Irving Tregerman

This is in response to the complaint ID#: ***Apparently, there is some confusion for this patient in regard to her dental applianceThe patient, *** *** was informed prior to treatment
that the occlusal guard that I make is an upgrade with a more expensive laboratory billThe patient agreed to the treatment and the fee and the treatment was rendered successfully without complaintI have spoken to Metropolitan Life representative and they informed me that I was well in my rights to charge her the upgradeSincerely *** *** ***

Review: 1. I believe that this office has made a fraudulent claim on my dental insurance. They performed a wisdom-tooth consultation for free, stating that consultations were free, without any reference to my health insurance. I believe this was done, with hopes of my return service. Upon my arranging to complete my treatment plan at another office (at a facility I felt much more comfortable with) then billed me for the $100 service that they then decided to make a claim on - stating that my insurance wouldn't cover it. My insurance did in fact, not cover the service - but I believe I was misinformed when told directly by the doctor and receptionists that I was eligable for a "free consultation". I have been unlawfully billed, and had I known that the service wouldn't be "free" had I decided to take my treatments elsewhere, I would have declined their services.

2. I have also received false information directly from the Doctor himself. My proposed treatment plan included services that were unnecessary and exuberant. Upon visiting I was told I had 8 cavities - and given a rather extensive treatment plan. Upon a second opinion, I learned that half of these "cavities" didn't exist and the doctor may have been trying to perform more treatment than necessary.

3. I was given false information on the service conducted on the day of July [redacted]. [redacted], upon completing scans - told me that there were 4 wisdom teeth in my mouth to be removed. [redacted] stated that it would be best I have two surgeries because getting all 4 removed at once can be too much.

When visiting another doctor for a second opinion, I learned that only 3 wisdom teeth even exist in my mouth! I am not sure if this is a result of a poorly done scan, incompetence, or carelessness to one's (potential) patient - but it shows a true lack of professionalism and expertise. I have a hard time believing he even looked at the scan after this.

4. Upon calling the office to let them know I was unhappy with the inaccurate bill I was sent, I was rudely informed by a receptionist that I was terribly wrong and that I can deal with collections, rather than dealing with the office directly to sort through the issue.Desired Settlement: I would like the office to cancel my $100 bill, return my account balance to $0, and to not be contacted by their offices again. I believe that the office attempted to take advantage of me and is unlawfully billing me.

Business

Response:

To whom it may concern,

I am responding to the letter:

ID Number: [redacted]

To begin, there was no fraudulent claim made on the patient's dental insurance. [redacted] presented to my office for a comprehensive examination and a full mouth set of x-rays. The insurance company was properly billed for those services which left a balance of $100.00. In fact, the patient paid a $25 fee by Visa knowing that the insurance would pay the balance of $100.00. The insurance company denied the claim due to the patient seeing another dental provider.

We did not imply or present to the patient that this was a free consultation in regards to his wisdom teeth. The $100.00 outstanding bill to patient is proper and fair and he is avoiding his fiscal responsibility to my office and the services were rendered and he is obligated to pay for those services.

Sincerely

Review: To Whom it May Concern,

The reason for this complaint is because I am having a very difficult time with [redacted]’s staff in receiving money owed to me for Dental services that they provided to me.

Currently, [redacted] owes me a total of $98.10. They are saying they owe me nothing which I can’t understand how they came to this conclusion.

Below is a recap that I’m hoping is clear.

On 1/** – I was charged 221.60 for 5 [redacted] that I was having treated.

The total amount of the [redacted] came up to $677.00 per the in network fees for each cavity. [redacted] is within the network.

[redacted] paid $564.30 (they applied my $50 deductible) which is 90% of the total amount.

[redacted] advised that I owed the dentist $112.70 but they didn’t know that I already paid 221.60 up front per [redacted]’s policy

I overpaid by a total of $108.90

On 2/** – I was charged $194.00 for the remaining 4 [redacted].

The total amount of the [redacted] came up to $572.00 per the in network fees for each cavity

[redacted] paid $512.70 (again 90% of the total)

[redacted] advised that I owed the dentist $57.20. Again they didn’t know that I already paid them an additional $194.00

I overpaid by $136.80

Just for the [redacted], I overpaid by $245.70

[redacted]Note[redacted]Please keep in mind that I didn’t know I was overpaying yet since by this time, my claims have not come through yet.

The Night/Occlusal Guard

On 2/** (same day as the 2nd [redacted] treatment) – I was told that I need a night guard that cost a total of $550.00

I paid $275.00 half of the amount and proceeded with the mold trial.

During this time, [redacted]’s office was supposed to put in the claim with [redacted] so that they can pay the remaining half.

The claim was NEVER given to [redacted] during this time.

On 3/* I go back to pick up my guard only to be told that I have a balance of $29.30 because they have not yet received any payment from [redacted] for the balance of the occlusal guard.

I was expecting a refund from the overpayment of the [redacted].

Instead, they held the $245.70 for my cavity refund hostage, added the $275 that I paid on 2/** for the occlusal guard and charged me an additional $29.30 for a total of $550.00

In addition, I was told (by a very loud and rude office manager) that they requested the incorrect guard. It should have been a “night” guard as opposed to a “soft” guard and now they have to resubmit the claim.

This is interesting considering I’ve only been wearing the guard for a couple of weeks and I’m grinding right through it.

Finally, on 4/**, (after going back and forth with [redacted] and [redacted]’s office), I received a check from [redacted] for a total of $224.90 as reimbursement for the night/occlusal guard (technically should have been for the [redacted] but I digress)

[redacted] has advised that the in network cost for the occlusal guard should be $454.00 not $550 which is what [redacted] charged me. If the dentist is within network, they have to abide by the in network fees

[redacted] paid $227 which is half of the amount for the guard $454.

My refund should have been a total of $323.00 (not $224.90) due to below breakdown:

245.70 – overpayment of [redacted]

77.30 – overpayment for the occlusal guard ($275 + $29.30 = $304.00, I should have only paid $227.00 for the guard according to [redacted] which is half of $454.00)

The balance is $98.10 which I need back immediately. I have every single receipt to show.

I called [redacted] on Monday 5/* who then directed me back to [redacted]’s office

On 5/* I called [redacted]’s office only to be told that they owe me no money. I was then put on hold for the Dr who left me on hold and never came to the phone. RUDE!

[redacted] attempted to call [redacted]’s office on 5/* but I’ve heard nothing else from either party.

I really need this resolved asap.

I can not imagine how many more people they owe money to. They charge their own prices up front instead of charging you the in network fee that is agreed upon with the insurance. Horrible practice!

The sad part about this is that I actually like [redacted] as a Dr. He is usually nice and personable. However, he needs to fire his entire front desk staff and start from scratch as they are all VERY rude and not customer friendly at all.Desired Settlement: To receive my $98.10 that is owed to me.

I don't care if it's by check, or put back on my credit card which is the original form of payment.

Business

Response:

This is in response to the complaint ID#: [redacted]. Apparently, there is some confusion for this patient in regard to her dental appliance. The patient, [redacted] was informed prior to treatment that the occlusal guard that I make is an upgrade with a more expensive laboratory bill. The patient agreed to the treatment and the fee and the treatment was rendered successfully without complaint. I have spoken to Metropolitan Life representative and they informed me that I was well in my rights to charge her the upgrade. Sincerely [redacted]