Martin Dominger, DDS, MD

Revdex.com: 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: [redacted] received the claim on July **, and processed this claim on October **, Benefits were not provided for the service of periodontal gum surgery because as per [redacted] it is inclusive of the Tooth Exposure The claim is attached for review As per my conversation with [redacted] minutes ago this claim has not yet been appealed by DrDominger's office DrDominger's office did call [redacted] once on December **, and [redacted] was greeted with hold music from the dentist office It is ***'s policy to wait minutes, however no one from DrDominger's office came back to the call What is Dr.Dominger's office waiting for? DrDominger's office is an in network provider and is contracted to accept what the insurance carrier pays If the office doesn't want to accept what a insurance carrier is willing to pay they should not participate with the carrier and not charge the patient moreNormally after a dentist bills [redacted] for services rendered, I myself send a claim to [redacted] the SUPPLEMENTAL insurance carrier DrDominger's office took it upon themselves to send a claim to [redacted] at the end of August because CIGAN was not processing the claim since DrDominger's office was not filing the claim with [redacted] correctlyI did sign an assignment of benefits, but that was for *** Again, [redacted] is a supplemental insurance carrier designed to help individuals with the cost of co-pay's It is out of my pocket In order for the Revdex.com to appropriately process your response, you MUST answer the question above Sincerely, [redacted] ***

The patient was treated for services that have still not been fully paid by the insurance company ***It is now in the process of appeals [redacted] has not paid any money to the office at allWhen both insurance companies have paid for all services rendered the patient will receive a refund if they are owed at that pointThe patient is looking to be paid for services rendered by the doctor even though they have paid no money out pocket

Revdex.com: 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: [redacted] received the claim on July **, and processed this claim on October **, Benefits were not provided for the service of periodontal gum surgery because as per [redacted] it is inclusive of the Tooth Exposure The claim is attached for review As per my conversation with [redacted] minutes ago this claim has not yet been appealed by DrDominger's office DrDominger's office did call [redacted] once on December **, and [redacted] was greeted with hold music from the dentist office It is ***'s policy to wait minutes, however no one from DrDominger's office came back to the call What is Dr.Dominger's office waiting for? DrDominger's office is an in network provider and is contracted to accept what the insurance carrier pays If the office doesn't want to accept what a insurance carrier is willing to pay they should not participate with the carrier and not charge the patient more.Normally after a dentist bills [redacted] for services rendered, I myself send a claim to [redacted] the SUPPLEMENTAL insurance carrier DrDominger's office took it upon themselves to send a claim to [redacted] at the end of August because CIGAN was not processing the claim since DrDominger's office was not filing the claim with [redacted] correctlyI did sign an assignment of benefits, but that was for *** Again, [redacted] is a supplemental insurance carrier designed to help individuals with the cost of co-pay's It is out of my pocket In order for the Revdex.com to appropriately process your response, you MUST answer the question above Sincerely, [redacted] ***

Revdex.com:
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:

[redacted] received the claim on July **, 2015 and processed this claim on October **, 2015.  Benefits were not provided for the service of periodontal gum surgery because as per [redacted] it is inclusive of the Tooth Exposure.  The claim is attached for review.  As per my conversation with [redacted] 5 minutes ago this claim has not yet been appealed by Dr. Dominger's office.  Dr. Dominger's office did call [redacted] once on December **, 2015 and [redacted] was greeted with hold music from the dentist office.  It is [redacted]'s policy to wait 5 minutes, however no one from Dr. Dominger's office came back to the call.  What is Dr.Dominger's office waiting for? Dr. Dominger's office is an in network provider and is contracted to accept what the insurance carrier pays.   If the office doesn't want to accept what a insurance carrier is willing to pay they should not participate with the carrier and not charge the patient more.Normally after a dentist bills [redacted] for services rendered, I myself send a claim to [redacted] the SUPPLEMENTAL insurance carrier.  Dr. Dominger's office took it upon themselves to send a claim to [redacted] at the end of August because CIGAN was not processing the claim since Dr. Dominger's office was not filing the claim with [redacted] correctly. I did sign an assignment of benefits, but that was for [redacted].  Again, [redacted] is a supplemental insurance carrier designed to help individuals with the cost of co-pay's.  It is out of my pocket.
 
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

The patient was treated for services that have still not been fully paid by the insurance company [redacted]. It is now in the process of appeals. [redacted] has not paid any money to the office at all. When both insurance companies have paid for all services rendered the patient will receive a refund if...

they are owed at that point. The patient is looking to be paid for services rendered by the doctor even though they have paid no money out pocket.

Revdex.com:
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:

[redacted] received the claim on July **, 2015 and processed this claim on October **, 2015.  Benefits were not provided for the service of periodontal gum surgery because as per [redacted] it is inclusive of the Tooth Exposure.  The claim is attached for review.  As per my conversation with [redacted] 5 minutes ago this claim has not yet been appealed by Dr. Dominger's office.  Dr. Dominger's office did call [redacted] once on December **, 2015 and [redacted] was greeted with hold music from the dentist office.  It is [redacted]'s policy to wait 5 minutes, however no one from Dr. Dominger's office came back to the call.  What is Dr.Dominger's office waiting for?
Dr. Dominger's office is an in network provider and is contracted to accept what the insurance carrier pays.   If the office doesn't want to accept what a insurance carrier is willing to pay they should not participate with the carrier and not charge the patient more.
Normally after a dentist bills [redacted] for services rendered, I myself send a claim to [redacted] the SUPPLEMENTAL insurance carrier.  Dr. Dominger's office took it upon themselves to send a claim to [redacted] at the end of August because CIGAN was not processing the claim since Dr. Dominger's office was not filing the claim with [redacted] correctly. I did sign an assignment of benefits, but that was for [redacted].  Again, [redacted] is a supplemental insurance carrier designed to help individuals with the cost of co-pay's.  It is out of my pocket.
 
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

Review: My son [redacted] received an oral surgery procedure from [redacted] is an in network provider of our insurance company [redacted]. The EOB from [redacted] for services dated 07/**/2015 states my responsibility on this claim is $156.60 after [redacted] paid $291.40. My supplemental insurance is through [redacted], it is a policy to help customers with monetary assistance to pay expenses that a primary policy does not cover. [redacted] paid [redacted] directly $265.00 in accordance with the Assignment of Benefits I signed in the office. This resulted in an overpayment to my son's account of $108.40. I have explained verbally to office staff and via certified letter to [redacted] a network provider is required to accept the contracted amount set by the insurance carrier [redacted] and not to charge me more than my plan states my responsibility is. The payment from [redacted] is considered as if I personally paid the $265.00. Verbally I was told regardless that [redacted] is the supplemental carrier the office does not refund insurance overpayments to the patient. There had been no response to my certified letter dated December **, 2015 which was signed for on December **, 2015.Desired Settlement: A refund of the overpayment by [redacted] in the amount of $108.40

Business

Response:

The patient was treated for services that have still not been fully paid by the insurance company [redacted]. It is now in the process of appeals. [redacted] has not paid any money to the office at all. When both insurance companies have paid for all services rendered the patient will receive a refund if they are owed at that point. The patient is looking to be paid for services rendered by the doctor even though they have paid no money out pocket.

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:

[redacted] received the claim on July **, 2015 and processed this claim on October **, 2015. Benefits were not provided for the service of periodontal gum surgery because as per [redacted] it is inclusive of the Tooth Exposure. The claim is attached for review. As per my conversation with [redacted] 5 minutes ago this claim has not yet been appealed by Dr. Dominger's office. Dr. Dominger's office did call [redacted] once on December **, 2015 and [redacted] was greeted with hold music from the dentist office. It is [redacted]'s policy to wait 5 minutes, however no one from Dr. Dominger's office came back to the call. What is Dr.Dominger's office waiting for? Dr. Dominger's office is an in network provider and is contracted to accept what the insurance carrier pays. If the office doesn't want to accept what a insurance carrier is willing to pay they should not participate with the carrier and not charge the patient more.Normally after a dentist bills [redacted] for services rendered, I myself send a claim to [redacted] the SUPPLEMENTAL insurance carrier. Dr. Dominger's office took it upon themselves to send a claim to [redacted] at the end of August because CIGAN was not processing the claim since Dr. Dominger's office was not filing the claim with [redacted] correctly. I did sign an assignment of benefits, but that was for [redacted]. Again, [redacted] is a supplemental insurance carrier designed to help individuals with the cost of co-pay's. It is out of my pocket.

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

Sincerely,