Ferguson Music Company

I am writing in response to complain # [redacted] filed by [redacted] on September 1, I have spoken to this patient on multiple occasions since January regarding her account balance Our office has not been a contracted in-network provider for the insurance company in question since February of Unfortunately we are unable to pick and choose who we give in-network discounts to When a provider is contracted/in-network it is either with all groups or none, it is considered insurance fraud to take anything more or less than what the insurance company provides as the customers out of pocket portion Our software generates estimates based off of the patients percentage, the insurance company then decides what they will or will not pay What our staff member did was create an estimate, yes the procedures provided are a covered benefit but we will not/cannot give in-network discounts to patients with insurance that we are not a contracted in-network provider with We sent numerous statements and the patient was in the office in September of 2014, when I explained in detail with herself and her husband and they agreed to pay the remaining balance When payment was not received as of June 2015, the account was turned over to a collection agency Our office prides itself on providing excellent care and will continue to do so All of our office financial policies are clearly printed in our paperwork and signed by the responsible party I believe the patient misunderstood what was explained to her, as we would not purposely tell someone we are an in-network provider or that we can give in-network discounts at our own will Please let me know if there is anything else that I can provide for you to solve this matter Sincerely, [redacted] Insurance & Financial Coordinator Valley Dental, Inc

I am writing in response to complain #*** filed by *** ** on September 1, 2015. I have spoken to this patient on multiple occasions since January regarding her account balance. Our office has not been a contracted in-network provider for the insurance company in question
since February of 2013. Unfortunately we are unable to pick and choose who we give in-network discounts to. When a provider is contracted/in-network it is either with all groups or none, it is considered insurance fraud to take anything more or less than what the insurance company provides as the customers out of pocket portion. Our software generates estimates based off of the patients percentage, the insurance company then decides what they will or will not pay. What our staff member did was create an estimate, yes the procedures provided are a covered benefit but we will not/cannot give in-network discounts to patients with insurance that we are not a contracted in-network provider with. We sent numerous statements and the patient was in the office in September of 2014, when I explained in detail with herself and her husband and they agreed to pay the remaining balance. When payment was not received as of June 2015, the account was turned over to a collection agency Our office prides itself on providing excellent care and will continue to do so. All of our office financial policies are clearly printed in our paperwork and signed by the responsible party. I believe the patient misunderstood what was explained to her, as we would not purposely tell someone we are an in-network provider or that we can give in-network discounts at our own will. Please let me know if there is anything else that I can provide for you to solve this matter Sincerely, *** *** Insurance & Financial Coordinator Valley Dental, Inc