Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12268278, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
[I did not present one side of the storyThis was not an emergency appointmentThere was plenty of time to contact my insurance to see if they did cover this temporary dentureI was told by Dr***'s staff that this would not be covered, or if was I would loss future benefits. After contacting my insurance company and that took minutes I found out that I was covered and it did not effect future replacements unless I lost this one or damaged it that I could not have it replaced for years or it would be at my cost.I really do not understand Dr***'s resistance to refunding the overpayment. This entire situation it just terribleIt looks shady on so many levels. Considering the negotiated rate with the insurance carrier was $266.00. He charged me and that was with a 10% discountI was never told my treatment would be delayed 6-weeks because of my insurance. I have never been to a dentist that would delay treatment because of insurance. What should have taken place is that his staff should have contacted my insurance and then at least given me the choice what I wanted to do.Yes, I am demanding my refund back and I expect in its entirety. I was not rude with his staff, but frustrated since they felt it was not a priority for them. They expect payment at the time of treatment, well I expect a refund for being grossly overchargedThey didn't not seemed to be concerned at all and really did not go out of their way to help meInstead of trying to avoid giving me a feeling that this would be taken care of promptly. I only went to Dr*** because he purchased the practice of my previous dentist and in the years I was with him, I never ever had a billing issue.I am also disputing the missed appointments. I did respond to their text that my daughter and myself would not be able to make it since my father was still in the hospital. They are doing that so that they can reduce the refund I am requesting.I am not requesting anything above or beyond what is owed to me. You would think they would be concerned on how this played out with a new customer. My parents, friends all went to the dentist's practice he purchased and I will tell you that this situation is being handled very unprofessionallyThis could have been handled completely differently-even now when they have the explanation of benefits- Which clearly states I over paid they are still not helpfulWhy is this just such a hassle-just refund my overcharge and I will gladly dismiss the complaintThis service happened on June 13, It is now July 31stI could see them treating me poorly if I was trying to get money that was not owed to me, but it is and it not a small amount. This is horrible customer serviceI really do not appreciate the condescending attitude I am receiving from him and his office staffHe really should have more people in the office that are compedent in dealing with insurance and not make assumptions all insurances are the same.Please see attached explanation of benefits from ***.
Regards,
*** ***
Dear Ms***:I would like to respond to the complaint made against my business on July 2017. I would like to remind the Revdex.com that my company has been in business for years now. We have maintained active membership with Revdex.com for most of that time without any prior
complaints. I am troubled by the complaint that was made on July 2017. I believe the individual who made the complaint only presented one side of the story. As in most cases, there is additional information that is pertinent to her claim.The individual was seen as an emergency patient with the request to resolve her problem. Due to the nature of the emergency and the speed at which she required resolution, there was not enough time to coordinate her insurance benefits. The staff explained that to the patient before treatment was rendered. The patient was given the option to have us coordinate her insurance benefits but doing so would delay her treatment for 6-weeks. She elected against having a predetermination of benefits done so that we could resolve her issue as quickly as possible. The staff informed the individual that in most cases, there are no insurance benefits available for treatments that are considered temporary solutions. Dental insurance plans do not work like medical insurance plans. Most dental benefit plans offer a very narrow spectrum of services that they cover. In the rare instance where dental benefits are applied for temporary treatment, most carriers will then enforce a "frequency limitation" thereby refusing benefits for definitive treatment. The staff made reasonable attempts to explain these facts to the individual prior to initiating treatment. To the best of our knowledge, she understood and accepted responsibility for her treatment.The individual called the office some time later to demand a refund for what she believed was an over-payment. When this was brought to my attention, I instructed the staff to have her insurance carrier simply send her a check for her benefit level. If she truly had benefits for the services rendered, there is no problem instructing her carrier to reimburse her for the carrier's portion of her treatment. The patient found this arrangement unacceptable and was verbally abusive to the staff over the phone. Prior to her refund demand, both she and her daughter missed appointments. We have no record of her cancelling those appointments. Our office requires a minimum of hours notice to cancel or change an appointment. All missed appointments carry a fee otherwise.We did offer this individual a solution. I instructed the staff to tell her that we would be happy to refund the difference between what she paid for her treatment and her contracted fee once her carrier reimbursed her for their portion and we accounted for her missed appointment fees. She found that offer unacceptable and chose to file a complaint against us with Revdex.com.We make every reasonable attempt to resolve issues when they arise. There is only so much we can do once an individual becomes combative. The staff was instructed to truncate any conversation should they encounter hostility over the phone. We will do everything we can to keep people happy but we expect a certain level of decorum in return. Once we sort out the benefit with her insurance company, any discrepancy will be refunded and the individual will be dismissed from the practice.Please contact Dr*** directly should you have questions with this response.Thank you for your time
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12268278, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
[I did not present one side of the storyThis was not an emergency appointmentThere was plenty of time to contact my insurance to see if they did cover this temporary dentureI was told by Dr***'s staff that this would not be covered, or if was I would loss future benefits. After contacting my insurance company and that took minutes I found out that I was covered and it did not effect future replacements unless I lost this one or damaged it that I could not have it replaced for years or it would be at my cost.I really do not understand Dr***'s resistance to refunding the overpayment. This entire situation it just terribleIt looks shady on so many levels. Considering the negotiated rate with the insurance carrier was $266.00. He charged me and that was with a 10% discountI was never told my treatment would be delayed 6-weeks because of my insurance. I have never been to a dentist that would delay treatment because of insurance. What should have taken place is that his staff should have contacted my insurance and then at least given me the choice what I wanted to do.Yes, I am demanding my refund back and I expect in its entirety. I was not rude with his staff, but frustrated since they felt it was not a priority for them. They expect payment at the time of treatment, well I expect a refund for being grossly overchargedThey didn't not seemed to be concerned at all and really did not go out of their way to help meInstead of trying to avoid giving me a feeling that this would be taken care of promptly. I only went to Dr*** because he purchased the practice of my previous dentist and in the years I was with him, I never ever had a billing issue.I am also disputing the missed appointments. I did respond to their text that my daughter and myself would not be able to make it since my father was still in the hospital. They are doing that so that they can reduce the refund I am requesting.I am not requesting anything above or beyond what is owed to me. You would think they would be concerned on how this played out with a new customer. My parents, friends all went to the dentist's practice he purchased and I will tell you that this situation is being handled very unprofessionallyThis could have been handled completely differently-even now when they have the explanation of benefits- Which clearly states I over paid they are still not helpfulWhy is this just such a hassle-just refund my overcharge and I will gladly dismiss the complaintThis service happened on June 13, It is now July 31stI could see them treating me poorly if I was trying to get money that was not owed to me, but it is and it not a small amount. This is horrible customer serviceI really do not appreciate the condescending attitude I am receiving from him and his office staffHe really should have more people in the office that are compedent in dealing with insurance and not make assumptions all insurances are the same.Please see attached explanation of benefits from ***.
Regards,
*** ***
Dear Ms***:I would like to respond to the complaint made against my business on July 2017. I would like to remind the Revdex.com that my company has been in business for years now. We have maintained active membership with Revdex.com for most of that time without any prior
complaints. I am troubled by the complaint that was made on July 2017. I believe the individual who made the complaint only presented one side of the story. As in most cases, there is additional information that is pertinent to her claim.The individual was seen as an emergency patient with the request to resolve her problem. Due to the nature of the emergency and the speed at which she required resolution, there was not enough time to coordinate her insurance benefits. The staff explained that to the patient before treatment was rendered. The patient was given the option to have us coordinate her insurance benefits but doing so would delay her treatment for 6-weeks. She elected against having a predetermination of benefits done so that we could resolve her issue as quickly as possible. The staff informed the individual that in most cases, there are no insurance benefits available for treatments that are considered temporary solutions. Dental insurance plans do not work like medical insurance plans. Most dental benefit plans offer a very narrow spectrum of services that they cover. In the rare instance where dental benefits are applied for temporary treatment, most carriers will then enforce a "frequency limitation" thereby refusing benefits for definitive treatment. The staff made reasonable attempts to explain these facts to the individual prior to initiating treatment. To the best of our knowledge, she understood and accepted responsibility for her treatment.The individual called the office some time later to demand a refund for what she believed was an over-payment. When this was brought to my attention, I instructed the staff to have her insurance carrier simply send her a check for her benefit level. If she truly had benefits for the services rendered, there is no problem instructing her carrier to reimburse her for the carrier's portion of her treatment. The patient found this arrangement unacceptable and was verbally abusive to the staff over the phone. Prior to her refund demand, both she and her daughter missed appointments. We have no record of her cancelling those appointments. Our office requires a minimum of hours notice to cancel or change an appointment. All missed appointments carry a fee otherwise.We did offer this individual a solution. I instructed the staff to tell her that we would be happy to refund the difference between what she paid for her treatment and her contracted fee once her carrier reimbursed her for their portion and we accounted for her missed appointment fees. She found that offer unacceptable and chose to file a complaint against us with Revdex.com.We make every reasonable attempt to resolve issues when they arise. There is only so much we can do once an individual becomes combative. The staff was instructed to truncate any conversation should they encounter hostility over the phone. We will do everything we can to keep people happy but we expect a certain level of decorum in return. Once we sort out the benefit with her insurance company, any discrepancy will be refunded and the individual will be dismissed from the practice.Please contact Dr*** directly should you have questions with this response.Thank you for your time