Jolly Smiles

Complaint ID: ***
*** *** ***
As suggested by you, I tried to reach out to our patient's mother and Responsible Party (*** ***) and it was to no
avail. I only could leave her a voice-mailAnd she did not return her call yet
I researched history of this patient with our office*** ***'s year old son (mother is not patient here) had been to the office on 7/2/and I was consulted and an 'examination' of his teeth was performedMother was concerned about his teeth having had an accidental hit recentlyThough the exam was brief, sufficient information was gathered that time to give assurance to the mother about the status of the teeth and probabilities that could ariseIt is routine to submit doctor's exams to insurance under a service code to get reimbursed for our professional servicesThe hygienist who is new at this practice had used a code that is not routinely used with this patient's insuranceWe realized this error after insurance response (payment / explanation of benefits EOB) came and the billing staff had already sent the patient a billing statement per insurance company's instructions in EOB (FYI - when we are contracted with insurance PPO network, insurance co defines what portion is covered and what portion is owed by the patient)In the past when such errors are picked up, we would resubmit to insurance co with the correct service code and then get paid for the service or discuss with patient if patient copay portion is largely different than originally estimatedThis is routine business
On August our accounting staff had a conversation with *** *** and had alerted her of this mistake on our part and the only way to fix it was to resubmit with the appropriate codeShe was apparently fine with that explanationWe had some delay in re-processing this paperworkIt was in my inbox and I was a little backed up in August and Sept because of an August vacationWe are proceeding with re submission of the service with the accurate code to the insurance co. It appears the mother never called back to inquire status and obviously we were not aware of her misunderstanding*** *** must have been anxious and acted on this prematurely without giving it sufficient time to self correct or calling us to clarify
Thanks for giving me this opportunity to explain a genuine mistake.
Sincerely
*** ***
*** * *** ***
President

Review: Hello, my three kids and I started seeing [redacted] primarily due to convenience from my primary residence. We have experience poor responsiveness from the admin staff and their billing practices are inferior. The bill received was inconsistent with the cost estimate provided prior to my kids visits. The exchange with the billing supervisor, [redacted], has been extremely tasteless and unprofessional. Needless to say, we are finding a new dentist.Desired Settlement: The invoice should be consistent with the cost estimate provided prior to services being rendered.

Business

Response:

Complaint ID: [redacted]

As suggested by you, I tried to reach out to our patient's mother and Responsible Party ([redacted]) and it was to no avail. I only could leave her a voice-mail. And she did not return her call yet.

I researched history of this patient with our office. [redacted]'s 2 year old son (mother is not patient here) had been to the office on 7/2/14 and I was consulted and an 'examination' of his teeth was performed. Mother was concerned about his teeth having had an accidental hit recently. Though the exam was brief, sufficient information was gathered that time to give assurance to the mother about the status of the teeth and probabilities that could arise. It is routine to submit doctor's exams to insurance under a service code to get reimbursed for our professional services. The hygienist who is new at this practice had used a code that is not routinely used with this patient's insurance. We realized this error after insurance response (payment / explanation of benefits EOB) came and the billing staff had already sent the patient a billing statement per insurance company's instructions in EOB (FYI - when we are contracted with insurance PPO network, insurance co defines what portion is covered and what portion is owed by the patient). In the past when such errors are picked up, we would resubmit to insurance co with the correct service code and then get paid for the service or discuss with patient if patient copay portion is largely different than originally estimated. This is routine business.

On August 12 our accounting staff had a conversation with [redacted] and had alerted her of this mistake on our part and the only way to fix it was to resubmit with the appropriate code. She was apparently fine with that explanation. We had some delay in re-processing this paperwork. It was in my inbox and I was a little backed up in August and Sept because of an August vacation. We are proceeding with re submission of the service with the accurate code to the insurance co. It appears the mother never called back to inquire status and obviously we were not aware of her misunderstanding. [redacted] must have been anxious and acted on this prematurely without giving it sufficient time to self correct or calling us to clarify.

Thanks for giving me this opportunity to explain a genuine mistake.

Sincerely

President