Lancaster Dental Arts

To whom it may concern:
We are writing to you in regards of id ***Mom filed a complaint against our office because her insurance company does not provide coverage for a treatment that was recommended for her childWe had the pleasure of explaining this to mom at child's appointment
on March 4, I have recently been evaluating offices and I received *** Chart*** was scheduled to start *** * *** TreatmentWhen I evaluated patient's chart, I saw that there was no approval of Prior AuthorizationBefore patient's appointment, I was able to go on the insurance website to print out the approvalUnfortunately *** was approved for ***, which are bracesWe tried to contact parent before appointment but they did not return our callPatient showed up to the appointment with Mom's boyfriendWe tried to explain this to him and he advised us to call momWe canceled the appointment and contacted momAfter I explained to mom about the wrong code being approved, she stated that she had copies at home because she had appealed the denial herselfWe told mom that if she would bring us documents that the procedure was in fact approved by the insurance we would gladly move forward with treatment*** *** stopped by the office on March 4, She brought with her all documents from her appealAfter reviewing all the documentation, we came to the conclusion that the insurance company in fact only approved ***We explained this to mom and gave her prices for the *** which we discounted the pricesMom left the office satisfied and understood.On April 1, we received a call from *** ***She was yelling and screaming over the phone demanding that we get on the phone and get contracted with the insurance for this procedure so her son can have it done or she stated you need to fill out a BLEI explained to mom that I could not change the contract with the insurance because the insurance does not cover the treatmentMom was very upset and kept screaming and demanding to speak to "whoever does the contracts for insurance"I explained that I wasn't even sure who I could direct her to because it's not something we can changeShe then demanded that I fill out a BLEI explained to mom that we do not fill out BLE forms because it is a non-covered procedureTherefore, the BLE is just basically stating the treatment will be done for free*** ***'s stated she didn't understand that she spoke to one of her friends and they told her that another orthodontist at another location had this procedure covered over a year agoWe explained that the insurance company at one time did cover the procedure but no longer doesWhen *** *** asked why we advised her to contact the insuranceWe also explained to mom that if another facility covered this we would understand if she would need to leave the practiceWe also asked that if this would be the case if she could provide us with the other practice name so we can in fact inquire as to why we are being told it is a non-convered procedure*** *** demanded to talk to the Doctor because she felt he needed to do this treatment and she didn't care who paid for it, but she wasn't going to*** *** was informed that the doctor was busy with other patients at the timeShe asked to be placed on hold which was done and she hung up*** *** called again about one minute later and was told the doctor was still being patientsShe was asked if she wanted to be placed on hold and she stated "yes" and was placed on holdShe hung up again after about a minuteWe tried to contact mom again but all attempts failedChristina K***
Lancaster Dental Arts

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because:
First and foremost, I was angry over the phone, however, I did not begin raising my voice until I was being treated very rudely MsChristina K*** was very curt with me and refused to submit a form in which the insurance company was requesting I do not understand if there is a not contract and the insurance company is called and informed of this, why they would advise me to have the doctor submit a BLE form if in fact it is not a covered procedure Wouldn't the insurance company be aware of this and advise me as such? I was only following through with what I was advised to do by the insurance company This is where my confusion lies because it seems that what the insurance company is saying and what the doctor is saying is two completely different things I was never expecting to receive services for my son for free and I informed Christine of this over the phone I am simply trying to get assistance from the insurance company for a procedure the doctor is advising to be "medically necessary" in order for my son's mouth to function properly
It was also stated that the doctor's office tried to contact me prior to the appointment on March 4, 2015, but this is not true I was only contacted on Monday, February 2, 2014, in which they called to say the doctor had to cancel my son's appointment scheduled for February 4, I answered this telephone call and this appointment was then rescheduled for March 4, Christine K*** also stated that I hung up the phone twice and this again is not true I had to call back to the office on April 1, over times! There is no reason I would have called back and also waited on hold for over minutes to hang up without getting the issue resolved Additionally, Christine is claiming that the doctor's office has tried to contact me since with all attempts failed, I have not been contacted one time by the doctor's office since April 1, I have my phone records to show this I even provided the office via *** message with my phone number on April 1, and I never received a phone call back
Regards,
*** ***

I was seen, along with my son, at Lancaster Dental Arts for 2 years. Please note, we were seen at the Lititz PA office located on 1555 Highlands Dr #190. I was never very happy with the services we were provided with there, but my insurance wasn't accepted anywhere else. This last time I was there, we not only waited over hour to be seen, but when we got into our exam rooms, I was just completely unimpressed. We both needed xrays. When I was getting mine done, I took notice the assistant was not leaving the room, nor protected from the radiation while she was taking my bite-wings. I asked her about it, and she replied that the equiptment wasn't working properly and she had to secure it with her hand while taking the xrays. She at one point, called another assistant into the office to finish because she said, "ive been exposed enough for one day." I was then seen by the actual dentist of the office who "cleaned" my teeth. Having a denta background myself, I know that she was not only unauthrozed to do that, but it's illegal. She took maybe 5minutes to "clean" my teeth and then checked a tooth I was having some issues with. She bypassed the fact that I have an abcess that I noticed the very next morning, My son and I have now used our yearly cleaning and have to go through a secondary insurance to have a re-clean from another office. I am concerned for others who do not have the background and understanding of the profession that I acquire. The atmosphere was very unprofessional, rushed, and unorthodox. I am hoping that this particular practice can be examined to prevent other patients from being robbed of their dental health.

Review: My two children used this business for a routine dental exam and cleaning. We were charged the full amount of the services provided even though we provided accepted insurance. The claim process settled out and we are owed $145 due from over charging. I am also unable to get adequate dental records for my children, even though I paid for them.Desired Settlement: Refund $145 and adequate dental records to include x-rays sufficient for review by another practice.

Business

Response:

From: [redacted] <[redacted]>

Date: Wed, Aug 28, 2013 at 12:51 PM

Subject: Re Id [redacted]

To: [redacted]

Regards

This is n reference to the complaint letter we received from Revdex.com for id [redacted]. complaint background:-product / service dentalpurchase date :- 06/27/2013.

purchased price : $ 395.00 and disputed amount : 145.00 $

desired outcome:- refund $ 145.00 and adequate dental records to include x rays sufficient for review by another practice.

In reference to this CASE insurance agent from [redacted] , myself and [redacted], we talked on conference call and cleared all confusion between insurance and our fee charged.

Finally I am going to refund his 120.00 $ and we can close the case after you talk with [redacted].

thanks

[redacted]Manager-

operation

Lancaster Dental Arts