I am writing in follow up to our telephone conversation last week As we discussed, due to privacy constraints, before Professional Dental Alliance (dba-Dental Care of Indiana) can provide a response to the above-referenced complaint, Ms [redacted] will need to give us permission to discuss the treatment she received in our Scatterfield Meadows office To this end, attached you will find a HIPAA Communication Form Please have Ms [redacted] complete and sign the Form Once the signed Form is returned to us, we will then be able to provide our written response to Ms [redacted] ’s concernsPlease do not hesitate to contact me if you have any questionsThank you, Pam Pamela LG [redacted] Paralegal
I am the Regional Manager Assistant at North American Dental Group and am writing in response to a complaint made by [redacted], who has been a patient at our Scatterfield Meadows Family Dental office since approximately 201 3).We truly regret that there has been a misunderstanding with respect to Ms. [redacted]'s billing statements and financial responsibility for her dental care. We make every effort to ensure our patients' understanding of these matters. To this end, all of our patients must sign a statement explaining our financial policy. A copy of the Financial Policy Ms. [redacted] signed is attached for your information.I have also attached signed treatment plans for the patient's dental history with the practice. These treatment plans also inform the patient that insurance benefits are estimated and not a guarantee of payment by the insurance company. and that the patient is responsible for any unpaid balance. In addition, our records indicate that a total of thirteen (13) account statements have been provided to Ms. [redacted] between 05/20/2013 and 01/03/2017.A review of Ms. [redacted]'s account balance and signed treatment plans indicate that, to date, she has received dental services totaling $6,038.60. According to the patient's explanations of benefits, after insurance payments. Ms. [redacted]'s financial responsibility totaled $5.120.60. Please understand that we are held to the fees and coverage amounts allowed by any insurance that may be in place. To date, Ms. [redacted] has paid a total of $4.894.10 to our office and has received a credit adjustment of $226.50. This leaves an account balance of $5,120.60.While we disagree that Scatterfield Meadows has acted improperly in any way. as a goodwill gesture, we are willing to absorb the unpaid costs associated with our care of Ms. [redacted]. If this resolution is acceptable to Ms. [redacted], we will prepare a release for her signature.Please feel free to contact me at 31 7-490-2929 or emailhoflhriant(dcindiana.com should you have further questions or need further documentation.Sincerely, Tonie H[redacted]Regional Manager AssistantNorth American Dental Group
I am writing in follow up to our telephone conversation last week. As we discussed, due to privacy constraints, before Professional Dental Alliance (dba-Dental Care of Indiana) can provide a response to the above-referenced complaint, Ms. [redacted] will need to give us permission to discuss the...
treatment she received in our Scatterfield Meadows office. To this end, attached you will find a HIPAA Communication Form. Please have Ms. [redacted] complete and sign the Form. Once the signed Form is returned to us, we will then be able to provide our written response to Ms. [redacted]’s concerns. Please do not hesitate to contact me if you have any questions. Thank you, Pam Pamela L. G[redacted] Paralegal
I am writing in follow up to our telephone conversation last week As we discussed, due to privacy constraints, before Professional Dental Alliance (dba-Dental Care of Indiana) can provide a response to the above-referenced complaint, Ms [redacted] will need to give us permission to discuss the treatment she received in our Scatterfield Meadows office To this end, attached you will find a HIPAA Communication Form Please have Ms [redacted] complete and sign the Form Once the signed Form is returned to us, we will then be able to provide our written response to Ms [redacted] ’s concernsPlease do not hesitate to contact me if you have any questionsThank you, Pam Pamela LG [redacted] Paralegal
I am the Regional Manager Assistant at North American Dental Group and am writing in response to a complaint made by [redacted], who has been a patient at our Scatterfield Meadows Family Dental office since approximately 201 3).We truly regret that there has been a misunderstanding with respect to Ms. [redacted]'s billing statements and financial responsibility for her dental care. We make every effort to ensure our patients' understanding of these matters. To this end, all of our patients must sign a statement explaining our financial policy. A copy of the Financial Policy Ms. [redacted] signed is attached for your information.I have also attached signed treatment plans for the patient's dental history with the practice. These treatment plans also inform the patient that insurance benefits are estimated and not a guarantee of payment by the insurance company. and that the patient is responsible for any unpaid balance. In addition, our records indicate that a total of thirteen (13) account statements have been provided to Ms. [redacted] between 05/20/2013 and 01/03/2017.A review of Ms. [redacted]'s account balance and signed treatment plans indicate that, to date, she has received dental services totaling $6,038.60. According to the patient's explanations of benefits, after insurance payments. Ms. [redacted]'s financial responsibility totaled $5.120.60. Please understand that we are held to the fees and coverage amounts allowed by any insurance that may be in place. To date, Ms. [redacted] has paid a total of $4.894.10 to our office and has received a credit adjustment of $226.50. This leaves an account balance of $5,120.60.While we disagree that Scatterfield Meadows has acted improperly in any way. as a goodwill gesture, we are willing to absorb the unpaid costs associated with our care of Ms. [redacted]. If this resolution is acceptable to Ms. [redacted], we will prepare a release for her signature.Please feel free to contact me at 31 7-490-2929 or emailhoflhriant(dcindiana.com should you have further questions or need further documentation.Sincerely, Tonie H[redacted]Regional Manager AssistantNorth American Dental Group
I am writing in follow up to our telephone conversation last week. As we discussed, due to privacy constraints, before Professional Dental Alliance (dba-Dental Care of Indiana) can provide a response to the above-referenced complaint, Ms. [redacted] will need to give us permission to discuss the...
treatment she received in our Scatterfield Meadows office. To this end, attached you will find a HIPAA Communication Form. Please have Ms. [redacted] complete and sign the Form. Once the signed Form is returned to us, we will then be able to provide our written response to Ms. [redacted]’s concerns. Please do not hesitate to contact me if you have any questions. Thank you, Pam Pamela L. G[redacted] Paralegal