Markowitz Dental

To whom it may concern,In response to the above mentioned claimI have provided copies of the correspondence between the office and the complainant.The initial contact with the complainant was made on 2/22/Our office makes every effort to let any potential patient know that we are not in any dental network and cannot verify coverage if dental insurance is going to be usedThe complainant was referred to our office by one or more of her co-workers whom all have the same insurance carrier provided by the employer and are patients in the officeAs explained to the complainant, based on the information that was provided to us we have no way of knowing that the individual plan that she chose was not the same as her co-workers because the group number provided by the complainant was the same as the information that we have for her employer and co-workersWe are not a participating provider for any insurance company and assume that the policy holder is aware of their coverageWe do submit insurance claims to individual's insurance carriers as a courtesy to our patientsThis is not a requirementThe common practice for non-participating providers is to have patients pay for their visits in full and provide the individual with the necessary information for them to handle their claims on their ownThe complainant was a new patient to this office and as industry standards dictate, in order to be able to treat a new patient properly a comprehensive exam is needed to determine if dental treatment of any sort is necessaryThis includes a thorough evaluation of the gum tissues surrounding the teeth and the tissues in the entire oral cavity and any facial abnormalitiesAdditionally, an x-ray evaluation is necessary to determine if there are any carious lesions on the teeth as well as any abnormalities in the bone and any abscessed areas all of which cannot be detected visuallyNone of the services that were provided were unnecessary, extraneous or “more expensive”The complainant was not “convinced” of having anything that was not neededIt would appear that the complainant did not know what her insurance coverage was, and was not aware that she had chosen a plan that required her to see someone on a specified listIf she was aware, she would not have called this office as we do not show up on any list to accept only insurance payments as payment in fullIf she was not aware and made the call to our office based upon referral from office mates, then again we would have no way of knowing that she chose a different plan than they did and she assumed the sameI don't feel the complainant was led to believe that she would incur no cost for her visit as she paid $and was told that insurance would be filedThe complainant made a subsequent appointmentI don't feel that this office was malicious or misleading to the complainant about her insurance coverage based on the information that she provided to us at the time of her visitIt was not until the insurance carrier sent a response that we were made aware that her insurance coverage was not what it had appeared to this office to beIt was then that the office sent the complainant a copy of her carrier's response and a copy of her account to have the bill reconciledThere appears to be no complaint about the dental services that were provided by the doctor, therefore I don't feel that the office did anything wrong in billing the patient for the services that she receivedThe complainant filed this complaint because she has chosen a dental plan that has restrictions that apparently she was not aware of and we had no way of knowing based on the information that was provided to usThe office has offered to make a payment plan for the remaining balanceThe correspondence between the office and the complainant are included along with a copy the office financial policy that the patient signed which states that we will submit claims for treatment, however if the office does not receive payment within days, the complainant is responsible for payment.Sincerely,Erin H [redacted] , DA, DOMMarkowitz Dental

To whom it may concern,In response to the above mentioned claim. I have provided copies of the correspondence between the office and the complainant.The initial contact with the complainant was made on 2/22/2016. Our office makes every effort to let any potential patient know that we are not in any...

dental network and cannot verify coverage if dental insurance is going to be used. The complainant was referred to our office by one or more of her co-workers whom all have the same insurance carrier provided by the employer and are patients in the office. As explained to the complainant, based on the information that was provided to us we have no way of knowing that the individual plan that she chose was not the same as her co-workers because the group number provided by the complainant was the same as the information that we have for her employer and co-workers. We are not a participating provider for any insurance company and assume that the policy holder is aware of their coverage. We do submit insurance claims to individual's insurance carriers as a courtesy to our patients. This is not a requirement. The common practice for non-participating providers is to have patients pay for their visits in full and provide the individual with the necessary information for them to handle their claims on their own. The complainant was a new patient to this office and as industry standards dictate, in order to be able to treat a new patient properly a comprehensive exam is needed to determine if dental treatment of any sort is necessary. This includes a thorough evaluation of the gum tissues surrounding the teeth and the tissues in the entire oral cavity and any facial abnormalities. Additionally, an x-ray evaluation is necessary to determine if there are any carious lesions on the teeth as well as any abnormalities in the bone and any abscessed areas all of which cannot be detected visually. None of the services that were provided were unnecessary, extraneous or “more expensive”. The complainant was not “convinced” of having anything that was not needed. It would appear that the complainant did not know what her insurance coverage was, and was not aware that she had chosen a plan that required her to see someone on a specified list. If she was aware, she would not have called this office as we do not show up on any list to accept only insurance payments as payment in full. If she was not aware and made the call to our office based upon referral from office mates, then again we would have no way of knowing that she chose a different plan than they did and she assumed the same. I don't feel the complainant was led to believe that she would incur no cost for her visit as she paid $50 and was told that insurance would be filed. The complainant made a subsequent appointment. I don't feel that this office was malicious or misleading to the complainant about her insurance coverage based on the information that she provided to us at the time of her visit. It was not until the insurance carrier sent a response that we were made aware that her insurance coverage was not what it had appeared to this office to be. It was then that the office sent the complainant a copy of her carrier's response and a copy of her account to have the bill reconciled. There appears to be no complaint about the dental services that were provided by the doctor, therefore I don't feel that the office did anything wrong in billing the patient for the services that she received. The complainant filed this complaint because she has chosen a dental plan that has restrictions that apparently she was not aware of and we had no way of knowing based on the information that was provided to us. The office has offered to make a payment plan for the remaining balance. The correspondence between the office and the complainant are included along with a copy the office financial policy that the patient signed which states that we will submit claims for treatment, however if the office does not receive payment within 30 days, the complainant is responsible for payment.Sincerely,Erin H[redacted], DA, DOMMarkowitz Dental

Complaint: [redacted]
I am rejecting this response as the dental office mislead me about accepting my insurance, despite my repeated best efforts (over the phone when I made the appointment, on the day of the appointment when I presented my insurance card, and at the time when the office attempted to up-sell me on costly services). I'm particularly disturbed that the dental office does not acknowledge that it made a serious error in misleading me. I would like other consumers to have awareness of this when seeking services from this practice.
Thank you to Revdex.com for your help to bring this matter to light. When a patient goes to a medical practice to seek services, and makes every best effort to confirm that their insurance is accepted, the dental office should either be honest that they do not accept insurance, or tell the patient that they cannot comment on insurance and tell the patient they will need to contact the insurance company directly. Certainly, the dental office should not make claims about insurance coverage that are misleading or false.