Gateway Dental

Good afternoon, DrN*** is an in network provider with *** / *** ***, Mr***'s *** insurance planShe has been an in network provider since She is permittedand has made changes on treatment plans based on the need of the patient, her diagnosis, and consent from the patientAgain, Mr*** gave verbal consent to DrN*** to proceed with his treatment.DrE*** was not in the office the last two times Mr*** had his treatmentsDrN*** is an associate doctor in charge of the office on Mondays and WednesdaysShe is an independent associate who is not required to work under the direction of another dentistIf she is treating a patient, she will do what is in the best interest of the patientMr***'s treatment plan was changed from limited deep cleaning to full mouth deep cleaningIt is not unusual for treatment to change from limited deep cleaning to full mouth deep cleaning after full mouth perio measurements, which were done by DrN*** on January 11, for the right side and on January 18, for the left sideOnce again, DrN***can make, change, or update a diagnosis without DrE***'s consent.Mr*** has the same number of teeth in each quadrant, depth of the pockets (site of infection), amount of tartar, and bleeding dictates the amount of time necessary to do the treatmentWe always provide a walkout statement (itemized receipt) to patients after each visitThere was no mistake made to facilitate a "cover up" as stated by Mr*** in his response for not being given a receiptStating we did not give him a receipt to cover up a mistake is absurd and blatantly untrueReceipts are always available on the day of the appointment or anytime after.Mr***, wrote a letter of complaint to *** *** in March and he sent a copy to our office, to which we replied back to *** *** and sent a copy to him as well.We again state DrE*** gave his recommended treatment plan based on a comprehensive exam and limited perio probing (involving only teeth), where as DrN*** did a comprehensive perio probing(all teeth) which can result in different findings and lead to a different treatment plan.Although Mr*** did receive the recommended treatment he agreed to with DrN*** and later made a complaint about the accepted treatment plan, to help resolve this fee dispute, DrE*** has decided to refund back the cost of quadrants of scaling with irrigation treatment which comes to a total of $332.00, which translates to the original amount of the treatment plan and diagnosis given by DrE***.This in no way suggests any wrong doing by DrE***, DrN*** or the office staff, this is simply in the interest of providing good customer service and resolving this issueWe will be happy to write Mr.*** a refund check for the above amount however we do require him to stop by the office to complete the refund transactionIt is advised for Mr*** to contact the office a few days prior to stopping by so we can make sure all proper documents and the refund check is ready. Respectfully,Cynthia H***, O.M.on behalf of Michael E***, D.D.SAttached: Exerpt from *** Fee Schedule

April 6, 2016This is a letter to respond to a patient complaint on 3/29/2016, ID number assigned ***.Mr*** states that we did not respond to his concern, which is an unequivocally accusationWe received a letter from Mr***, which was dated on March 3, We responded back to
Mr*** with a letter addressing his concernA copy of this letter and our corresponding letters are included.DrE*** saw Mr*** in our office on December 29, for a new patient exam, full mouth x-rays, and a periodontal screening, which involves a limited number of teeth and surfaces in each quadrant of the mouth (quadrants)Mr*** was given a treatment plan based on DrE***'s screening for deep cleaning of two quadrants in one visit based on his *** insuranceA walk out statement was also given to the patient on this dateHis out of pocket expense for the date of service December 29, was $based on his insurance planOn January 11, 2016, when Mr*** saw DrN***, she performed comprehensive points assessment of each single tooth (teeth x6)The full mouth periodontal probing revealed that he has more extensive gum disease than previously noted by DrE***, based on his screeningThe patient was informed of the change in treatment from a limited deep cleaning, to a full mouth, four quadrants of deep cleaningAfter obtaining the required verbal consent to treat the patient, DrN*** proceeded with his treatment.The patient was given a walk out statement for a deep cleaning of half of his mouth on January 11, The patient returned on January 18, to complete the second half of his deep cleaning, which required minutes to hourHe was given another walk out statement indicating the deep cleaning for the other half of his mouthOn January 18, 2016, Mr*** also received a fluoride treatment, after obtaining his verbal consentMr*** did not voice any concern on January 11, 2016, January 18, or any other date in betweenThe letter dated March 3, was the first time we had received notice of any concern from the patient.The patient ledger included with this letter indicates charges based on his *** insurance: deep cleaning $per quadrant (x4), which equals $548.00, gingival pocket irrigation $per quadrant (x4) equals $Based on the patient's insurance, the pocket irrigation is a non-covered benefit, and was reduced by our office from a fee of $to $as a doctor courtesyThe fluoride treatment was also reduced from $to $The total out of pocket charges based on the patient's *** insurance was $689.00, not $as he stated in his letterEach individual procedure was discussed with Mr***, as well as the cost of each procedureThe $amount does not include the new patient exam and x-rays from December 29, for $In regards to the claim that we owe Mr*** money for treatment rendered, we are confident that we do not owe the patient any money because it was done based on comprehensive diagnosis of his gums and teeth, and his consent at the time of treatment on January 11, and on January 18, Please see ***'s fee for scaling and root planing in the attached document. Respectfully,Cynthia H***, O.M.on behalf of Michael E***, D.D.S

Good afternoon,
Dr. N[redacted] is an in network provider with [redacted] / [redacted], Mr. [redacted]'s [redacted] insurance plan. She has been an in network provider since 2015. She is permittedand has made changes on treatment plans based on the need of the patient, her diagnosis, and consent from the patient. Again, Mr. [redacted] gave verbal consent to Dr. N[redacted] to proceed with his treatment.
Dr. E[redacted] was not in the office the last two times Mr. [redacted] had his treatments. Dr. N[redacted] is an associate doctor in charge of the office on Mondays and Wednesdays. She is an independent associate who is not required to work under the direction of another dentist. If she is treating a patient, she will do what is in the best interest of the patient. Mr. [redacted]'s treatment plan was changed from limited deep cleaning to full mouth deep cleaning. It is not unusual for treatment to change from limited deep cleaning to full mouth deep cleaning after full mouth perio measurements, which were done by Dr. N[redacted] on January 11, 2016 for the right side and on January 18, 2016 for the left side. Once again, Dr. N[redacted]can make, change, or update a diagnosis without Dr. E[redacted]'s consent.
Mr. [redacted] has the same number of teeth in each quadrant, depth of the pockets (site of infection), amount of tartar, and bleeding dictates the amount of time necessary to do the treatment. We always provide a walkout statement (itemized receipt) to patients after each visit. There was no mistake made to facilitate a "cover up" as stated by Mr. [redacted] in his response for not being given a receipt. Stating we did not give him a receipt to cover up a mistake is absurd and blatantly untrue. Receipts are always available on the day of the appointment or anytime after.
Mr. [redacted], wrote a letter of complaint to [redacted] in March 2016 and he sent a copy to our office, to which we replied back to [redacted] and sent a copy to him as well.
We again state Dr. E[redacted] gave his recommended treatment plan based on a comprehensive exam and limited perio probing (involving only 4 teeth), where as Dr. N[redacted] did a comprehensive perio probing(all teeth) which can result in different findings and lead to a different treatment plan.
Although Mr. [redacted] did receive the recommended treatment he agreed to with Dr. N[redacted] and later made a complaint about the accepted treatment plan, to help resolve this fee dispute, Dr. E[redacted] has decided to refund back the cost of 2 quadrants of scaling with irrigation treatment which comes to a total of $332.00, which translates to the original amount of the treatment plan and diagnosis given by Dr. E[redacted].This in no way suggests any wrong doing by Dr. E[redacted], Dr. N[redacted] or the office staff, this is simply in the interest of providing good customer service and resolving this issue. We will be happy to write Mr.[redacted] a refund check for the above amount however we do require him to stop by the office to complete the refund transaction. It is advised for Mr. [redacted] to contact the office a few days prior to stopping by so we can make sure all proper documents and the refund check is ready.
 
Respectfully,
Cynthia H[redacted], O.M.
on behalf of Michael E[redacted], D.D.S
Attached: Exerpt from [redacted] Fee Schedule

April 6, 2016
5pt;">This is a letter to respond to a patient complaint on 3/29/2016, ID number assigned [redacted].
Mr. [redacted] states that we did not respond to his concern, which is an unequivocally false accusation. We received a letter from Mr. [redacted], which was dated on March 3, 2016. We responded back to Mr. [redacted] with a letter addressing his concern. A copy of this letter and our corresponding letters are included.
Dr. E[redacted] saw Mr. [redacted] in our office on December 29, 2015 for a new patient exam, full mouth x-rays, and a periodontal screening, which involves a limited number of teeth and surfaces in each quadrant of the mouth (4 quadrants). Mr. [redacted] was given a treatment plan based on Dr. E[redacted]'s screening for deep cleaning of two quadrants in one visit based on his [redacted] insurance. A walk out statement was also given to the patient on this date. His out of pocket expense for the date of service December 29, 2015 was $83.00 based on his insurance plan. On January 11, 2016, when Mr. [redacted] saw Dr. N[redacted], she performed comprehensive 6 points assessment of each single tooth (28 teeth x6). The full mouth periodontal probing revealed that he has more extensive gum disease than previously noted by Dr. E[redacted], based on his screening. The patient was informed of the change in treatment from a limited deep cleaning, to a full mouth, four quadrants of deep cleaning. After obtaining the required verbal consent to treat the patient, Dr. N[redacted] proceeded with his treatment.
The patient was given a walk out statement for a deep cleaning of half of his mouth on January 11, 2016. The patient returned on January 18, 2016 to complete the second half of his deep cleaning, which required 45 minutes to 1 hour. He was given another walk out statement indicating the deep cleaning for the other half of his mouth. On January 18, 2016, Mr. [redacted] also received a fluoride treatment, after obtaining his verbal consent. Mr. [redacted] did not voice any concern on January 11, 2016, January 18, 2016 or any other date in between. The letter dated March 3, 2016 was the first time we had received notice of any concern from the patient.
The patient ledger included with this letter indicates charges based on his [redacted] insurance: deep cleaning $137.00 per quadrant (x4), which equals $548.00, gingival pocket irrigation $29.00 per quadrant (x4) equals $116.00. Based on the patient's insurance, the pocket irrigation is a non-covered benefit, and was reduced by our office from a fee of $81.00 to $29.00 as a doctor courtesy. The fluoride treatment was also reduced from $89.00 to $25.00. The total out of pocket charges based on the patient's [redacted] insurance was $689.00, not $714.00 as he stated in his letter. Each individual procedure was discussed with Mr. [redacted], as well as the cost of each procedure. The $689.00 amount does not include the new patient exam and x-rays from December 29, 2015 for $83.00. In regards to the claim that we owe Mr. [redacted] money for treatment rendered, we are confident that we do not owe the patient any money because it was done based on comprehensive diagnosis of his gums and teeth, and his consent at the time of treatment on January 11, 2016 and on January 18, 2016. Please see [redacted]'s fee for scaling and root planing in the attached document.
 
Respectfully,
Cynthia H[redacted], O.M.
on behalf of Michael E[redacted], D.D.S.