That the dentist, Dr. [redacted] , be asked to speak with me directly to answer why the amount billed is different from the amt on his quote. Direct contact with the dentist.
Revdex.com: 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 When I asked for the price BEFORE the service, I clearly explained that our insurance would not cover it because it was a new policy and wet had a waiting periodI expect the the price I was quoted and paid would be the actual price not charged an additional amountI did sign the I would cover cost beyond insurance but I did not use our insurance for this service Regards, [redacted] ***
I am Writing in response to the Customer Concern you received from [redacted] on 8/9/2016 with the assigned [redacted]...
[redacted].AS explained in our phone Conversation, I have tried repeatedly to explain to Mr. [redacted], the situation with his insurance. Mr. [redacted] is under the impression that We billed his insurance more than what we were supposed to. However, we bill everyone from a set fee schedule, our office fee schedule, and then are either contracted with or not contracted with an insurance and have to accept their negotiated rate and Write off the difference between the two fee schedules (which we did for Mr. [redacted], as We do for all of our patients whose insurance we are in network with). The issue really lies with Mr. [redacted]'s insurance and the fact that he went over is maximum allowable for the year. Therefore he is responsible for anything over his maximum and that is billed at our rate. As you can see from the corresponding documents, insurance has his responsibility as the $622.00 + a previous balance owed of $70.80, making Mr. [redacted]'s balance due, a total of $692.80. We cannot legally write this off for Mr. [redacted], as this would be considered insurance fraud. I have tried to explain this to Mr. [redacted], and am not sure how much more I can do to make it understandable to him. I know that insurance is difficult to understand, and for this reason I had Mr. [redacted] contact his insurance Company, as Well, for an additional explanation, but this has not seemed to help either.Please see the corresponding documents, to include the original treatment plan, the insurance E.O.B.'s, our office fee schedule and the insurance document that Mr. [redacted] signed, stating he is responsible for alla CCOuntbalances.Thank you,Office Manage Hyde Park Pediatric Dentistry
Revdex.com:
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.
When I asked for the price BEFORE the service, I clearly explained that our insurance would not cover it because it was a new policy and wet had a waiting period. I expect the the price I was quoted and paid would be the actual price not charged an additional amount. I did sign the I would cover cost beyond insurance but I did not use our insurance for this service.
Regards,
[redacted]
That the dentist, Dr. [redacted], be asked to speak with me directly to answer why the amount billed is different from the amt on his quote. Direct contact with the dentist.
I am writing in response to the customer concern you received from [redacted] on 9/26/2016 with the assigned ID# [redacted].This is from a claim back from 4/27/2015. The patient was seen in our office for a procedure and we billed the patient, what was an estimate of what insurance would not pay....
The balance was sent to the insurance and the insurance sent back with no payment, stating that the child had no coverage for this procedure, for 6 months (there was a waiting period, from when they signed up for the insurance). Insurance stated in the explanation of benefits, that patient is responsible for "our fees" nother insurance rate fees. I am including Corresponding documents from the insurance that states that the patient owes $237. I spoke with mom, back on 1/6/2016 about past due balance (past due since 5/2015) and mom stated that she would not pay Mom said that she didn't feel like she owed us anything, since we did not tell her that her insurance was not going to pay, Explained that we were not aware that she had a 6 month Waiting period, and that her insurance, is her responsibility to know. Tried to collect the balance for over 8 months and finally sent the account to collections in January of 2016.Please see the Corresponding documents, to include the insurance E.O.B. and the document that Ms. [redacted] signed, stating she is responsible for all account balances.
[redacted]Office Manage Hyde Park Pediatric Dentistry
That the dentist, Dr. [redacted] , be asked to speak with me directly to answer why the amount billed is different from the amt on his quote. Direct contact with the dentist.
Revdex.com: 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 When I asked for the price BEFORE the service, I clearly explained that our insurance would not cover it because it was a new policy and wet had a waiting periodI expect the the price I was quoted and paid would be the actual price not charged an additional amountI did sign the I would cover cost beyond insurance but I did not use our insurance for this service Regards, [redacted] ***
I am Writing in response to the Customer Concern you received from [redacted] on 8/9/2016 with the assigned [redacted]...
[redacted].AS explained in our phone Conversation, I have tried repeatedly to explain to Mr. [redacted], the situation with his insurance. Mr. [redacted] is under the impression that We billed his insurance more than what we were supposed to. However, we bill everyone from a set fee schedule, our office fee schedule, and then are either contracted with or not contracted with an insurance and have to accept their negotiated rate and Write off the difference between the two fee schedules (which we did for Mr. [redacted], as We do for all of our patients whose insurance we are in network with). The issue really lies with Mr. [redacted]'s insurance and the fact that he went over is maximum allowable for the year. Therefore he is responsible for anything over his maximum and that is billed at our rate. As you can see from the corresponding documents, insurance has his responsibility as the $622.00 + a previous balance owed of $70.80, making Mr. [redacted]'s balance due, a total of $692.80. We cannot legally write this off for Mr. [redacted], as this would be considered insurance fraud. I have tried to explain this to Mr. [redacted], and am not sure how much more I can do to make it understandable to him. I know that insurance is difficult to understand, and for this reason I had Mr. [redacted] contact his insurance Company, as Well, for an additional explanation, but this has not seemed to help either.Please see the corresponding documents, to include the original treatment plan, the insurance E.O.B.'s, our office fee schedule and the insurance document that Mr. [redacted] signed, stating he is responsible for alla CCOuntbalances.Thank you,Office Manage Hyde Park Pediatric Dentistry
Revdex.com:
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.
When I asked for the price BEFORE the service, I clearly explained that our insurance would not cover it because it was a new policy and wet had a waiting period. I expect the the price I was quoted and paid would be the actual price not charged an additional amount. I did sign the I would cover cost beyond insurance but I did not use our insurance for this service.
Regards,
[redacted]
That the dentist, Dr. [redacted], be asked to speak with me directly to answer why the amount billed is different from the amt on his quote. Direct contact with the dentist.
I am writing in response to the customer concern you received from [redacted] on 9/26/2016 with the assigned ID# [redacted].This is from a claim back from 4/27/2015. The patient was seen in our office for a procedure and we billed the patient, what was an estimate of what insurance would not pay....
The balance was sent to the insurance and the insurance sent back with no payment, stating that the child had no coverage for this procedure, for 6 months (there was a waiting period, from when they signed up for the insurance). Insurance stated in the explanation of benefits, that patient is responsible for "our fees" nother insurance rate fees. I am including Corresponding documents from the insurance that states that the patient owes $237. I spoke with mom, back on 1/6/2016 about past due balance (past due since 5/2015) and mom stated that she would not pay Mom said that she didn't feel like she owed us anything, since we did not tell her that her insurance was not going to pay, Explained that we were not aware that she had a 6 month Waiting period, and that her insurance, is her responsibility to know. Tried to collect the balance for over 8 months and finally sent the account to collections in January of 2016.Please see the Corresponding documents, to include the insurance E.O.B. and the document that Ms. [redacted] signed, stating she is responsible for all account balances.
[redacted]Office Manage Hyde Park Pediatric Dentistry