Horizon Dental Care

August 6, To whom it may concern,I am writing this in response to *** ***'s complaint, id number ***,I understand ***'s concern that she was told there would be no fee other than the $dedHowever, if *** *** wil refer back to her original treatment plan that was given to her it states on the treatment plan “Estimated Insurance payment” and "Estimated patient's portion"All of our treatment plans are estimates, because as in this case changes with the insurance company which we have no control over happenIn this case *** ***’s employer changed her dental plan AFTER she was given the treatment plan, and *** *** never notified us stating there was a change in her insurance planTherefore, we had no way of knowing that the insurance plan changed from the time she was given the original treatment plan, to the time the work was completed and the insurance company paid for the procedureEven when *** *** came in on July 1st, she declined to update us with her insurance changesThe outstanding balance of $will remain and if unpaid the account will be sent over to collectionsIf there is anything else we can do to resolve this matter, please let us know.Thank you,Michele R
Horizon Dental Care

July 28, 2014To whom it may concern,I received your letter in the mail in regards to the complaint against our office. I am now writing our written response to this matter.My name is Michele R[redacted] and I am the Office Manager for Horizon Dental Care ([redacted] location). On June 10,...

2013 [redacted] was seen in our office as a new patient, where she had a prophy (cleaning) done, along with radiographs and a full exam. She was then treatment planned for a deep scaling on 1-3 teeth on the upper right side along with a night guard. Before coming into the office we verified [redacted]'s insurance and got her coverage benefits. (as we do for all pts before coming into the office). When [redacted] was given a treatment plan her patient portion was only estimated to be $25 (her deductible for the year). She agreed to the treatment. Upon receiving the insurance claim back there was a balance of $76.40 from her night guard and her $50 deductible for the year. I called the insurance company myself (I handle all insurance payments) and explained to them that we called and were told she had 100% coverage and only a $25 deductible. The representative told me that as of July 1, 2013 her insurance plan had changed PER HER EMPLOYER and that it wasn't updated in their system until after the first week in July but it was back dated to July 1st. So when her insurance was verified we were given the correct information for what the insurance company had. But because her employer changed the plan and gave an effective date of July 1st, there was nothing the insurance company could do other than back date it. So yes there is still a balance of $76.40 that is owed. We tried to explain this to the patient when she called, but she would not hear what we had to say.If you have any other questions or concerns please feel free to give our office a call. Thank you for your time,Michele ROffice ManagerHorizon Dental Care

that  to assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because I was assured that I would not have to pay anything because my insurance would pay 100%. This is what I was told.  I knew nothing about a balance due until it came in the mail by surprise. No one ever told me when I accepted the month guard that it was an estimate. I was told that my final cost would be 0. That is the only reason I went along with getting a mouth guard. No one ever told me that I was given an estimate.
I feel like they used a fraudulent tactic. They lied to me because I said I would not get a night guard if I have to pay anything. The dental employee left and came back and ASSURED me that I would not have to pay anything.
She should have been more efficient. I'm not paying for her mistake. She should have told me that this is just an estimate [redacted]. But she didn't do that.
Regards,
[redacted]