Hawaii Dental Clinic LLC

Complaint:
I am rejecting this response because:From: *** *** [mailto:k***[email protected]] Sent: Tuesday, April 11, 5:PMTo: Revdex.com Subject: Re: You have a New Message from Revdex.com of Hawaii Regarding Complaint #12086459I don't know how to reply to the message to Revdex.com and Hawaii Dental ClinicSo, I like to use this mail.I don't understand the insurance process like Nolan's statement.Nolan's letter sound like try to intimidating me because English is not my first language.I talked to his staff only once regarding about computer error and fees and charges with Shawna.Other conversation were all e-mails except an appointment phone call and give a clerical my insurance information before visit.The calculation of estimated overcharge of $was based onattachment#and #difference from my insurance fee and charge (Pre Check amount).So far, he didn't give me any information which I was interested to find out.I would like to know the followings;Did they send their claim to my insurance company? if yes, when? My insurance company did not receive Hawaii Dental Clinic claimWhat were the right fee and charge on D7140, Dand D4341?Why was Shawna's fee and charge (which was almost same as my insurance company) differ from your Active Treatment Plan(attachment#and #2)?What was the computer error and how it affected to fee and charge?Why was the clerical accept my insurance before visiting office, knowing DrMicheal Luu was not register with my insurance?I would like to find out aboveI think I have a right to know.I believe the customer service is to satisfy customer's need and explain the reason why this situation is happening in this case.I don't need their treatment any more because I found a reasonable clinic but I want to know why this happen with reasonable explanation.*** ***

Re: Complaint ID *** Claimant: *** *** Aloha,We have received your complaint regarding ID *** in the matter of *** *** vsHawaii Dental Clinic - Kapiolani Office.We are sorry that Mr*** was not satisfied with the quality of services receivedWe strive to provide high quality
service to all of our patients in all of our locations.There are several important points related to the situationPlease note the following information:We have tried, over more than a dozen communications, to explain and resolve this situation with Mr***In each instance, Mr*** has responded by either changing his story, changing his demand, or escalating the disputeIt is quite difficult to reach an amicable resolution with someone who is clearly uninterested in an amicable resolution.Mr*** states that he called his dental insurance company’s customer service phone number prior to making an appointment at any officeMr*** further states that he chose the provider based on the information from his dental insurance companyIt is unfortunate that Mr*** was given erroneous information by his dental insurance companyHowever, Mr. ***’s dental insurance company is a separate entity from any of our individual office locationsAs such, any misinformation provided by Mr***’s dental insurance company is not the responsibility of Hawaii Dental ClinicI would suggest that Mr*** may want to consider a Revdex.com or other regulatory complaint against his dental insurance company for having provided incorrect information.Mr***, by his own admission, confirms that he consented to the procedures which were performedSince Mr*** consented to the procedures performed and the procedures were performed successfully, it would appear that all services were rendered as intendedIf Mr*** received the services he expected to receive, then it would appear that Mr***’s complaint is related to the insurance process rather than the dental treatment received.Mr***, by his own admission, included printed copies of his treatment plan estimatesThese estimates include the fees to be chargedThe presence of these documents indicates that Mr*** had knowledge of the fees related to each procedure prior to receiving treatmentIt is difficult to rationalize the basis for providing a refund to someone who consented to procedures performed, was aware of the charges, and acknowledges that treatment was acceptable.Mr***’s insurance company, United Healthcare, has a standard claims policy of requiring a one-year period to pass between the date of service and the final processing timeline for a claimMr***, by his own admission, received his first treatment from the office on 2/14/Less than two months have passed since Mr*** initially received treatment from the officeTwo months is well within the one-year timeline that United Healthcare sets for finalizing insurance claimsAs such, any legal or regulatory complaint would be far prematureAgain, it would appear that Mr*** is very eager to escalate the dispute rather than to take the time and effort necessary to find an amicable resolution.Mr***, by his own admission, provided a accounting of the situation to me, via my direct work email address, less than two weeks prior to this Revdex.com complaintIt would appear that Mr*** is not interested in resolving this situation amicably since he has both provided information and allocated insufficient time for our staff to generate an appropriate response.It would be ideal if all patients could use any insurance to receive no-out-of-pocket cost treatment from any dentist in the countryUnfortunately this is not how dental insurance worksEach dentist decides whether to participate, accept, or reject a variety of dental insurance plansSimilarly, each patient is free to select a dentist on the basis of whether that dentist participates, accepts, or rejects his/her specific dental insurance plansI suspect the root cause for this Revdex.com complaint is Mr***’s lack of familiarity with his own dental insurance plan and United Healthcare’s inability to adequately explain the details of the insurance plan to their own customers.Mr*** has a factual misunderstanding of a variety of insurance terminologyDrMichael Luu, as with many other dentists in Hawaii, do in fact accept dental insurance, including dental insurance from United HealthcareThe acceptance of dental insurance is a different concept than whether the dentist is a participating provider in the contractual restrictions imposed by the dental insurance companyAt the present time, DrMichael Luu does not have a signed participating provider agreement with United Healthcare even though he does accept patients who have United Healthcare insuranceAgain, Mr***’s dental insurance company representative would be the ideal person to answer questions regarding his own dental insurance plan. Mr*** was rude and disrespectful to our in-office staff at the Kapiolani locationIn particular, our Office Manager, Shawna Farris, noted that Mr*** was quite combative and disrespectful in communicationI also do not appreciate the fact that Mr*** explicitly threatened one of our dentists and further demanded money in exchange for not following through on his threat.Mr*** engaged in ethically and legally questionable actions in this processMr*** wrote:“You need to pay me at least $Please pay as soon as you can .I will bring this to Revdex.com or other which give me assistance if you don’t give me .”I am not a legal expert so I would not go so far as to state that this was extortionHowever, I am confident saying that Mr*** provided no basis for his $calculationIt is additionally clear that Mr*** fully intended to use the threat of harm to the dentist in an attempt to be paid money.It is unfortunate that the Revdex.com would support such behavior.In light of the situation, our group practice is forced to permanently dismiss Mr*** as a patientOther than a short-term emergency exception mandated by the government, please note that Mr*** will not be allowed to receive treatment from any Hawaii Dental Clinic or affiliated office for the rest of his lifeWe strive to provide good quality treatment to all of our patientsIt is unfortunate that good quality treatment costs moneyMany other organizations, such as low-income community health centers, provide substantially less-expensive treatment and these lower-priced options may be a better fit for someone in a less-than-ideal financial condition.I am more than happy to discuss the explicit details of this case with anyone from the Revdex.com or other legal or regulatory agencyDue to the litigious and combative nature of the complainant, all communication regarding this case should be in writing.Please feel free to send written correspondence to the main address at top or to email me directly at ***@hawaiidentalclinic.comMahalo, Nolan K***