount toward his work for 2012. However, Dr. [redacted] does not participate with this plan. That was the dentist that he saw in 2012. She does not participate in discount plans. She has been practicing for 35 years and is in high demand and does not feel it necessary to discount her services. As for 2013, we gave him the standard 10% discount for a senior, as Emmert Dental Associates no longer participates in that Aetna Discount Plan. As far as the Preventive Plan that he signed up for in March, that plan was utilized in full in March, the second cleaning is done as a courtesy for our cash paying patients. There would be no refund due for this, either, a dental cleaning, exam and x-rays exceeds $190 for a visit. I am sorry that Mr, [redacted] feels that he has an issue, however, I do feel that he was treated very fairly in the discounts that were applied in 2012. I would be willing, as a courtesy, to apply a $250 credit on his account in our office for future treatment.

Consumer

Response:

This letter is in response to Emmert's undated letter that you forwarded to me today via email. Emmert's letter was signed by [redacted]. [redacted], General Manager. I believe that this is the same "[redacted]" who sits next to the receptionist ([redacted], last name unknown) and advises her regarding what to charge patients at the end of their appointments. [redacted] has been there (within earshot of my conversations with [redacted] and sometimes providing input) every time (or virtually every time) I have been to the Emmert office. I address the points in Ms. [redacted]'s letter seriatim (quotations are from her referenced letter): 1. "Mr. [redacted] has been a patient in our office for the last 2 years." This is not quite accurate. As previously explained, I was a patient in their office from July 9, 2012 through July 11, 2013. 2. The second paragraph of Ms. [redacted]'s letter is self-contradictory. She admits that I saw Dr. [redacted] in 2012 (Dr. [redacted] is, in fact, the only dentist I have ever seen at Emmert) and that Emmert applied the Aetna discount for Dr. [redacted]'s services to me in 2012. However, the letter then goes on to say that Dr. [redacted] "does not participate in discount plans. She has been practicing for 35 years and is in high demand and does not feel it necessary to discount her services." If that is the case, why did they apply the Aetna discount in 2012? This constitutes a confirmation that, in response to my specific question at the time of my first visit, Emmert told me that the Aetna discount would be applied to Dr. [redacted]'s services. Emmert did, in fact, apply that discount in 2012, and I have no issue with the 2012 charges. 3. The third paragraph of Ms. [redacted]'s letter states: "As for 2013, we gave him the standard 10% discount for a senior, as Emmert Dental Associates no longer participates in that Aetna Discount Plan." It is undisputed that Emmert never informed me until August 5, 2013 (long after I had paid their 2013 charges without benefit of a statement) that they no longer participated in the Aetna discount plan. My first 2013 appointment at Emmert was on March 13, 2013. This was for a cleaning and checkup. At this appointment I reminded [redacted] that I was still in the Aetna discount plan and that my services on that date should be discounted accordingly. [redacted] responded that it would be "cheaper" if l went with the Emmert pre-paid plan for checkups/cleanings, which was $98.00 for two such appointments per year. I responded that if, in fact, their plan for check-ups/cleanings was cheaper than the Aetna discount plan, then I would go with their plan. I paid the $98.00 on my credit card, and we made the second checkup/cleaning appointment for September 11,2013 (which I canceled in my letter to them dated and mailed August 1, 2013). [redacted] did not tell me that Emmert no longer participated in the Aetna discount plan but rather said that it would be cheaper for me to use the Emmert checkup/cleaning plan than to use the Aetna discount for these services. 4. I am enclosing again the two pages of statements mailed by Emmert, in response to my repeated requests, and received by me on July 31, 2013. The one-page statement attached to Ms. [redacted]'s letter contains entries through March 13, 2013, but does not contain the entries (see second page of enclosed statements) for May 27, 2013 through July 11, 2013, which is the bulk of the expense for 2013. The statements I received on July 31, 2013 (I had not previously received any statements from Emmert) did not contain the entries for March 13, 2013. These March 13, 2013 entries (enclosed with Ms. [redacted]'s letter) were for the checkup/cleaning mentioned above. Emmert credited me only $49.00 for my payment. However, I paid $98.00 (Emmert receipt enclosed) on that date. There is also a $35.00 charge on that date for "INTRAORAL-PERIAPICA." I don't know what that is, but I understood that my $98.00 paid that day covered everything related to Emmert's services on that date and on the forthcoming September 11, 2013 checkup/cleaning appointment (later canceled). In any event, this $35.00 charge (of which I have learned today for the first time) probably explains the May 28,2013 "Initial Balance Forward" of$35.00 on the second page of the enclosed statements. However, until today I was never informed of this charge. Moreover, their statement received today shorts me $49.00 of the $98.00 (see enclosed Emmert receipt) I paid on March 13, 2013. 5. The second page of the enclosed statements also discloses a May 31, 2013 charge in the amount of$38.80 for "ObamaAffordableHealthCareAct." There is no way to characterize this charge other than to say it is fraudulent. I never agreed to pay any such charge, and Obamacare doesn't even apply to me (I am a retired lawyer, and I have a Medicare Advantage plan). 6. By failing to include the May 27,2013 through July 11,2013 charges with their response to my Revdex.com complaint, Emmert gives the impression that the issue is with the 2012 charges and that, in Ms. [redacted]'s words, "I do feel that he was treated very fairly in the discounts that were applied in 2012." Exactly! That is why I said in my Revdex.com complaint that I had no issue with the 2012 charges. My issue is with the 2013 charges, to which Ms. [redacted] admits that they only applied a 10% "senior" discount. Since Emmert confirmed to me on March 13, 2013 that they were still in the Aetna discount program and never informed me otherwise (until weeks after I had paid all their charges for 2013 services), I properly assumed that the Aetna discount would still be applied to the post-March 13, 2013 services I received (including a root canal and crown and not including the alleged $35.00 "Initial Balance Forward" and the Obamacare charge discussed above). The total amount charged for these services was $2,763.00. The Aetna discount applied in late 2012 for a similar root canal and crown was 43%. Accordingly, applying a 43% discount ($1,188.09), I should have paid $1,574.91. In fact, I paid $2,417.10 (subtracting the "Initial Balance Forward and the Obamacare charge from the $419.70 Emmert "senior" discount). Accordingly, I overpaid these charges by $842.19. When I filed the Revdex.com complaint, I may have made some computational errors in calculating my damages. As demonstrated above, I overpaid what should have been charged for the 2013 root canal and crown by $842.19. This amount accounts for the $35.00 "Initial Balance Forward" and $38.80 Obamacare charges but not the failure to credit $49.00 of the $98.00 I paid on March 13, 2013. Thus, it appears from Emmert's 2013 statements that I was overcharged in 2013 by $891.19. In order to avoid having to go to court on this matter, I would be willing to settle for a $800.00 refund. Needless to say, I will not accept any settlement based on a credit to future services, as Emmert now disclaims participation in the Aetna discount plan, and I do not want Emmert to have any further opportunities to bill for such nonexistent charges as "Obamacare." I notified Emmert in my August 1, 2013 letter that I will not be a patient of Emmert going forward. Sincerely, [redacted]. [redacted] Enclosures #[redacted] Home Phone : (412) [redacted] Work Phone : (412) [redacted]

Business

Response:

Please be aware that an agreed upon refund has been issued to Mr. Alan Johnson. We

consider this matter closed.

Thank you,

Emmert Dental

Review: September 15, 2014 Dear Investigator,The following is a detailed account of my concerns:1.Appointment July 18, 2014 @ 10:30 am to have tooth 24 and 25 resin filled.2.Was asked to sign a Emmert waiver form (in case the x-ray did not take).3.Lower gum line was numbed. Waited ten minutes for it to take effect while Dr. [redacted] took care of another [redacted].4.An x-ray was then taken (Dr. [redacted] stated that if the x-ray did not take that [redacted] would not pay the claim).5.About thirty minutes or so later all was done. I went to check out with the receptionist. She logged onto the computer and looked at the contents on the screen then got away from the computer and left the room with my chart. She went in the back office to talk to Dr. [redacted].6.Upon returning the receptionist stated to me that I owed $558.00. WHY?, I asked. The x-ray did not take and that the claim to [redacted] was refused. I told her that Im on social security and cannot afford that kind of money. Thats alright we can have a finance company pay for it. (No interest for six months if I paid [redacted] Financing $93.00 a month). I told her I should have had the teeth pulled, it would have been cheaper.7.Three weeks later or so something I received from [redacted] provoked me into investigating the July 18, 2014 work on teeth number 24 and 25. Much to my surprise Emmeret Dental DID NOT file a claim for the July 18th work as of August 14, 2014. I called Emmert Dental that day to find out what is going on? They told me that it was submitted to [redacted] on July 19th. I called [redacted] AGAIN to find out what is really going on with the claim for the work from July 18th.8.To this day, date and time I have yet to get a straight answer from Emmert Dental and especially from the Office Manager by the name of [redacted] As a matter of fact this past Wednesday (September 3rd) she call me because I threatened to go to the Revdex.com. She said that shes sorry Im so upset with this whole billing issue that she is willing to cut the price in half so all I would owe is $250.00 to [redacted] Financial and the Emmert Dental would pay the rest.9.Folks, something is not proper with this billing issue let alone the work ethics with this profit center and Ms. Boyd (Office Manager). I now have documents that show payment approval from [redacted] pending the x-ray being forwarded to them for official approval (that they [redacted], have yet to receive as of this date). Then, take note of this, there is a copy of Dental Explanation of Benefits, from [redacted] dated, August 28, 2014 and it states, These services were performed by a participating provider. This provider has agreed NOT TO BILL YOU.In conclusion, I am between a rock and a hard place with this profit center (Emmert Dental Associates). I am into [redacted] for $558.00 that according to [redacted] should never have happened. Just so you know I investigated Emmert Dental at the Revdex.com website and they have a F rating with a claim made against Emmert almost every month for the past years.Desired Settlement: They Emmert Dental Associates refund to [redacted] Dental Financial $558.00 and SDF refund to me the monthly payments (to date $51.00) and that [redacted] (my dental insurance company)pay EDA for the work that was done. [redacted] has been notified (09/05/2014) about Emmert and nothing has been resolved to date. I need your help before another payment is due.

Business

Response:

Mr. [redacted]’s desired settlement was for his Springstone to be refunded. This was done on 10-28-2014. Please not that Mr. Anbrose DID ~we our office this money. I, as a professional courtesy, wentahead and gave him the money back, because he really did not understand why his insurance did notcover the procedure.This was resolved on our end and considered closed on 10-28-2014

Business

Response:

As far as our records show he was refunded $588.00 on 10/28/2014. We believed that this concluded this complaint. Mr. [redacted] takes umbragewith the grammar of previous responses. Again, we apologize for any phrases that were upsetting to him. In reality this matter has been concluded for some time. We consider it resolved.

Review: I paid for 2 teeth cleanings and they told me they would not give me my second cleaning that I already paid for. I was told it was too late it expired after 6 months. I was never told that it could expire and they usually send me a card and a phone call and they did neither.Desired Settlement: I feel if they are not going to clean my teeth as promised I should get a refund.

Business

Response:

It has come to my attention that you did not receive a response for complaint #[redacted] for a Mr. [redacted]Mr. [redacted]’s desired settlement was for his 2nd Preventive Plan to be given to him. I have enclosed a copy of our guidelines for the use of our in-office plan.Mr. [redacted] was late for his 2nd cleaning, which we consider a free cleaning and was asked to pay,based on our policy.As a courtesy, even though he was 4 months late for his cleaning we went ahead and gave it to him at no chargeThis was resolved on our end and considered closed on 8-15-2014.

Review: My son had filling completed at Emmert Dental. They did not use the approved filling material stated in his insurance coverage guidelines. They then charged me for the entire service. Upon contacting my insurance company, I found out that they violated the insurance contact guidelines. Now after multiple call to the office, the business office manager will not return my call to rectify the situation.Desired Settlement: I would like Emmert Dental to provide a refund for the service because it was their responsibilty to follow the guideline set up by the insurance company. I did not provide authorization for the filling material that was used and thus I should not have to pay out of pocket for it.

Business

Response:

[redacted] presented to the office with decay and carious lesion involving an upper

back, left tooth. This decay was noted first during a routine cleaning in January. 2013.

The decay was identified again in August, 2013 by a second, dentist during another

routine exam and cleaning. There was a period of eight months between these visits in

which the decay increased. Restoration was necessary for decay removal, function,

structural support and protection of the remaining tooth with assurance that sensitivity

and discomfort are prevented. Given [redacted]’s age (8 years old) and the decayed tooth

(permanent molar) the preferred filling would be a posterior composite filling. White

composite fillings are the standard of care in dentistry and the filling of choice today.

White fillings are most certainly an approved filling material as indicated in any

“insurance coverage guideline”. There was no violation of any insurance contract

guideline”. Silver fillings are frowned upon due to the mercury content within the filling

material. Mercury has been associated with multiple deleterious systemic health effects

including seizures, tinnitus, and depression. In children silver fillings have been linked to

autism, and ADD. In fact there is a movement in the dental community to discontinue the

use of silver fillings that is gaining much support. White fillings require less grinding of

the tooth and less loss of natural tooth structure, always preferred, especially in children.

White fillings are very durable and aesthetically appealing. In short; composite filling

material was the best choice for this case. Unfortunately, Miss [redacted]’s insurance

offered no coverage for this procedure. As a courtesy, the office did discount the

treatment cost. Miss [redacted] incorrectly states that “they then charged me for the entire

service”. We regret any confusion but always attempt to choose the best treatment for the

patient to achieve the most positive clinical outcome.

In ;m effort to provide customer satisfaction we invite Miss [redacted] to appoint to any of

our three offices for a Zoom whitening session (a $600.00 value). If Miss [redacted] prefers,

she is welcomed to bring [redacted] to the office to have the superior composite filling

removed and amalgam filling placed in the prepared tooth.

Thank you,

Emmert Dental Associates

Consumer

Response:

In response to the information submitted in the letter from Emmert Dental Associates. According to multiple representatives at United Concordia, under the DHMO contact a facility that is amalgam free must provide the composite filling at the co-pay indicated by the plan. If the facility offers both amalgam and composite, it is the responsibility on the Dental practice to ensure the appropriate filling is used to ensure coverage under the plan. The patient however, can accept financial responsibility for say a composite (white) filling over amalgam (silver ) if it is preferred but not covered. In my case no option was ever provided, nor did I sign any forms requesting the composite filling. I spoke with Lynn a receptionist at the Emmert Dental office who stated the internal policy of the office is to have the patient or responsible party sign financial responsibility if the composite filling is used and not the choice outlined in the insurance guidelines. Michelle, the office manager of Emmert Dental stated to me on 9/6/13, that no acceptance of financial responsibility was found in the chart of [redacted]. It was also stated in the letter from Emmert Dental that "silver fillings are frowned upon due to the mercury content within the filling material" due to systemic health effects including seizures, tinnitus, depression, and links to autism and ADD. The dentist who performed the filling on [redacted] in August of 2013 never mentioned these potential adverse effects to me, thus taking away my ability to make an informed choice for my child. According to the American Dental Association website www.ada.org, amalgam or silver fillings are often the best choice for larger cavities or for those teeth that need to chew (such as the upper back left tooth in question) because of it’s durability and the fact that it hardens quickly. It also states that amalgam is a " safe, stable material" based on extensive scientific evidence. Multiple health organization such as ADA, American Academy of Pediatrics and Autism society agree that it poses no health risks. I spoke with Michelle, office manager at Emmert Dental on September 6, 2013. She offered to bring [redacted] back in to the office and drill out the composite filling and replace it with an amalgam filling. For her to even suggest that I put my child through a dental procedure that is unnecessary is unethical and lacks the compassion that I expect from a health care provider. It was stated in the letter that Emmert Dental attempts to "choose the best treatment for the patient to achieve the most positive clinical outcome." Is exposing a 8 year old child to an unnecessary terrifying dental procedure the best course of treatment for a positive clinical outcome? My son was scheduled with a dentist he felt at ease with and when we got to the office for his filling another dentist was there with no call to me or explanation. When I spoke with Michelle on September 6, 2013, she kept referring to the dentist as "He" when in fact the doctor who treated him was woman. I called multiple times to try to resolve the situation with no response form anyone until 9/6/13. The only thing I was provided with at Emmert Dental was poor customer service, poor quality of care and a horrible first dental procedure for my 8 son.

Business

Response:

I have received a copy of your letter dated 9-20-2013 concerning complaint # [redacted] . 1 did

speak to Ms. [redacted] on September 11, 2013 and gave her the options that were available to her

for her son. She did not like any of the choices that I gave her,

I, then, agreed at that time to refund the full amount of her payment which was $175,1 did this

as a courtesy and considered this matter settled.

1 do not feel that there is anything further that I can do for her.

If there are any further questions or concerns, please don't hesitate to call.

Regards,

Review: I received dental services from Emmert Dental on 4/26/14. At the time of service, they were a participating provider with my insurance plan. I was surprised when they charged me $396 at the time of my visit without running the claim through my insurance first. I paid that charge on 4/26. I have an EOB from my insurance showing that I owe a total of $137.20 for these services. That is a $258.80 over payment that I made. I have been trying since May to work with my insurance company, and the dental office to have a refund processed. The insurance company is ignored by the provider, and the billing manager, [redacted], is never in the office. I was contacted by [redacted] once, who collected my credit card information over the phone and told me I would be refunded. I thought the issue was over at this point. A few weeks later I received a statement showing I owed $230.80. I called the office and was told this statement had something to do with the refund and it could be disregarded. Again, I thought the issue was resolved. Then on October 15, 2014, I received another statement for $230.80 that said I was over 90 days past due. I called the office who confirmed that I owed this money and I was told that [redacted] would contact me. This prompted me to check all of my credit card statements since April, and sure enough I was NEVER refunded.Desired Settlement: I would like to be refunded the $258.80 which I was not responsible for paying according to the explanation of benefits I received from my insurance, with whom the dental office was a participating provider. I would also like my account cleared so that I no longer receive these statements.

Review: I have ongoing billing issues with Emmert Dental since my initial visit on July 3, 2013. I am currently trying to obtain a $488.04 refund from Emmert Dental, which is an overpayment for July 2013 dental services paid out of pocket. This office demanded out of pocket payment in the amount of $1045.74 (paid through a series of 3 checks; the last cashed by their office on August 5, 2013) for dental services prior to completion all of dental work or even filing a claim with my insurance carrier. In September 2013, I received a 60 day delinquent notice (dated September 7, 2013) for payment of services directing me to contact my insurance carrier. However, not only was this my first notice regarding this matter I was advised by my insurance company that a claim was never filed by Emmert Dental for July 2013 services. My insurance carrier contacted the dental office to request that they file a claim; once Emmert filed the claim, it was promptly processed and paid by my insurance carrier. I am now trying to obtain a refund of $488.04 from Emmert as I was only responsible to pay $557.70, which is almost 1/2 of what Emmert billed and was paid in July. My insurance carrier and I are unable to get any information from this office regarding this matter. My insurance carrier has processed a provider complaint regarding my billing issues with this office as they have encountered the same lack of communication from this office. I am very upset about this situation as I feel the neglect and lack of communication from this office indicates that they have no intent of refunding my overpayment. This has been going on since July and I find it incomprehensible that I cannot get any information or status regarding this matter and would not want this to happen to anyone else.Desired Settlement: I need a refund of $488.04 from Emmert Dental as I paid them $1045.74 out of pocket when they were only due $557.70. Emmert Dental received an excess of $488.04 following my out of pocket paymenet along with insurance carrier's payment under my dental plan.

Business

Response:

I have received your Complaint #[redacted] for Ms. [redacted]. I am very aware of this situation. But unfortunately, at this time, I can not offer a final solution. According to my records, Ms. [redacted] has paid the correct co-payment. There are additional services that have not been processed with her insurance company. These services, from what [redacted] told me on 10-28-2013 are still pending. When, I have the final payment from [redacted] for the outstanding services, I will be able to calculate and refund any overpayment, if there is one. I, also! spoke to Ms. [redacted] on 10/30/2013 and made her aware of the same. Sincerely,

Consumer

Response:

I made a follow up call to my insurance carrier earlier this week to follow up on the status of Emmert Dental's recently submitted claim of dental fees; which was Emmert's response to my request of out of pocket refund based on the eplaination of benefits for work performed in July 2013. My insurance carrier indicated that they have requested explaination of services/fees from Emmert in order to process their recently submitted claim. I am very displeased with their customer service; but most importantly their handling of paperwork and accounting practices. Given the many issues I've had with this office thus far, I am not very confident with their recent discovery of over $2,000 in July 2013 service fees that they somehow did not discovery were not processed/paid until I contacted them regarding my request for an overpayment refund. I kindly request that they expedite this request and any further requests made by my insurance carrier in order to resolve this matter; given that it is now mid November and these services were completed on July 3 and July 24, 2013.

Regards,

Business

Response:

This message is in reply to Revdex.com complaint #[redacted]. I do understand her frustration and acknowledge her concerns. I, too, am waiting for the final decision from her insurance carrier. I was told today that they do have all the necessary information to finalize processing. I spoke to a Mandy at [redacted]. If there is any overpayment it will be refunded immediately upon receipt of the final decision from [redacted].

Review: On August 14, 2013, I received a dental service from Emmert Dental and was charged $409 for the service as insurance copay. In September,I received two letters from my insurance company ([redacted]), informing me that I only need to pay $268 as insurance copay for the service and Emmert Dental had agreed not to bill me for the rest of the services that they had provided during my visit on August 14th. I called the insurance company confirming the accuracy of this Benefit Explanation, and then Emmert Dental asking why there was the difference in the copay charges. The Office Manager at Emmert Dental requested me to deliver the Benefit Explanation form to them and promised a refund for the copay difference. I did what she said, but never received the refund that she promised nor any further explanation from her. I contacted Emmert Dental many times after that, but was unable to get in touch with the Office Manager again (She seemed to be out of office most of the time). The receptionists who answered my phone calls promised that they would leave a message to the Office Manager and ask her to call me back. But I had never received any phone call from anyone on this matter till now. One of the receptionists kindly offered a partial refund of $68 for my troubles, but this only covered half of the charge that I over-paid for my service. Furthermore, I was constantly ignored by Emmert Dental on this matter. I don't think this is right way to treat a loyal customer.Desired Settlement: I demand a full refund for the charge that I over-paid.

Consumer

Response:

The only refund that I have received from Emmert Dental was the the partial refund of $68 that was issued on Sept. 28th, 2013. That refund was issued by one of the receptionists at Emmert Dental , not by Ms. [redacted], because she was, according to the receptionist, not in her office on that day. After that, I haven't received any phone call from Ms. [redacted], despite that I have called and visited the office several times, asking different receptionists to leave her a message about my situation. In addition, Ms. [redacted] claimed in her response that she tried to call me today (Oct. 31st, 2013) to discuss this issue. I happened to be at home all day today, but didn't receive any phone call from her on my home phone or cell phone. I was wondering which number did she use to make the phone call, or if she confused me with another patient. Thank you! Regards, [redacted]

Business

Response:

I have received the response with the additional concerns of Ms. [redacted], dated 11-4-2013 with the complaint ID #[redacted]. I do acknowledge her additional concerns, but, I do feel that this matter has been resolved. I did speak to Ms. [redacted] on Friday 11-1-2013 and explained to her that her additional refund was processed through our bank on 10-13-2013, At which time, I double checked with our Merchant Processing Services through [redacted] and they verified that she did in fact receive her refund. Her response may have crossed in the mail. But, I feel this has been concluded. If there are any additional questions, please feel free to call me. Kind regards, Emmert Dental Associates

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. Just to sort things out, I managed to speak with Ms. [redacted] on the phone on 11-1-2013. (She did call me as she said in her last response, but the call was made to my office number. I was at home on the day she called, so I didn't get her message until the next day.) It turns out that there might be a miscommunication between she and their Merchant Processing Services through PNC bank. According to Ms. [redacted], she sent out the remaining refund on 10-13-2013, but the refund was not posted on my credit card until 11-01-2013. The unusual delay was what caused the misunderstanding between me and Emmert Dental. Regards, [redacted]

My husband had a teeth cleaning done in 12/2014 at which time they talked him into a crown for one of his teeth to the tune of $1800 after insurance. Well that crown came out today so since we no longer wish to go back to Emmert we went to a private dentist and the crown which originally cost over $2600 with Emmert will only cost him over $700 for the same tooth! What ripoff artists these places are. And Aspen is worse!

Review: On 10/29/14, I was made to pay $148 by Emmert Dental even though the amount billed was questioned at the time. I have recently found out that I was defrauded out of this money and that my entire procedure was covered by 100% by [redacted]. Further more the amount billed was not reported to [redacted] to reflect on my claim.

I have contacted Emmert Dental of [redacted] (###-###-####) multiple times, since they do not return phone calls, and each time spoke with Densie who informed me that the General Manager will not allow a refund to be issued.Desired Settlement: I would like a full refund for the amount of $148 which I was incorrectly charged for.

Business

Response:

Mr [redacted] was seen in our dental office back in 2014 for some fiIlings~ One of his fillings wascovered at %100 by his insurance carrier [redacted]. The other filling was not covered under hisplan. Mr. [redacted] paid for that 2~ filling out of pocket $148.He called the office approximately 1 year afterthls procedure and indicated that he believed that hisinsurance should have paid for the 2nd filling. He again was advised that it was not covered by hisinsurance. I resubmitted the procedure to his insurance company so that would be verified. UnitedConcordla once again denied the procedure as non covered. Mr. [redacted] was responsible to pay for thatprocedure. I have enclosed a copy of that Explanation of Benefits. You will also note that we chargedhim less money than what [redacted] allowed us to.There was no refund given, because there was no refund owed.Mr. [redacted] also filed a claim with the Pennsylvania Attorney General. There findings concurred that hewas not overcharged:

On 10/19/15 my husband went in for an annual exam. They told him he needed scaling and root planing as well as two root canals. So we scheduled the first half of the S&RP. I went with him. They then said he needed 3 root canals and 4 fillings. He has never had ANY work on his teeth before. He felt no pain at all. Never even a filling before. I called back to get a treatment plan and payment/insurance info and they would not let me speak or set up an appointment with the dentist. He went back for the second half of the S&RP where they told me it was not 3 root canals and 6 fillings. I told the office manager to talk to the dentist and have her review the xrays (the dentist did not see my husband for either of the scaling/planing visits) and call me back. They called me back at 7-something that evening to explain that now he needed SEVEN fillings and at least one root canal.
We went for a second opinion. He has 3 areas that need fillings, none of which need drilling (which was what they told us) and NONE of the teeth numbers that Emmert Dental gave us matched. Honestly this was a terrifying experience and I am SO GLAD that we didn't just follow what they told us. Dr. C[redacted] is terrifying and the internet is wrought with other negative reviews.

Review: They falsely stated that the doctor who performed most of my dental work participated with my insurance. They falsely submitted to me insurance that someone else performed the procedures so it would be covered. And when I complained that I overplayed when they overcharges me for my dental work, they told me that I either leave it alone or they would submit it "correctly" (which they should've done to begin with) and I would be required to pay the full amount.Desired Settlement: If I could get the money that I overpaid back, that would be great. But if they end up resubmitting these items to the insurance under what they should've done to begin with, I will be required to pay more. At this point, I don't even care about having to pay more as long as they cannot do this to any other customers. They basically threatened me. I just hope for better customer service , better treatment, and to not have people get weasled out of their money!

Business

Response:

We are writing in response to a complaint filed by Miss [redacted], She was seen in our office between dates

of service 7-5-2013 and 6-25-2014 at which times she had multiple dental procedures completed. As of

9-26-2014 the date at which the complaint was submitted she had a dental account balance of $41.48. If

she had an issue with her account balance a proper response would be to call the office and speak to an

account representative who would have been more than happy to address any concerns and resolve any

outstanding account questions or issues. Instead she opted to file a complaint stating that the crux of

the problem is “that I overplayed when they overcharged me for my dental work”, her words. Miss Gari,

was not overcharged, She was not “weaseled out of money”, again, her words. We resent those remarks

and take umbrage with any commentary insinuating the [redacted]e. Payment, co-payment or co-insurance is

due at the date and time of services. That is true for any medical or dental office. Our records indicate

she absolutely did not overpay, Co-insurance and copayments were calculated in accordance with her

insurance fee schedule. If Miss Cam feels that there was overpayment she should contact the office and

present her explanation of benefits to resolve the matter. Her allegations are baseless and unfounded

carrying defamatory and slanderous tones. Those allegations and this matter are taken very seriously.

Furthermore, the correct insurance information was provided to her insurance company which as

required for submission includes the billing dentists or dental entity, treatment location, treating dentist

and or the primary provider. This information includes potentially 4 different dentists as well as the

dental entity which is different from the primary provider. All were listed and complete in accordance

with insurance guidelines. Despite the fact that Dr. Monaco was the treating dentist, Emmert Dental

Associates (the billing dental entity) was listed on the claim as well as possibly Dr. Emmert, as he and

Enimert Dental Associates are one and the [redacted]e. However, despite all of this information the most

recent claim was denied. Upon receiving the denial the office simply resubmitted the claim in an effort

to be paid for services rendered, This is the proper recourse when an adverse benefit determination has

been made by the insurance company. The office merely appealed the adverse decision and

resubmitted the claim with supporting documentation which is appropriate. The insurance company did

reopen the claim for reconsideration but the process can be lengthy, often taking up to 60 days to

resolve which coincide with the bill for $41.48. We are assuming that Miss [redacted]’s accusations are rooted

in the fact that Miss [redacted] is unfamiliar with the claims submission and resubmission process. As a

customer service we have zeroed her account removing the outstanding balance of $41.48. We

consider this matter resolved.

Consumer

Response:

I do want to include that I made MULTIPLE phone calls to Emmert Dental regarding this matter and stopped into the office more than once. I was assured that I owed nothing on my account as I overpaid... Which was confirmed by receptionist, [redacted] I never received a bill for this until AFTER my complaint. I also looked on the Emmert Dental website for a CEO contact to resolve my matter, but there was no contact information for it. It seems as if the company is trying to place blame on me for not understand, which I resent. I made multiple attempts at getting answers and continued to do so in a prompt and polite manner until Michelle threatened to make me pay more for my work. It was inappropriate on the offices part. I no longer with do business with Emmert Dental nor will I recommend it to others. I am accepting this response because it is exhausting to have to draw this entire process out. It's my hopes that in the future, you will not treat other customers in the matter I have been treated (I was berated on the telephone by your staff member). Thank you for your time and listening to this matter.

Review: The office has overbilled me, and, after numerous attempts by the insurance company and me to resolve it, they will not resolve it. It has been over two months.Desired Settlement: The office needs to immediately correct the billing issue, in its entirely, without further delay.

Business

Response:

We are writing in response to a complaint filed by Mr. [redacted]. Mr. [redacted] presented to the office onAugust 4, 2015 for dental treatment. At that appointment his insurance coverage could not be verified.In fact, multiple attempts to ascertain coverage resulted In a cancelled insurance contract with noeffective coverage nor benefit. Mr. [redacted] was informed of this and despite no verifiable coveragerequested immediate treatment opting to pay for services rendered out of pocket. As a courtesy, theoffice contacted the insurance company and explained that Mr. [redacted] did pay out of pocket fortreatment On 8-4-2015. The insurance company then made the decision to retro activate the coverageand benefit policy on behalf of Mr. [redacted], After collaborating with the insurance company a claim wassubmitted by the office for services rendered, The reactivation of insurance plus claim submission andprocessing took over 60 days. An insurance payment on the behalf of Mr. [redacted] was received by theoffice and posted to his dental account leaving a reimbursement of $601.20, This amount was refundedpromptly. Mr. [redacted] has received his refund as of the writing of this response and we consider thematter closed.Thank you,M B[redacted]Emmert Dental Associates

Review: I fell in my driveway on the evening of 11/22/13, and broke part of my tooth that had an existing crown on it. Since all dental offices were closed at that time, I had to wait until Saturday morning (11/23/13) in order to try and get an appointment. The only option that I could find on a Saturday, in my network, was Emmert Dental. I called on the morning of 11/23, and spoke to [redacted] at Emmert. I told her my dental insurance information to confirm that it was accepted there. She informed that is was. She also said that they were able to see me that day. I went in, and the dentist put on a temporary crown, and put a filling in the tooth next to it. Upon leaving, [redacted] said that I had to pay $1975 before they could order the permanent crown. I said that I dont have that kind of money, and suggested that she submit a claim to my insurance company, [redacted]. She said that they wont cover it, and I needed to open a line of credit with Care Credit to pay the full amount. Since she works at the front office, I assumed that she was providing me with the correct information, and opened the Care Credit account. She also said that I should submit a claim to my homeowners insurance. I found that a bit strange, but told her I would contact them to find out what I need to do. When I got home, I called my homeowners insurance and explained the situation to them. I was told that they do not cover the homeowner (thats what medical and dental insurance is for). They only cover other people (depending on the situation). I had to wait until Monday (11/25/13) to get in touch with someone from [redacted]. They told me of course thats covered until your dental insurance. I then called Emmert and told them what was going on. I assumed since I informed them that Delta would cover the procedure, that they would submit a claim to them, and withdraw the line of credit with Care Credit. I called Delta later in the week to see if Emmert submitted the claim. they said no. I called Emmert to see what was going on. [redacted] said the claim was denied. Come to find out, Emmert didnt try to submit the claim until 12/5/13.which was approved (as should be) and paid to them. The agreed contract amount between Delta & Emmert is $1017. Emmert cashed check number [redacted] in the amount of $827 on 1/3/14. My co-pay is $190.which I am willing to pay, but have yet to see a bill in that amount. The discrepancy here is, that Emmert should reimburse Care Credit the amount that they are trying to get from us. Ive been in constant contact with Care Credit. I currently have a second dispute complaint open with them. opened with [redacted] from Care Credit. The first dispute I opened resulted in Emmert paying them back $384. Im not sure where they came up with that figure. They owe Care Credit the remaining balance of $1591, since Delta paid Emmert the contracted amount. My wife, [redacted], and I tried numerous times to get this resolved with Emmert. Phone call, after phone call was getting us nowhere. We were told to speak with [redacted], the general manager. We waited for well over a week without a phone call back from her. We went into the office and tried to speak with the dentist who performed the procedure Dr. [redacted] He wanted no part of talking to us. He said we need to talk to [redacted]. I told him weve waited over a week to hear back from her. He & [redacted] said she was on vacation that she would be back the following week. Apparently she is the only person in the company who can resolve billing issues. Finally, about 2 weeks later, [redacted] called my wife. She asked my wife to fax her the Explanation of Benefits from [redacted]. My wife took all the paperwork to her in person on 1/31/14. [redacted] told my wife that she will reimburse Care Credit the remaining balance of $1591...as she should since Emmert was paid by Delta. [redacted] also told her something about submitting another claim to Delta with someone she knew at Delta. Now, since their meeting, weve received a letter from [redacted] stating that [redacted] does not cover the procedure. She states in her letter that what we are doing could be construed as fraud. Im not sure what she means by that. If anyone is committing fraud, its Emmert. Theyve been paid $1975 by Care Credit (well actually $1591 since they paid $384 back), and then $827 by Delta, and trying to charge me $190 (for my co-pay, which I know I owe), plus $448 more through Care Credit. I think they purposely told me I had to go through Care Credit in order to get more money. They know that insurance companies wont pay the full amount that they are asking for, but Care Credit will. I feel what they are doing is unethical and amoral and possibly fraudulent. I spoke to a second [redacted] representative on the evening of 2/6/14 and was informed that [redacted] tried to request a denial from my homeowners insurance on 1/31/14. Delta told her that is not something that they shouldnt be. They also told her that they are under contract with Delta. Another thing that [redacted] tried to tell my wife on 1/31/14 was that they dont participate in Delta which is obviously false. I called my homeowners again tonight (2/6) to verify they dont cover anything like this. Again, they said no. I didnt file a formal claim (as will possibly make my homeowners go up), but they did tell me on 2 separate occasions that they wont cover something that. If absolutely needed, I can obtain a denial letter from them. I received a certified letter from [redacted] (Emmert Dental) on 2/6 which is attached. I tried to call her immediately, but [redacted] said she wasnt in. I called again on 2/7, and of course she was not in. I left my name and number both times. We received a message from [redacted] on 2/8 saying that [redacted] said she will call later that afternoon. Again, no phone call. On Monday (2/10) [redacted] called and spoke to my wife, [redacted]. [redacted] toDesired Settlement: Emmert misinformed us and told us the procedure was not covered by insurance. Since it was covered and paid for by my dental insurance, Emmert should pay back Care Credit $1591 they were over paid.

Business

Response:

I received your complaint #[redacted] in the mail today concerning Mr. [redacted],

I did not underANv circumstance misinform the Koelilers.

[redacted] is in the process of investigating this claim for the possibility of insurance fraud

from their member Mr. [redacted]r. They misrepresented to me that this claim was submitted to

their homeowners insurance. So, [redacted] did In fact reimburse us. lam to assume that

after the investigation, that they will ask us for the money back.

In the meantime, I did refund Mr. [redacted]'s Care Credit because we were in fact paid twice. In

the event that [redacted] asks us for a refund, he will be sent a bill for his services,

Review: 3/2/15 - I had my chipped tooth repaired at my regular dentist. Through my insurance, it is usually out of pocket $36.20. It has been repaired numerous times over the years and it is always around the same amount.

3/12/15 - My tooth chipped again and my regular dentist was unavailable, so I went to Emmert Dental, which was close to my work. When they were done, I had to pay $163 out of pocket even though I have insurance and Emmert Dental is in network.

4/22/15 - I checked my explanation of benefits and it said Patient Responsibility was $34.60. So I called Emmert and requested a refund for the difference. I faxed the information to Abby. She called back and said that I had to pay that but there was an office fee that was waived and I didn't owe anything. So I let it go.

Mid May 2015 - I got an invoice to pay $62.60 and that it is 30 days past due. I didn't even know that I had a balance. I called and left a message; I didn't hear back from them. I thought it was resolved. The phone always goes to voicemail - as if they are screening calls.

Mid June 2015 - I got another invoice to pay $62.60 and now it was 60 days past due. I called and of course it went to voicemail. So I called another branch, I believe Steubenville Pike office and explained my situation. The lady was nice and said she was going to give Michelle my number to call me. At this point, I already spoke to the insurance company and asked them to investigate their billing practices. The representative said they didn't even submit the claim correctly. She was sending out the paperwork for me to complete to begin the investigation. I explained that to the lady at the Steubenville Pike office. I told her I was sending the $62.60 for the outstanding balance and opening a case with the Revdex.com and the insurance company.

7/1/2015 - Michelle leaves a message on my voicemail and said she is sending out a registered letter along with my check. I figured there is an explanation in the letter.

7/9/15 - I left a message with Michelle that I haven't received a registered letter or my check. It hasn't been cashed. My new concern is where did she send the check? Does someone have my bank/account number?Desired Settlement: I should have paid from the beginning - $36.20. I should be reimbursed for the difference.

$163.00 - 36.20 = $126.80 Refund and my uncashed check of $62.60 sent to me

If they are going to cash the check

$163.00 + $62.60 = $225.60 - $36.20 = $189.40 Refund

Business

Response:

Miss [redacted] presented to our office on 3/12/2015 with a broken fractured front toothrequesting immediate treatment. She stated that the tooth had broken previously and wanted andimmediate repair. There was no evidence of decay, necessitating a bonding procedure to repair thetooth. Her insurance was contacted and subsequently informed this office that the tooth had beenrepaired less than two years prior, negating due to frequency any applied insurance benefit. Noinsurance benefit would be applied to the repair given the recent repair. Also, the procedure to repairthe tooth was solely cosmetic in nature given that there was no evidence of dental decay. Miss [redacted]was not a current patient of record, but our office was more than willing to restore the tooth.Given the urgency of the request and given that the insurer indicated an adverse benefitdetermination, an out-of-pocket expense to Miss [redacted] was unavoidable. Miss [redacted] was financiallycounselled and informed that the fee to repair the tooth would be $263.00. After much discussion, Miss[redacted] indicated she could afford only $163.00. In an attempt to be as sensitive as possible to herfinancial concerns, as a courtesy to her, we agreed to discount the treatment by $100 to a budgetfriendlyamount of $163.00. Miss [redacted] agreed to this amount and consented to the treatment.The tooth was restored and currently is cosmetically and structurally sound. A service thatwould normally cost over $263.00 was discounted to meet Miss [redacted]'s budget at an agreed-upon priceof $163.00. We feel that no refund is due to Miss [redacted] at this time. Further, we believe that if she hasa complaint that it should directed against the dental office which placed the original failed faultytreatment.We at Emmert Dental were happy to see and treat her during her dental crisis, not a currentpatient of record, cosmetically restoring her obvious broken front tooth. We provided an immediatetreatment solution in an efficient, inexpensive, and appropriate manner. Because this office did notplace the original restoration we were never paid by insurance. There is obviously no coverage to repairanother office's faulty treatment. If Miss [redacted] wanted no out-of-pocket cost, then she needed toreturn to that office and have the work replaced by that dentist. This office has a right to be paid for ourtime and for the work that was performed. Her cost was discounted by $100.00 to accommodate herbudget. She currently has a zero account balance with us. If a miscommunication occurred at somepoint, we do apologize.Bonding is never a covered service. The repair was needed to correct faulty treatment byanother office, which is also never a covered repair. Further, the fee was immediately discounted withany outstanding amount adjusted to reflect zero on her account. Again, no refund is due on our part.Miss [redacted] has mentioned that she is sending an additional check for $62.60, but we have notrequested any additional payment, as her account balance is zero. However, to date, no check has beenreceived. If we should receive such payment, we will immediately return it to her.We do regret any inconvenience or confusion over this matter, and we would like to invite Miss[redacted] to return to Emmert Dental for a free teeth cleaning, Zoom whitening, or cosmetic consultation.Thank you.Emmert Dental Office Manager

Review: On Jan. 8, 2014, I visited this Emmert Dental office for the first time. I filled out all the new patient paperwork they presented to me so that I could be seen. I had two teeth that werex-rayed, drilled, and filled. At no time was I verbally told that insurance would not pay for this procedure. At the end of the appointment, I was told I owed $110 for my co-payment and I charged it on my credit card. After I got home and looked at my dental insurance policy, I realized that I should have only been charged $38.20 for my co-payment. I called the office and spoke to the receptionist and she said that I was charged that because she thought I had a higher co-payment. I asked them to credit my credit card for the $71.80 difference. It has been two months and I have not gotten a credit. I finally called the insurance company UPMC Advantage to find out what the status was on my claim. The insurance company told me that Emmert Dental did not provide them with all the information to settle the claim. The insurance company intervened on my behalf and called Emmert Dental and spoke to Michelle the billing manager. Michelle told them that I was informed that these fillings would probably not be covered by insurance because there was no decay and that I had signed the form saying that I was the responsible party for the bill. Yes I signed that form so that I could be seen as a patient, but I was under the impression that these were standard fillings covered by insurance. AT NO TIME WAS I VERBALLY INFORMED THAT THESE FILLINGS WOULD NOT BE COVERED BY INSURANCE. I would not have agreed to the treatment. Now I have received another bill from Emmert Dental dated 3/4/14 stating that I owe an additional $135.40. I do not feel like I should have to pay this since I was not verbally informed that this treatment may not be covered.Desired Settlement: I would like the $110 that I have paid to be marked as payment in full since I was not verbally informed that this treatment may not be covered by insurance.

Business

Response:

I received your complaint [redacted] in the mail today concerning Mr. [redacted].

I understand his frustration and have spoken to the Insurance company. The bottom line is

that his “plan does not cover fillings unless there is decay. There was no decay present on

these teeth, so the patient is responsible.

There are two consent forms that he signed that were for fillings only. There is not a consent

just to be seen in our office,

I would be willing to split the difference with him in an effort to satisfy him.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. I also spoke to my insurance company and they believe me when I say that I was not verbally informed by Emmert Dental that these fillings would probably not be covered by insurance. My insurance company has told me that they would support me in this matter and would supply any information needed. I have already paid them $110 which was 2 1/2 times the amount that my co-payment should have been. I am very dissatisfied with this company's customer service and billing practices and consider this $110 as payment in full.

Review: On November 6, 2013, my son visited the dental office and got three resin based fillings and an exray. He used my debit card to pay for the services, which totaled $257. After I received the EOB from Delta Dental, which is my insurance company, I saw that the patient responsibility was only $101.20 based on the contracted rate of the services. I have called the office and requested a refund and spoken to [redacted] 3 times. She stated she would speak to the office general manager and get back to me. She has not done so. I have emailed her and gotten no reply. I also sent her the EOB showing my responsibility. Still no reply. I have not received any money back and feel I am being ignored. I have the EOB and my receipt for the dentist.Desired Settlement: I am owed a refund and would like one ASAP. Thank you.

Business

Response:

[redacted] presented to the office November 6, 2013 with cavities and decay

involving three posterior (back) teeth. Filling placement was advised and recommended

with an option given for white or silver fillings. Mr. [redacted] opted for white tooth-colored

fillings. The nature of the treatment was explained and Mr. [redacted] had the opportunity to

ask any questions. He opted for white filling placement. He authorized and requested

white filling placement. The signed, enclosed dental treatment consent forms attest to that

fact. The white fillings do in fact carry an additional cost, a fact Mr. [redacted] was made [redacted]_

of prior to the initiation of treatment. Again, please see the enclosed signed consent

forms. The difference in cost does reflect an amount associated with the use of the white

fillings. We regret any inconvenience or misunderstanding. Miss [redacted] or [redacted] are

invited to join us for a free courtesy in-office zoom whitening or dental whitening of their

choice. Miss [redacted] is welcome to join us for a free cosmetic consultation with one of

our prosthodontists. However if Miss [redacted] would be so kind as to either fax or mail

her EOB to me I will submit that to the practice administrative office. If an overpayment

has been made (as determined by the accounting department) she will be promptly

refunded.

Thank you,

I went to see Dr. [redacted] a few years ago for a routine cleaning and exam. Avoid this place. He's a crook and a scam artist. I ended up having almost every tooth in my mouth crowned. He can fool you and take you for your money. I naively believed him when he said I needed my teeth worked on. Big mistake. My teeth were not that bad. This dentist is from hell. The final bill was in the thousands. 8 to 10 thousand dollars. Maybe more. He was not gentle with some of the work being done and would not give anesthia or anything to comfort the pain. Brutal. While I was in pain all he had to say was "so sorry". He's not sorry when he's raking in the dough due to people's lack of knowledge about his "conclusions" as to what should be done to somebody's teeth. This guy is not a good dentist.