Jared Fortman DDS

Initial Business Response / [redacted] (1000, 5, 2015/11/23) */ Contact Name and Title: [redacted] ***/Office Manag Contact Phone: XXX-XXX-XXXX Contact Email: [redacted] @ [redacted] 11/20/ To Whom It May Concern: In response to our patients complaint for service on 9/15/I deal with many patients, 100's of insurance companies and thousands of insurance plansWe are in contract with only two insurance companiesWe have to accept their fees and I know their feesFor all other insurances we are considered not in networkI do not know their fees, and legally they do not have to tell meI let every patient know before their appointment if we are out of network with their insurance, what benefits they have remaining for the year and what their ESTIMATED co-payment isEvery patient is told this before they ever see the doctor and they have signed all the paperwork stating they are aware of the fees and the estimatePatients sign all paperwork stating that they are financially responsible for whatever their insurance does not pay and this is an ESTIMATE ONLY For this particular patient I informed him we were out of network with his insuranceThis was also written in my hand writing on his receiptHe was informed he had a $max for the year with $left in remaining benefits for the yearHis treatment estimate was $For out of network insurances I always give an estimate of 50% coverage for treatmentSince he only had $remaining I collected $1,from the patient to cover the cost of treatmentAlmost all out of network providers will cover at least 50% of our feesUnfortunately his insurance plan only covered $of the entire treatmentThis is a very low fee reimbursement for this treatmentThe patient was absolutely right when he stated his insurance company did not give me the amount they would cover on his treatmentAgain we are not in network with them and legally they do not have to tell meThe only information they gave me was his maximum for the year, what is remaining for the year and if there is a deductibleWhich they did and which I told the patientWe also did a core build up on his tooth at the request of his general dentistThis is to seal the tooth which made our fee higher than the other doctors he called I never tried to take advantage of this patient and he was told all fees and insurance information up frontEverything was disclosedPatient was well aware of all fees and his remaining insurance for the yearHe signed all the paperwork taking financially responsibility for whatever his insurance did not payI tried to explain this to the patient several times over the phoneHe was very rude and became verbally abusiveScreaming he was going to ruin our office on yelp, Revdex.com and over the internetI feel like I did everything possible to help this patient he was treated fairly and with respect Office of Dr [redacted] D.D.S [redacted] Office Manager Initial Consumer Rebuttal / [redacted] (3000, 8, 2015/11/24) */ (The consumer indicated he/she DID NOT accept the response from the business.) I understand their responseAlthough when I called my insurance company they told me that they never told them a coverage of $It was misleading to meIt may seem routine to them to under estimateI feel they do hold some burden of responsibility Final Business Response / [redacted] (4000, 10, 2015/11/30) */ I called and spoke with his insurance company on 9/14/the day he scheduled his appointmentAgain the $was what he had left in benefits for the yearIt was just an estimate on what his insurance would cover for the treatmentHis insurance company will not tell me what they would cover on his treatment which again is why it is an estimateThe patient however, could of called his own insurance company at anytime and got that information himselfThey have to tell him because he is the policy holderThe patient is ultimately responsible for knowing their own insurance benefits [redacted] ***

Initial Business Response /* (1000, 5, 2015/11/23) */
Contact Name and Title: [redacted]/Office Manag
Contact Phone: XXX-XXX-XXXX
Contact Email: [redacted]
11/20/15
To Whom It May Concern:
In response to our patients complaint for service on 9/15/15. I deal with many...

patients, 100's of insurance companies and thousands of insurance plans. We are in contract with only two insurance companies. We have to accept their fees and I know their fees. For all other insurances we are considered not in network. I do not know their fees, and legally they do not have to tell me. I let every patient know before their appointment if we are out of network with their insurance, what benefits they have remaining for the year and what their ESTIMATED co-payment is. Every patient is told this before they ever see the doctor and they have signed all the paperwork stating they are aware of the fees and the estimate. Patients sign all paperwork stating that they are financially responsible for whatever their insurance does not pay and this is an ESTIMATE ONLY.
For this particular patient I informed him we were out of network with his insurance. This was also written in my hand writing on his receipt. He was informed he had a $1250.00 max for the year with $876.00 left in remaining benefits for the year. His treatment estimate was $2073.00. For out of network insurances I always give an estimate of 50% coverage for treatment. Since he only had $876.00 remaining I collected $1,200.00 from the patient to cover the cost of treatment. Almost all out of network providers will cover at least 50% of our fees. Unfortunately his insurance plan only covered $384.00 of the entire treatment. This is a very low fee reimbursement for this treatment. The patient was absolutely right when he stated his insurance company did not give me the amount they would cover on his treatment. Again we are not in network with them and legally they do not have to tell me. The only information they gave me was his maximum for the year, what is remaining for the year and if there is a deductible. Which they did and which I told the patient. We also did a core build up on his tooth at the request of his general dentist. This is to seal the tooth which made our fee higher than the other doctors he called.
I never tried to take advantage of this patient and he was told all fees and insurance information up front. Everything was disclosed. Patient was well aware of all fees and his remaining insurance for the year. He signed all the paperwork taking financially responsibility for whatever his insurance did not pay. I tried to explain this to the patient several times over the phone. He was very rude and became verbally abusive. Screaming he was going to ruin our office on yelp, Revdex.com and over the internet. I feel like I did everything possible to help this patient he was treated fairly and with respect.
Office of Dr. [redacted] D.D.S
[redacted]
Office Manager
Initial Consumer Rebuttal /* (3000, 8, 2015/11/24) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I understand their response. Although when I called my insurance company they told me that they never told them a coverage of $876.00. It was misleading to me. It may seem routine to them to under estimate. I feel they do hold some burden of responsibility.
Final Business Response /* (4000, 10, 2015/11/30) */
I called and spoke with his insurance company on 9/14/15 the day he scheduled his appointment. Again the $876.00 was what he had left in benefits for the year. It was just an estimate on what his insurance would cover for the treatment. His insurance company will not tell me what they would cover on his treatment which again is why it is an estimate. The patient however, could of called his own insurance company at anytime and got that information himself. They have to tell him because he is the policy holder. The patient is ultimately responsible for knowing their own insurance benefits.
[redacted]