Review: I wanted to transfer our (me plus spouse) Delta Dental Insurance to a closer location to our home. Through miscommunication with Delta I understood that the Ione Dental Center was a member of the Delta Dental clinics that I could go to. I called for and was given an appointment for March 11, 2015. Upon arrival the receptionist ([redacted])wanted to call and verify our coverage before providing any services. She did call Delta Dental but couldn't get any details regarding our particular plan. Being late in the afternoon [redacted] gave the go-ahead to provide services. Hence we each saw Dr [redacted] and received a check up, cleaning and X-rays. The check-up indicated that much more work would have to be done. Since [redacted] didn't know what our co-pay amounts would be I offered to pay $350 and [redacted] agreed that should be more than enough. Unfortunately it turns out their clinic is not an approved one with my Delta Dental Plan. I don't know when [redacted] learned that but I found out later through Delta Dental. I called right away and suggested we arrive at a compromise. Had they been an approved clinic my out-of-pocket would have been $10 for me and $10 for my wife.I've contacted [redacted] several times and also wrote a letter to Dr [redacted].....all for naught! [redacted] has never returned my calls despite promising to do so on several occasions. She also never provided me an itemized bill the day of services. But a later itemized bill magically adds up to $350! [redacted] is lying to cover her inefficiency. [redacted] didn't know what % of the services provided we would have to pay for because she never determined that their office was an approved clinic for my plan. Since I anticipated returning for more work I told her I would pay $350 at that time which I thought would be more than enough for the cleaning, check-up and X-rays provided that day. In the next few days it was learned that their clinic was NOT an approved clinic. I called to try and work a compromise with them.Desired Settlement: I paid them $350. I accept some blame since I told them I thought they were an approved clinic. However they are the professionals here and knew they needed to call to verify coverage. They did this and made the incorrect conclusion of being an approved clinic for my plan. Thus I believe they should be responsible for at least half of my loss.Services they provided would have cost me $20 total ($10+10) at an approved clinic. Hence $350-20= 330. Half of $330 is $165. I suggest a $165 refund.
Business
Response:
Company states: We did inform that we did not know if he would be covered or not before the services were done. He said he wanted it to be done because he talked to Delta Dental rep. We told him that if they were not covered we would give back the amount. He had an HMO plan through his Delta Dental. So he had an assigned dentist. He said he tried switching it and he said that his insurance said it was okay.
Consumer
Response:
I am rejecting this response because: Dr, [redacted]'s office is avoiding a response to the accusation that Stacey is lying and has manipulated her records to hide the truth. However let's put some closure to this incident. In the business' response they state that they agreed if we were not covered they would give our money back. Well, we were not covered so write us a check and let's go on our ways.I do agree that I am partially to blame since I was of the understanding that my Delta plan would apply. You however have a policy to confirm coverage before giving service. And your attempt to do so resulted in an incorrect conclusion.I paid you $350 on Visa. If I had gone to my "assigned" dentist my out-of-pocket would have been $20. Hence I paid $330 too much for the services you provided. I am a fair man and pride myself on integrity.....that's why Stacey's actions really rub me wrong. However I am willing to accept a refund from you for half of the $330, which is $165.00.[redacted]
Review: I wanted to transfer our (me plus spouse) Delta Dental Insurance to a closer location to our home. Through miscommunication with Delta I understood that the Ione Dental Center was a member of the Delta Dental clinics that I could go to. I called for and was given an appointment for March 11, 2015. Upon arrival the receptionist ([redacted])wanted to call and verify our coverage before providing any services. She did call Delta Dental but couldn't get any details regarding our particular plan. Being late in the afternoon [redacted] gave the go-ahead to provide services. Hence we each saw Dr [redacted] and received a check up, cleaning and X-rays. The check-up indicated that much more work would have to be done. Since [redacted] didn't know what our co-pay amounts would be I offered to pay $350 and [redacted] agreed that should be more than enough. Unfortunately it turns out their clinic is not an approved one with my Delta Dental Plan. I don't know when [redacted] learned that but I found out later through Delta Dental. I called right away and suggested we arrive at a compromise. Had they been an approved clinic my out-of-pocket would have been $10 for me and $10 for my wife.I've contacted [redacted] several times and also wrote a letter to Dr [redacted].....all for naught! [redacted] has never returned my calls despite promising to do so on several occasions. She also never provided me an itemized bill the day of services. But a later itemized bill magically adds up to $350! [redacted] is lying to cover her inefficiency. [redacted] didn't know what % of the services provided we would have to pay for because she never determined that their office was an approved clinic for my plan. Since I anticipated returning for more work I told her I would pay $350 at that time which I thought would be more than enough for the cleaning, check-up and X-rays provided that day. In the next few days it was learned that their clinic was NOT an approved clinic. I called to try and work a compromise with them.Desired Settlement: I paid them $350. I accept some blame since I told them I thought they were an approved clinic. However they are the professionals here and knew they needed to call to verify coverage. They did this and made the incorrect conclusion of being an approved clinic for my plan. Thus I believe they should be responsible for at least half of my loss.Services they provided would have cost me $20 total ($10+10) at an approved clinic. Hence $350-20= 330. Half of $330 is $165. I suggest a $165 refund.
Business
Response:
Company states: We did inform that we did not know if he would be covered or not before the services were done. He said he wanted it to be done because he talked to Delta Dental rep. We told him that if they were not covered we would give back the amount. He had an HMO plan through his Delta Dental. So he had an assigned dentist. He said he tried switching it and he said that his insurance said it was okay.
Consumer
Response:
I am rejecting this response because: Dr, [redacted]'s office is avoiding a response to the accusation that Stacey is lying and has manipulated her records to hide the truth. However let's put some closure to this incident. In the business' response they state that they agreed if we were not covered they would give our money back. Well, we were not covered so write us a check and let's go on our ways.I do agree that I am partially to blame since I was of the understanding that my Delta plan would apply. You however have a policy to confirm coverage before giving service. And your attempt to do so resulted in an incorrect conclusion.I paid you $350 on Visa. If I had gone to my "assigned" dentist my out-of-pocket would have been $20. Hence I paid $330 too much for the services you provided. I am a fair man and pride myself on integrity.....that's why Stacey's actions really rub me wrong. However I am willing to accept a refund from you for half of the $330, which is $165.00.[redacted]