Manhattan Bridge Orthodontics

Review: I went to MBTO in 2011 to have braces placed on my child's and my teeth to correct alignment. After the consultation I was quoted a price which included an amount that my insurance was supposed to cover and the amount I would have to pay out of pocket. During the duration of my visits to MBTO I was happy with the service I received until April 2013 when it was time to take off my childs braces. MTBO stated that we had a balance, which I didin't understand how that could be when I paid out of pocket the agreed amount which was quoted to me. I was NEVER made aware from MBTO or my insurance carrier that MBTO was out-of-network until April 2013. MBTO should have made me aware of this when they was quoting me my initial price and also made me aware of the billing issue before now. Their solution is pay more out of pocket to have my child's and my braces removed. MBTO continued to bill my insurance company and maxed out my office visits and all of my coverage including billed my insurance company for aftercare and retainer whereas they have done such services at all. From the beginning they were deceptive in their practices and billing just to get customers then at the end of treatment they stuck me with a bill even after maximizing out my insurance coverage and utilizing my benefits for services and visits I never received. I took my child to another dentist to look at her teeth and was told that her braces weren't put on correctly. A few of her teeth are displaced and the same issue with mine. I am ready to file malpractice claims and or sue. They did many unethically things and I am not happy with this situation at all.Desired Settlement: I want MBTO to refund me all of the money I paid and all of the money received from my insurance company because their practices were misleading and fraudulent. I will be contacting the Dentistry board and everyone who gives them accreditation. I want these braces removed at their expense and a refund issued to my insurance company and myself for all fees.

Business

Response:

[redacted] and her daughter, [redacted], came to my office in 2011 to fix their teeth - one for alignment and one for spacing. After their consultation, our treatment coordinator quoted them a fee which took into account their estimated insurance coverage and their out of pocket costs. The insurance coverage amount was based on written information that we received from their insurance company via fax. In that document, it states that [redacted] and [redacted] both have a $2500 total benefit for orthodontic treatment which would be paid out over 24 months.

Their insurance ended up paying $440 upfront and then $48 per month for 24 months. This amount totals $1592 each. This shortfall could be due to changes within their insurance plan. I also have never billed for services not rendered. I have never submitted a claim for aftercare and retainers to her insurance as [redacted] has claimed.

My office is fully compliant with insurance procedures and has maintained excellent billing practices. We have an independent auditor from Medco Consultants, ###-###-####, audit our billing practices and assure all billing rules are being met. Their findings show we were following all the rules and [redacted], CPC told me personally I had one of the best run practices billing-wise.

Prior to [redacted] and [redacted] starting treatment, their treatment contract was reviewed with them and they signed indicating they agree to the terms. Their treatment contract says that any insurance benefits are estimated and any unpaid insurance balance would need to be paid prior to removal of braces.

In January [redacted] of 2012, it has been documented in their folders that our treatment coordinator, [redacted], informed them that their insurance is not paying as expected and that there may be a balance remaining when its time to remove their braces. At that point, [redacted] stated that her insurance had actually increased to $4000 and that they should cover the balance – however this did not turn out to be the case.

I know [redacted] and [redacted] are very good people and I was always happy seeing them during their appointments. During the course of the past two years, their treatment has gone very well. Even though there was a deep impinging overbite (when the bottom teeth have such a deep bite they bite on the gums of the top teeth), the cooperation from them as patients helped allow for excellent treatment progress.

Towards the end of April 2012, when [redacted]’s braces were ready to come off, there was still an insurance shortfall. [redacted] informed them again that this balance would need to be paid as per our treatment contract. At that point [redacted] stated that she does not want to pay the balance and would seek to finish treatment elsewhere.

When they went to see a dentist for a 2nd opinion, that dentist can remark on what they see at that time point and be critical about the placement of the braces. However, without knowing where the patient’s teeth began initially, this dentist cannot know how much effort it took to correct the bite problems or how the bite may have prevented ideal placement of the braces at the onset. Also, a dentist is different from an orthodontic specialist in that they don’t have additional training in bite correction. I have had 3 additional years of training at Columbia University (after getting my dental degree) to achieve a Master of Science degree in Orthodontics. It’s been 6 months since I’ve last seen [redacted] and [redacted] for their braces adjustment and it is also possible that their teeth may have shifted a bit since then.

I want them both to return. I would be thankful to have an opportunity to fix any detailing that may be needed and mend this relationship. They should both have great smiles that they can be proud of showing off with confidence. There has been some miscommunication from my team members as to how much I value them as patients. I have since emailed and left messages on [redacted]’s phone asking her for an opportunity to fix this issue. To this day, she has not called me back. Resolving this complaint is a priority for me. When she calls back, I will personally make sure we do what it takes to make her happy. I have spoken to all the staff about how to improve on our end for this not to happen again.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

To be completely honest after all that transpired, I don't trust this dentist or the people who work there especially with something that has to do with my child's health and also my own. I tried to deal with it before contacting your office but wasn't given any consideration at all not only that like I said I was told by another dentist that the placement of the braces are incorrect. These people can do anything to us at this point including exposurjng us to harmful and unclean equipment because of how this situation has escalated. How can I trust them when the history with them didn't should that they had integrity at all. All I want is a refund so I can get the work done that should have been done here. She is correct in saying that I hadn't been there in six month or more yet they still billed my insurance like I have. Who would allow someone to work on them when the work wasn't done right and on top of that they are demanding money after you thought the financial aspect was taken care of. I expected to pay a certain price and I did so. They misquoted me and that's not right. All I want is a refund and complete refund and the release of my records from their care. I would never recommend them to anyone else. I want to file a malpractice lawsuit but I first want to handle it this way. So no she will never have the opportunity to touch or work on our mouths again because she didn't do it right and also her staff were not honest at all with their billing practices.

In order for the Revdex.com to appropriately process your response, you MUST answer the question above.

Sincerely,

Business

Response:

Dear [redacted]: Are you and your daughter still in braces? Please be advised that it is not safe to be in braces without them being monitored by an orthodontist. If you have not already done so, please see another orthodontist; if you do not, serious consequences can occur.

You are entitled to your records. You and your daughter only need to sign a records release and we will send them to you. I have mailed you releases which both of you should sign and return to our office. If you prefer, you can come in to sign them.

Because you and [redacted] were good patients, your treatments progressed well; you were both ready for demanding in January. I tried to always keep you informed of what was going on. Because January preceded the anticipated end-of-treatment date, there was a balance due, of which you were informed. I think the trust was lost when that occurred. It’s not easy for health care providers to estimate how much insurance will pay in healthcare; the staff did their best with their initial estimate. At this time, your outstanding balance has been waived and the offer to remove braces and provide retainers at no additional charge still stands.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved.

The issue has been resolved to my satisfaction. Sometimes misunderstands occur and at this time I would be to remove any negative statements made so [redacted] isn't effected anymore by this situation.

Thank you.

Sincerely,