Memphis Center for Family & Cosmetic Dentistry

Before scheduling appt.to clean my teeth on 7/8/2015, I had contacted the dental office 4 times to confirm that they were in my Humana Dental Network.Before scheduling an appointment for dental cleaning on 7/8/2015, I spoke with the staff of Memphis Center for Family & Cosmetic Dentistry FOUR different times within the prior 2 weeks to verify that they are participating provider in my Humana Dental Network. I was told by the office staff 2 different times,YES. Later, I went on Humana website to see if Memphis Center for Family & Cosmetic Dentistry or Miles Moore, D.D.S. were participating provider in my Network. It did not show them listed. So, I called the office again to inquire if there was a mistake because the staff has confirmed 2 times earlier that they were participating provider in my Humana network. Again, I was told, Yes, so I ask the office lady to call my insurance company while I was on hold. She called the insurance company and then came back to me and told me that they were participating provider in my Humana network and that the website has not been updated. I agreed to keep the appt. on 7/8/2015. After my exam and cleaning, I was presented a treatment plan. At that time, I requested the staff to review my dental coverage of the recommended treatment plan. They printed 9 pages of my Humana dental coverage details and reviewed them with me. Unfortunately, the recommended treatment was not covered. So, upon leaving, I ask again, do I owe you anything for today? They told me again, you are 100% paid. You don't owe us because its covered under you plan. Then, I receive an EOB from Humana Dental and they deny payment by stating,code 45/6NZ, THIS SERVICE WAS PERFORMED BY A NON PARTICIPATING PROVIDER. On 8/19/2015 I receive a statement in the amount of $239.00 due on 9/3/2015. I called and spoke to Reena on 10/20/2015. Reena told me that she would find out why I was being billed. She called me today and told me that they were not in the Humana network because it was a PPO and that I had $100 deductible and the bill was already discounted from $333.00 to $239.00. I told her that this is wrong to do patients this way and that I had a $79.00 credit with them and they could have the $79.00 because I'm not paying them another dollar because they intentionally mislead me in order to keep me as a patient. She threatened me with collections. I told her fine, I'm filing with Revdex.com today and inform them of your practices and hung up the phone. I don't need this stress, so here I am telling my story of being lied to just to increase their pocketbooks and possibly ruin my credit worthiness. This type of business practice needs to be stopped.Desired SettlementI want Memphis Center for Family & Cosmetic Dentistry to give me a Zero balance on my account. They can keep my $79.00 credit that's on my account. I will not be returning to this dental office in the future. I do not want them to contact me on my cell or daytime phone number. I would like for the Miles Moore, DDS to take this complaint seriously and educate his staff on the plans that they actually are Participating Providers. This situation could have been avoided, if I had not been lied too, whether intentionally or not. A LIE IS A LIE!Business Response In response to Ms. [redacted]'s complaint. Dr. Miles Moore purchased Dr. Denis Freiden's practice 11-21-2013. Any and all credits or balances on a patients account prior to this date would have been to or owed by Dr. Freiden I have attached the credit voucher that the patient is referring to. This had nothing to do with Dr. Miles Moore and had an expiration date with Dr. Freiden of 10-2013 that being said even if Dr. Freiden was still the owner it would be void. As far as the insurance goes the contract is between the patient and the insurance, we are a third party and can only do our best to give the patient the info that was given to us by HER insurance. Our office policy is as follows..... If you have dental insurance, it is important to understand that your actual insurance benefits may differ from the benefits estimated in your Treatment Plan Estimate. Your Treatment Plan Estimate of insurance benefits is based on information provided by your insurance company and by you. It is an estimate and your insurance benefits may be higher or lower than estimated. In all cases, you are responsible for amounts not covered by your insurance.While we do our best to verify dental benefits prior to your first appointment, this does not guarantee coverage or payments.Please note that any difference in payment from your insurance company and your account balance is your responsibility. Any unpaid balance will be subject to interest charges of 2% per month, from the date of service, until the account is paid in full. If payment has not been received on the account during the 90 days, the account risks being sent to a collection agency or an attorney, additional collection fees will be applied to any unpaid balance. Any attorney or collections fees incurred due to delinquency in payment or collection efforts will also be charged to you, including court costs and fees. In Ms. [redacted]'s case we filed her claim with her insurance company Humana with whom we ARE a participating PPO provider for. They did not pay stating that her plan is an indemnity plan and that there was $100 deductible and that a panoramic xray under her policy was not a covered benefit. We called and verified this info once receiving the EOB with Henry on 08/19/2015 @ 10:54am ref # XXXXXXXXXXXX because this contradicted what we were initially told on 04/21/2015 by Christine @ 12:16pm with Humana. I explained this to patient on XX-XX-XX who then became irate and would not listen to anything I had to say. Then on XX-XX-XXXX I received another EOB from Humana with a payment of $153.00 and patient responsibility of $118. Obviously Humana made a few mistakes and gave wrong information regarding this patient several times. As you can see I even discounted the patient part to $86 versus the $118 we are allowed to charge per her insurance company. I called pt to tell her the good news XX-XX-XX but she did not respond to my message. I have attached both EOBS, signed financial documents,pt ledger, GC from previous Dr. Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)First all, I can not open the attached documents.It just gives me jibber jabber. Maybe, Memphis Center for Family and Cosmetic Dentistry will be so kind as to take a few minutes and make multiple smaller files that can be downloaded and read. As, I stated in my original complaint. When I called Humana, they informed me that Dr. Moore was not in their network.Humana put me on hold and called Dr. Moore's office staff, who insisted that they were in the Humana Network and that I would not owe anything for my dental exam and cleaning. I'm sure that Humana records all phone conversations. I will need more time to get this recording from Humana. And I will get it for confirmation of my statements made here today. Also, the credit on my account is left over from a Dixon Gallery Auction Certificate that I paid cash for at the Auction, and yes it had an expiration date. Dr. Moore extended the date and scheduled me a dental exam and cleaning of which left me a credit on my account. I used part of the certificate and the staff told me that there would be a credit applied to my account. Now, when a company buys a business, it is customary for accounts receivables and payables and client ledgers to be transferred with out taking money out of the clients account. After all, those are important in placing a value on a company when it is sold. I'm pretty sure an attorney will agree. Since, it was Dr. Moore who did my first exam and cleaning when I used my certificate, he would acknowledge that I indeed have this credit on my account because we discussed it when he actually gave me a treatment plan for future use of my account credit. Today, I opened my mail and found a collection statement dated Oct. 29,2015, stating that they have attempted to contact me 3 times and billing me for $239.00. I have not seen any type of adjusted billing as Dr. Moore's office claims. I would prefer to see this corrected information via invoice/statement sent to me in the mail. It has been 2 weeks since they answered my complaint with Revdex.com. Which is ample time for me to have received these documents and an adjusted statement showing these changes on my account that they say are there. I disagree with the fact that I don't have credit on my account. We can resolve this matter if they will take the credit amount of my account and subtract it from the $86.00 balance. Then, I will pay that balance in full with no problem. But I am due the credit because I used the certificate , within the allowed extension date that was given to me by Dr. Moore. The balance/credit should not be taken away from my account. That is stealing. So, apply my credit and let's close this today.I want to take a moment and thank everyone at the Revdex.com who is helping me to resolve this issue.Final Business Response In response to Ms. [redacted]'s Rebuttal. I apologize that she can not open attached documents I know of no other way to submit them. We are not honoring said gift certificate that has nothing to do with Dr. Moore and is expired. Dr. Moore never agreed to honor said gift certificate. We are a Humana provider and they did pay as such. The original claim was processed incorrectly at no fault of our own. As far as the purchase of our practice Ms. [redacted] has no idea what she is talking about and I invite her to get an attorney involved if she feels this is necessary. Ms. [redacted] owes the practice $86.00.

This dentist and company are billing patients wrongly and trying to make them pay extra over and above what insurance pays by coding what you went in for incorrectly. I have been dealing with this dentist and company for months since the first time they billed me and I spoke to my insurance, and the dentist assistant who assisted during my visit, who both informed me that their coding was wrong. I also spoke with their office manager [redacted] who initially told me that the coding was wrong and that they would correct the information with the coding and resend it to my insurance. I was told this problem was taken care of, then all of a sudden I got another bill from them this past week. Again, I called to sort this matter with them and with my insurance and they decided to be incredibly rude to me and to speak to me in a matter that you should never speak to your patients. I was was spoken to rudely by the office manager and by the dentist who worked on me and who owns the practice. They lied to me several times, telling me they could not email me my records when I asked for them (they are a digitally run company). Then, I was told they would mail them to me. Then during a third phone call when they basically called me back to harass me and intimidate me into taking a review I wrote about them on Facebook down, I was told that all of a sudden there was a charge for my records (which didn't exist, the first 2 times I asked for them. The dentist there also called my personal cell phone number after he read a review I wrote on his practice and basically called me to harass me and intimidate me into taking my review down, by telling me he would sue me for slander if I didn't take my review of them on Facebook down. This was my review of them: Absolutely rudest people I have ever had to deal with...down from their front assistants to the office manager to the dentist. They are charging patients for things that are not performed and for things that my insurance has told me they are improperly coding. When I called them to bring it to their attention and to ask for a detail report of my visit they were downright rude and completely unprofessional. I will be reporting them to the Revdex.com among other things!!! Absolutely horrible business and people!!! *I would also like to add that not even an hour after I wrote this review, this dentist decided to call my personal cell phone to basically harass me and try to intimidate me into taking this review down by telling me he was going to sue me for slander. He also then tried to lie to me and charge me for the inquiry of my records, which I had asked for previously through 2 different phone calls and told they would be sent, but was never told there was a charge for obtaining my own records (which all of a sudden there was now). I am absolutely shocked at the way these people have spoken to me and treated me and at the fact that they think this an okay way to treat your patients and conduct your business.*Product_Or_Service: Second opinion for proposed dental treatment Account_Number: [redacted] - AcDesired SettlementI was told by the office manager [redacted] and the dentist that I was being sent to collections. I would like for my appointment to be re-billed with the correct codes to my insurance, like I was initially told they would do the first time I contacted them about this issue. I would also like a new bill to be sent stating a zero balance like I should have had the first time. I would also like for no further contact to be made to me from this business unless it has to do with my statement or balance. Business Response Contact Name and Title: [redacted] ownerContact Phone: XXX-XXX-XXXXContact Email: [redacted]@gmail.comPatient was seen at my office on September 9, 2014 for a comprehensive evaluation. Patient was concerned with treatment plan from another dentist and wanted me to examine her teeth and develop a treatment plan. Patient had x-rays sent from previous dentist. I read PANO and BWs along with an IOE of hard and soft tissue. My assistant typed in the clinical notes and put that we did a limited exam (who was her friend). This was incorrectly recorded as a comprehensive exam was performed. The correct procedure code was charged out to the insurance company. There was no error in billing the insurance company.Patient contacted my office after receiving a statement. She said that I should have charged out a limited exam and not a comprehensive exam. I explained to the patient that reading a FMX, examining all of her teeth, and developing a treatment plan constituted a comprehensive exam. If I would have only looked at one specific area of her mouth then I would have charged out a limited exam but this was not the case. She continued to argue with me on what type of exam was performed. In the patient's complaint she refers to the dental assistant who told her the coding was wrong. The dental assistant that was present at the time of the patient's exam is a friend of the patients. I had to terminate this assistant for dishonesty a couple of months after this patient came in. I believe her statements are biased based on their relationship with one another. The patient requested her records and there is a $25 charge for copy and transfer of records. The patient stated that this was a made up fee but this is clearly listed on our record release form. I waived this fee for the patient in order to try to resolve the situation. Patient also stated that we could not email her records, on the record transfer form which she filled out there is a selection to have them sent digitally. Her records were sent digitally. Patient requested that I rebill her insurance company and change the treatment to a limited exam. I am not agreeing to this because a limited exam wasn't performed and this would be insurance fraud. I cleared the patient's balance in an attempt to resolve the situation. She no longer has any debt with my dental practice. If I can be of any further assistance please feel free to contact me at XXX-XXX-XXXX. Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)The only thing I accept about this response is that my balance was cleared and they gave me back my records. Other than that I do not accept anything else because the rest of the letter consists of lies. First of all, I contacted their office way before March and way before I spoke with him. My initial contact was back in Oct. when I firsy received a bill. I spoke to their office manager [redacted] and I asked her why I'm getting a bill when I was told by their office that my insurance covered a second opinion to go to them. She told me to call my insurance and to see why they didn't pay all of it. I did and they told me they were not billed for a second opinion (a limited exam). That they were build for a comprehensive exam with x-Rays and everything and I told them, those services were not performed during my appointment that my X-Rays and everything else came from my regular dentist. They told me that the bill to them was coded wrong and that I needed to call the dentist office back and tell them the mistake with the coding and for them to fix it and rebuild them. (None of this came from "my friend" as he is trying to state). This was all said by my insurance. So I called the dentist office back and spoke to [redacted] again and she was very nice about it and stated that I was right and that my insurance was right and that they would take care of it right away and that I didn't owe anything. I heard nothing from then for months, so I assumed this was taken care off like I was told back in Oct. Then all of a sudden in March out of nowhere I get another bill for the exact same thing. So once gain I call their dentist office and spoke with [redacted] once again stating that I received the same bill and that I thought that this was supposed to be taken care back in Oct. This time I was met with nothing but rudeness and treated horribly and told that I would be sent to collections, etc. Not once did I bring my friends name up who formerly worked for them. They actually brought her name up to me several times. So I get off the phone call my insurance, the dental assistant present during my exam, my current dentist, and another dentist to get more confirmation on the difference between a limited exam and a comprehensive exam. They all tell me the same thing. I did not have a comprehensive exam, all I had was a limited exam. I called the dentist office back and this time the dentist gets on the phone and states he is looking at my chart and notes right now and that he performed a comprehensive exam (this was a complete lie, because later I received my chart and my notes, which I will attach, and clear as day it says that a I came in there for a second opinion and that a limited exam was done on the date of my appointment, then after I spoke with them and told them I was reporting the to you they added an addendum to the notes lying to basically cover their [redacted], but on their notes any time anything is changed it puts the new date in there which they can't erase. The dates they put that in was March 11, 2015, the second time I called). So if my friend was being dishonest (which is a lie) and he performed a comprehensive exam on me why did he not go back and look over the dental assistants notes and correct them, his name was signed to the chart and the notes. Why did they wait til March 11, 2015, seven months after my appointment and on the day I called to change the notes and state what he supposedly did to me. How did he remember 7 months later what he did to a patient that has only been in his office one time? Why did he decide to call my personal cell phone later that day after hours to threatened me and tell me he's going to sue me for slander if I didn't take a review down that I wrote on his office, why did he call and harass me about how he was going to send me to collections? Why did he try to talk to me like I was some young ignorant girl? He made the mistake of thinking that just because I looked young he could overcharge me, my insurance, and threatened and harass me into what he wanted. I'm a 35 year old women with a Master's degree, who is employed. The bill wasn't even that big, but it's the principle of it and the fact that I was not going to pay for a service that was not performed and that frankly it's considered insurance fraud. I also spoke with another patient of his who is a friend of mine, that also only went to his office just once, because after he went he also was charged for services that were not performed. He was charged for a cleaning that the dentist office never performed. The only reason he didn't complain about it was because his insurance covered it because he hadn't had a cleaning in 6 months, but that's the reason he never went back to them. I would be willing to bet that he has been doing this for years and just hasn't gotten caught or has been successful in the harassment of other patients into not complaining. All I know is I want nothing more to do with this office and this dentist, but I just couldn't sit there and say nothing after all of the lies he decided to say in his response. Again, nothing he stated was the truth, it was pretty much all lies. The only thing I accept from this letter is that yes, after I reported him, he did email me the next day and tell me that my balance was clear that I had a zero balance with his office and that he sent me my records after. That is the only thing I will accept from this latter!