Kings Dental Group

Mr. and his family have been faithful patients of Kings Dental Group since 2008. His daughter, *** has been under the care of Dr. *** ever since she was 5 years old.

*** was born with congenitally missing lateral incisors. This means her two front lateral permanent teeth never formed since birth. We always knew that as she got older this would be something that would need to be addressed.

In 2017, *** was almost completing her orthodontic treatment and Dr. *** and Dr. Rose (her orthodontist) were pondering over the best treatment plan to replace ***'s front teeth. Her father was included in all her consults and treatment planning.

On Oct 29th 2019, it was finalized that we would do bridges on her upper front arch to replace her missing teeth and the treatment plan was sent to Mr. via email on October 30th 2019. Please see attached email. The treatment plan was also submitted to her insurance company for pre-authorization.

On November 14th, their insurance company responded to us stating that this is not a covered benefit and if the patient still wanted to proceed with treatment, it would be an out of pocket expense entirely. The same was relayed to Mr. *** via email, to which he also responded. Please see attached the email correspondence.

On November 27th, Mr. *** came into the office to sign the consent and treatment plan for his daughter's treatment and made a down payment of $2500. We explained to him that since I, Dr. *** was going to be working on his daughter, his total cost of treatment would be reduced since my fee schedule with his insurance carrier is lower. Mr. understood the total amount the treatment would cost.

On January 3rd 2020, *** came in for treatment. We explained to him we will resubmit to his insurance company to see if they will help pay for part of the portion, however it was an attempt and since we had already received a denial the first time, it was possible that he would need to pay the entire amount. It also stated the same on his treatment plan, which he signed and is attached.

***'s treatment was completed on February 25th , when her final bridges were delivered. Everything went smoothly and she was very happy with the results. Her father was billed for the remaining portion of the treatment as his insurance denied it one more time. He was upset and claimed he was not informed that he would be responsible for the balance. We reminded him that we have email correspondence stating the same and signed treatment plan. On 7/8/2020, he paid his remaining balance.

Mr. *** was aware of the treatment costs for his daughter and was informed ahead of time that it would not be covered benefit. We attempted to appeal to the insurance carrier; however, that was unsuccessful.

Mr. claims that we 'completed the procedure without insurance approval'. That is false as explained above. In addition, insurance companies do not "approve" dental treatment that is proposed, planned, or provided. He also claimed that he was 'strung along for several weeks,' which is also untrue as he was informed in November that it was not a covered benefit. He also stated that he was 'stuck with $4000 bill,' but he was aware of the total cost and signed attesting to it.

Thank you for reaching out to me to clarify the situation. I trust that I have submitted enough documentation to prove that his claim is without validity.

Thank you.

Kind regards,

Dr. ***

Owner of Kings Dental Group.

To Ms. ***,

Thank you for reaching out to me to clarify the response to Mr. ***. I just received the second letter this morning and I apologize for not responding to you sooner.

In response to Mr.s complaint, his conversation with our office manager ***, has been documented by her in the treatment notes and a copy of that was sent to you already. Furthermore, a copy of the email communication between the two was also forwarded to you for review that clearly states in writing, that Mr. was well aware of the situation beforehand.

Dr. *** was the previous owner of Kings Dental Group. As of December 1st 2019, I, Dr.*** purchased the practice from him. I am the current owner and lead dentist of the practice. Therefore a complaint against Kings Dental Group affects me personally. Yes, Mr. discussed the treatment plan for his daughter with Dr. *** prior to the sale of the practice. Dr. *** still works at the office alongside me, but I was the one who rendered the treatment on the patient. This, infact, was better for Mr. as the total he would owe on treatment went down drastically as I have a lower fee schedule negotiated with his insurance. There were no problems with treatment being done and everything went as planned. *** and Mr. were happy with the results of her treatment.

I have sent a dismissal letter to the patient and his family withdrawing from further dental care. We have a right to refuse treatment, and as the owner of Kings Dental Group, I prefer not to work on patients who don't trust our office protocols and accuse us of 'cheating them' and 'insurance fraud'. I personally called Mr. last week to try and rectify the situation. He stated that he will never be returning to our practice and will spread the word so that no one else does the same. He was rude and his tone was demeaning. Three days after our conversation, his son came in for his routine check up and cleaning. In order to avoid further misunderstandings on any financial issues, I felt it was best to dismiss the patient and offered him emergency care for 30 days should he or his family need a dentist. We also offered to forward all his records to his new dentist.

Please do not hesitate to reach out to me in case of any further clarification. Thank you.

Kind regards,

Dr.***.