Machado Maxillofacial Surgery

Review: On 10/15/13, I was given a referral to Dr [redacted] office from my dentist to get an estimate for bone augmentation since I do not have enough bone in my jaw for a dental implant. A set of x-rays were sent. The dental assistant in my dentists office told me that the visit should be free since this is a referral. I called Dr [redacted] office for verification that there would be no charge & if he received the x-rays. I ended the conversation with his office assistant with the understanding that there would be no charge for the visit. Dr [redacted] performed a cone beam ct. He did not put through a pre-authorization request with my insurance company. He did not mention the cost of this procedure to me. He did not tell me that I might be billed for the procedure. He told me absolutely nothing. As an oral surgeon who does this on a daily basis, he should know if this is a covered procedure and how expensive it is. If he was unsure, HE SHOULD HAVE PUT THROUGH A PRE-AUTHORIZATION REQUEST TO MY INSURANCE COMPANY TO FIND OUT and then to give me the opportunity to opt out. Now I receive a bill for $200. I would have never made the appointment with him if I knew this. On Dr [redacted] website, it says sign up for your free consultation and receive a complimentary 3D CT scan, yet his office assistant refuses to remove the $200 charge from my account.Desired Settlement: I want this company to delete the $200 charge from my account.

Business

Response:

January 27,2014

RE: ID #[redacted]

To whom it may concern:

Thank you for forwarding the complaint by email. I apologize for the delayed

response but I never received the original complaint by mail. Here is our response to

the patient's complaint.

The patient [redacted] did schedule a consultation'appointment with my office for

November 19,2013. At the time of scheduling we requested the patient to log on to

our website and do his registration forms online, which he did. Mr. [redacted] also let us

know that he had [redacted] for dental insurance and we let him know that we are

providers with his dental insurance. Our office policy is to bill the insurance first as a

courtesy to the patient. Once the insurance processes the claim they will then forward

an "explanation of benefits" with the patient's co-share if any. At that time we will

then send an invoice to the patient.

At rio time did we ever tell the patient that there was no charge for the visit. As a

matter of fact when the patient was completed with the consultation appointment my

treatment coordinator, [redacted] went over all the fees, see attached with the

patient. We advised the patient that we would bill the insurance for the consultation

and ct cone beam scan and if there was a balance due we would send him a bill.

On December 9, 2013 we received partial payment from the patient's insurance and

the explanation of benefits showing that the patient's responsibility was $200.00. An

invoice was generated and mailed to the patient.

On December 18, 2013 we received a phone call from the patient inquiJ.ing on the

balance. My office manager, [redacted] spoke to the patient and apologized for

any misunderstanding but that our office did not do free consultation and xrays. We

billed his insurance first as a courtesy but balance due was $200.00 and if he would

like, he could make payments on the balance. At that time the patient said that his

general dentist, Dr. [redacted]'s office told him that we do "free consultation and xrays".

instructed my office manager to contact Dr. [redacted]'s office to see if they were

instructing their patients that the visits would be free and the receptionist at Dr.

[redacted]'s office stated that they never tell the patients our examination and xrays are

free.

My office manager informed me of the miscommunication between the patient, Dr.

[redacted]'s office and our office and I instructed her to write off the balance on January 9,

2014, see attached.

Our goal is to give excellent customer service and help our patients with their oral and

maxillofacial surgical needs. I am sorry to hear that Mr. [redacted] was unsatisfied with his

experience with our office. I hope this information helps to clarify what transpired at

my office.

Sincerely,

[redacted] MD, DDS