Midwest Dental, Inc.

Dear
Sir or Madam,
Midwest
Dental responded to [redacted] @ the Department of Agriculture, Trade and
Consumer Protection on May 20, 2015, regarding a complaint from [redacted]. Enclosed
is a copy of that response.Midwest
Dental has not changed their position, as the Treatment plans were...

presented
in advance of dental treatment.
The patient had the opportunity to reach out to their dental insurance carrier
to verify coverage, as the treatment estimate lists the specific ADA codes. The
Midwest Dental Baldwin office was contacted for comment on the complaint and below is their
response:“The family had immediate dental needs
and none of the services provided were cosmetic in nature.  The husband’s
chart notes indicate that he was in urgent need of dental care and was also
working with an oral surgeon for implants.  The family members had
significant active decay.
Patients presented with two insurance
plans.  Both were DD of MN plans.  We did caution them at their first
appointment that there may be a coordination of benefits or non-duplicating
clause.  The conversation regarding the insurance that the patient had
referenced in the complaint was a primary/secondary assignment issue for the
children.  The husband had only one insurance
plan, but had presented with two.  He was not included on his wife’s
plan.  When [redacted] had quoted him at the desk, she stated “now with your
two insurance plans . . .” and the patient did not deny secondary insurance
coverage. The
maximum was shared for the family which was a new limitation of the plan. “Patients have an obligation and assume
responsibility of their insurance benefits and provider panel.  We certainly are available to assist in the
process, but it is ultimately the patient’s responsibility to consent to care
and accept financial responsibility.  The service was rendered and the
balance stands at $2358.20. Regards,[redacted]Collections
ManagerMidwest
Dental, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
They are referencing my account and not that of my Husband's visit.  This is not an issure related to my visits but his.  Please resend them the complaint as it appears they are scapegoating the issue.  The visit was on 12/17/2015.  [redacted] (my husband) was the patient. 
Regards,
[redacted]

Midwest Dental Madison West offered a refer a friend, family or co workers program through October 31, 2016. If you referred someone, each patient would receive $40.00. The rule that came into play was that the established patient and the referred patient must both be 18 years of age. The...

established patient in this case was dad, but the referred patient was his son- who was 4 years old. Thus the referral was not valid. However, the patient was sent a $20.00 card anyway. Enclosed is the actual e-mail sent which mentions the rules and restrictions and verification that the patient received the same e-mail on 9/1/16.As a goodwill gesture, our marketing department sent (1)$50.00 and (1)$20.00 Visa gift card to the patient.We are asking that this dispute be closed.Thank you.Jo Ann [redacted]Midwest Dental, Inc.enclosures attached

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted].   I was finally able to speak with [redacted] from Midwest Dental and she was beyond awesome!  We were able to talk through what happened for both sides to understand where each was coming from.  We were able to come up with a presentable offer which she submitted to her team.  The offer was accepted and our bill is paid.  This resolution is beyond satisfactory to me.  
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
We keep going back and forth without any resolution - I feel I paid what I had agreed to pay; they feel I owe 400% more because they didn't do what they said they did.  I have referred this to the wisconsin attorney generals office. 
Regards,
Jeanette Rose

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.] Based on the documentation I received both prior to and at the time of the visit, including the attached receipts, there is no balance owed by me. The fact that they feel they did not receive full payment from the insurance company is strictly due to the businesses own faulty billing practices and the patients should not be held accountable for their employees mistakes.  Since my involving the Revdex.com did not resolve this, I have it to the Wisconsin Attorney General's office.
Regards,
[redacted]

Review: The business office manager told me they were a preferred provider of my insurance plan without checking with the plan. After the appointment, she called the insurance plan and found out they are not a preferred provider. Consequently, the insurance will pay only half of the charge. I agreed to the appointment fully based upon the manager's assurance to me of their preferred provider status. I would have made the appointment only with a preferred provider.Desired Settlement: Please credit my account for any balance due caused by the manager's failure to verify preferred provider status with the insurance company.

Business

Response:

Midwest Dental will respond by the end of today.

Thank you.

Jo Ann Franz

Business

Response:

[redacted] was seen on 8/26/14} the same day she filed the complaint.

As of this date} Midwest Dental has not received payment from her insurance

carrier} so we are unable to respond at this time. Once we receive payment and

the explanation of benefits} we would be able to provide a response.

Thank you for your time.

I was a patient at Midwest Dental for 14 years. Last October I missed a visit and they charged me $37. I called multiple individuals and they would not remove the charge. I would have expected that after 14 years of collecting my families money for services that they could excuse my error. Very disappointed in the customer service. Customer beware!!!

Review: On January 20, 2015, my daughter was seen by the provider. It was determined some additional dental treatment was necessary and I received a treatment plan that stated my portion of the $1,148.00 estimated charges would be $114.80. I agreed to the treatment based on this price as I was told they had verified my insurance coverage. It even states in their "Patient Treatment" policy that "we will do all we can to ensure your estimate is as accurate as possible".

On 04/08/2015 I received a bill in the amount of $417.60. I called [redacted] at Midwest Dental on 04/09/2015 to inquire as to why the 463% increase in my portion of the bill. She stated that my insurance doesn't cover the type of filling material used on back teeth. I inquired about what information was provided to Delta Dental (my insurance provider) so I could find out if the mistake was on their part or Delta Dental's. She assured me that they call and verify insurance and that they had informed Delta Dental what type of material would be used. I immediately called Delta Dental, my insurance provider, and spoke to [redacted] who informed me that no one had ever called to verify my insurance and that if they had, they'd be given a confirmation number. She asked I get the confirmation number or the name of the person Midwest Dental spoke with. I then called [redacted] at Midwest Dental back and she said insurance verifications were done by their Insurance Center (###-###-####). She reassured me that all insurance is verified and their insurance center could provide me with the information I needed. I called Midwest Dental's insurance center on 04/13/2015 and left a message for [redacted] to call me back. I never heard back from [redacted] but [redacted] called me back and said it had been verified via Delta Dental's automated system. She was unable to give me any confirmation number to prove they attempted to verify insurance prior to these charges. I informed [redacted] that I would not have agreed to the services had I known the true cost of the services.Desired Settlement: I want the remainder of the bill waived. They lied about verifying insurance coverage on numerous occasions and their failure to do their due diligence is nothing short of extortion.

Business

Response:

Dear Sir or Madam, As with all patient's insurance, we would encourage them to review their insurance policy.Patient's treatment is not based on insurance coverage, it is based on individual patient needs to achieve the best outcome of treatment.While benefits are verified, restorative procedures which include amalgams and composites, the treatment estimate was based on information on the insurance website.The treatment plan includes codes in which the benefits to include limits, frequencies ect. can be verified by the patient. We feel our forms clearly outline this opportunity and expect payment from the patient.Thank you.Sincerely,[redacted]Collections ManagerMidwest Dental, Inc.

Consumer

Response:

My elderly mother was a client of Midwest in Eau Claire where she got good enough care. She has recently moved to Green Bay to Asst Living. In Dec she had broken tooth and Midwest filled it. They encouraged me to get her teeth cleaned. I made an apt on June 20 2013 for today July 31. Last evening around 5:15 I got a call from them letting me know they would be doing xrays perhaps a panoramic view even of her to assess what type of cleaning she would need and the cost would be well OVER $350. I said it was my moms wish to not spend this and I never heard of needing xrays to determine type of cleaning. She is 93 1/2 Years old!! There was no budging on their part. I called the Midwest headquarters in Mondovi this morning and they were concerned I was just made aware of this last night and promised to call back perhaps even giving my mom free xrays for all the hastle. I NEVER heard back from them...only the Midwest dentist here in town saying well my mom could have oral cancer, she could have absc

ess on and on. She mentioned nothing of the issues I had talked to the headquarters about. I have contacted my own dentist in town who is willing to see my mom and do limited xrays exam and cleaning for about $169.00. I had all arrangements made with the asst living to bring mom into today and now have to start all over. All this with NO caring or offer to work with me. I do NOT recommend using Midwest Dental to anyone. Money does NOT grow on trees for the elderly!

Review: The billing practices of this company are very underhanded. They give an "estimate" of the cost of services but fail to inform the patient that the services being performed are not covered by the insurance company. The company has an obligation to give an accurate representation of costs involved, this company did not under the guise of an estimate. They gave me enamel fillings instead of amalgam, didn't give me a choice. They had every opportunity to verify my dental insurance coverage but did not. As a lay person I had no idea the difference in cost between enamel and amalgam nor did I know I had a choice in materials. This is the cost that was misrepresented. As a provider it is their responsibility to quote a price that is indicative of the procedure and materials being provided, as well as give me options to mitigate my costs not my responsibility as a patient to make sure I'm not being mislead.

Product_Or_Service: cavity fillingDesired Settlement: DesiredSettlementID: Refund

Many dentists will write off this extra expense, I will not ask the dentist write off the entire difference however I'm asking them meet me half way and split the difference. I'm not unreasonable but do believe they have to be held accountable for fair billing practices.

Business

Response:

Mr. [redacted] and his son [redacted] presented for their appointments on August 7,2013.

At that time, [redacted] was presented with a treatment plan for himself and a treatment plan was

presented to [redacted] for their son [redacted]. The procedures were explained and [redacted] signed his

treatment plan and [redacted] (mom) signed [redacted]'s treatment plan and they were given a copy.

Both treatment estimates state the following:

THIS IS ONLY AN ESTIMATE. Insurance coverage is subject to exclusions, deductibles and

maximUlns which is your responsibility. Please contact your insurance company for a detail

of your benefits.

The services that Mr. [redacted] is disputing were done on August 14, 2013. He had every opportunity to

contact his insurance carrier to inquire on benefits available, prior to the services being rendered.

In addition, the patient was presented with Midwest Dental's Financial Policy; that he signed. Which

includes language about estimates and benefits quoted that may differ substantially due to any number

of reasons for which we do not have access to the complete dental policy. These include but are not

limited to:

• Exclusions and Limitations

• Waiting Periods

• Previous Treatment

• Medically Necessary

• Age Restrictions

• Specific Code Restrictions

• Insurance Company

Enclosed is a copy of the signed Financial Agreement that states:

I understand the about statements and agree to be personally responsible for my care, even

in the event my insurance company denies care, for any reason.

Patients have an obligation and assume responsibility of their insurance benefits and provider panel.

We certainly are available to assist in the process, but it is ultimately the patient's responsibility to

consent to care and accept financial responsibility.

The balance due was $248.16 and now has been paid in full on September 20,2013.

Thank you for your time.

Patient Finance Coordinator

Midwest Dental, Inc.

Enc:

Account

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

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

Review: I have been going to Midwest Dental for years, and went to my dentist for pain in tooth. They sent me to a specialist for a root canal in December. I was under the impression that this was all included as the same procedure. UNTIL they sent me a very large bill and telling me that my dental insurance had ended at the end of Dec. Midwest Dental put a temp. crown in on Jan 20th. I was not informed that this was going to be two different bills.

Business

Response:

Dear Sir or Madam,

We do not understand how the patient can believe that the charges from Endodontic Specialists ( who are NOT affiliated with Midwest Dental) could be considered to include future work to be done by Midwest Dental. As an example: If you hire a plumber to repair some plumbing issues in your bathroom and once those issues are resolved, you have a contractor instill a new fixture in that bathroom, you would not assume that the fee that the plumber charged for his services would cover the cost of the new fixture and its installation by the other contractor; just because both services were necessary to resolve the problem.

Midwest Dental did not learn of the patient's insurance termination until a claim for the crown had already been submitted.

Again, the patient would have been informed of his insurance status by his insurance provider.

The balance due is $ 322.40.

Thank you for your time.

Regards.

Review: Paid for services in advance and as a result overpaid by almost $800 after insurance claim was processed. Dentist acknowledged partial error and committed to audit of account for refund of overpayment in Nov 2012, to no avail. Dentist also bills minor child for patients unrelated to our family - a clear HIPAA violation that has been brought to their attention more than once. Dentist office refuses to respond to correspondence from me and my attorney and has failed to reimburse for overpayment though they have acknowledged it exists. Further, they have discontinued any and all billing correspondence since attorney became involved, indicating that they know there is an existing problem.Dentist billing practice is unethical.

Product_Or_Service: DentalDesired Settlement: DesiredSettlementID: Refund

full refund of remaining overpayment in amount of $496.60

Business

Response:

Enclosed are copies of account ledgers for [redacted]'s family and copies of the explanation of

benefits for [redacted] .

After further review of her account, we found that insurance had not processed for DOS 12/28/11 for a

total of $85.00.

We will re-submit to her insurance carrier to see if they will pay the claim, however they may deny the

claim because of timely filing.

Regardless, $85.00 was adjusted off her account today and a small insurance adjustment was reversed;

leaving a credit of $86.00. [redacted] will be refunded the $86.00 the week of 8/12/13.

Her total refund is $439.60, which includes the $353.60 that was refunded earlier.

Thank you .

Patient Finance Coordinator

Midwest Dental, Inc.

Enc.

Review: I brought a transplant external dental exam form to the Midwest Dental Reedsburg office, and asked the reception to look into the form. It turns out the reception took away my form to a dentist, and filled in everything on the from WITHOUT my agreement. I didn't even see a dentist on my visit. A potential post-effect could be I am removed from the transplant list due to the dentist unauthorized action!!

Business

Response:

This is in response to the complaint that [redacted] has filed with your organization.

Mr. [redacted] presented at our Reedsburg office on July 8,2013, with a transplant external dental exam

form from the UW Health Transplant office to complete.

Enclosed is a letter from [redacted], our Business Office Manager at the Reedsburg clinic, which

explains the events that occurred on July 8, 2013. In addition, I have enclosed a copy of the completed

UWHC Transplant office form; that Dr. [redacted] completed.

The patient was diagnosed with active abscesses and as of this date has not scheduled treatment.

Midwest Dental fulfilled their obligation by completing the form with the information available.

If Mr. [redacted] was removed from the transplant list due to an infection that has not been addressed, this is

beyond our control. This would be Mr. [redacted]'s responsibility.

Thank you in advance.

Regards,

Patient Finance Coordinator

Midwest Dental, Inc.

Ene: Letter from clinic

Review: I have had problems with this company for the last year. They repeatedly rescheduled my appointments a couple hours before the appointment or asked me to change my appointment on numerous occasions. I missed work on numerous occasions only to be rescheduled again. I had gone in for a filling this previous summer and they actually had me scheduled for a filling on a tooth they had removed per their referral. several months prior. I also had an appointment this fall that was for a repair causing extreme constant pain. I was asked to come in earlier and when I was able to leave work I was told the appointment had been cancelled after waiting 3 weeks to get in and not being able to eat solid food. The receptionist is very rude and not a people person and is terrible at people relation. She should not be a receptionist anywhere. She was not accommodating at all and talks in circles and does not give clear responses when asked a question. She was unwilling to help find another dentist to help with the pain issue, that same day after getting in another office they had shut down the office for the day, so I was not able to get all records needed, as the receptionist failed to fax documents requested by the office completing the repair. It is also one of the most unprofessional businesses I have ever been to. I know the personal details of the perpon who cleans your teeth and the dental assistant to the point the dental assistant told me how much she disliked the receptionist and how she purposely gave her bogus compliments to kill her with kindness,so the receptionist would not be so unfriendly to her. . As a patient I was extremely dissatisfied to know another the personal turmoil between staff. The fillings I got are all subpar and need to be replaced. They did not even allow enough room for flossing. And my bite does not align at all. Also previously with having a tooth removed they did not mention anything about spacers for implants which should have been done at the time of extraction. Their advertising says they do removals but they do not you are referred to a different company. They did not explain details of procedures either. I just received a bill for services done 4 months ago with no due date, I called and said I can not pay this right now it will be about a month. When asked how much actual time she said "1month" I asked if that is becasue I said it would be about a month she said yes. What kind of a business does not give an actual due date. After going here I visited a other dental office and their practices were much different making this particular companies practices completely out of date and subpar. I have never been more dissatisfied in my life. Also at one point the receptionist double billed me asked me to come to the office because she needed card in hand again left work early and when I got there she said she took care of it. I never received update information so I again missed work and went across town for nothingDesired Settlement: I want the actual dentist to know what is going on at her location as the receptionist will not let you talk to anyone in the building except herself. You ask to speak to someone else and she flat out says no.

Business

Response:

To whom it may concern:[redacted], who is Midwest Dental's Professional Services Coordinator, called [redacted] on December 17, 2015 and December 21, 2015, and left a messages on [redacted]'s voice mail to return [redacted]'s call.[redacted] requested that [redacted] provide records from her current dentist for our review, as of this date; [redacted] has failed to call [redacted] back.Once [redacted]'s records are received, Midwest Dental will be able to respond to [redacted]'s complaint. Thank you in advance.[redacted]Collections ManagerMidwest Dental, Inc.

Consumer

Response:

Review: MidWest Dental located in Wells, MN and part of this company has failed to make sure the dentist that performed my dental work was registered with the state for MA and then charged me on both my CC and sent in a claim to the state for the charges without taking it off the cc so they charged me twice. this is unethical and I think fraud. they say they will not remove the charge from my cc until the state has paid them but the state has said that they have not even billed MA but they say they did. All I want is for them to stop the cc from charging me and calling me. they know they will get the money from MA so they need to remove it from the Care Credit credit card that they charged it to. They also need to stop givimg us the run around and get ALL the dentist accredited with the state if they are going to practice in this practice.Desired Settlement: I want them to issue a credit to the Care Credit credit card for the full price of $351.00 plus intrest and late fees used for the procedure and submitt the bill to MA like they was supposed to do!

Business

Response:

[redacted] was seen at our office on 9/3/2013; on an emergency visit for a toothache and

associated swelling. The patient had no insurance coverage or Medical Assistance coverage on

9/3/2013.

Dr. [redacted] discussed the treatment options for tooth #15 with the patient, and the patient

opted to extract #15 and insisted it be done that same day.

Prior to extracting #15, the cost for a routine extraction or surgical extraction was throughly

reviewed with the patient. The cost was written on the extraction consent form, signed by the

patient, doctor and witness.

We ask that patients without dental coverage to pay for the treatment the same day service is

completed. The patient paid for the treatment with a Care Credit card.

The patient then later, received dental coverage 9/13/2013 through Medical Assistance. We

submitted the claim on 9/24/2013 because Medical assistance is able to back date coverage.

The claim was filed for payment of treatment.

Spoke with Patients wife, [redacted] and she was informed that we can not pay back the amount

billed until we receive payment from insurance. Also, since Care Credits agreement is IINo

Interest" as long as monthly payments are made on time. They should continue to make payments

and Midwest Dental will pay back the full amount of the fee that was billed to patient.

Dr. [redacted] M, [redacted]

Midwest Dental

Review: In November 2015, my husband and I went in for cleanings with Midwest Dental. We were provided with "estimates" of what we needed done and cost associated. We were told we have money left with our dental plan for the yearand we should use it up by the end of the year. I questioned the estimate and was told it was correct; with 4 kids I lose track and count on them to be honest. My husband's appointment was scheduled for one week later. He had ALL his work done in two 4 hour appointents and before my appointment I received our EOB's saying we owed the full amount for his work. I went in for my appointment and questioned it and was told it was submitted wrong to insurance and to not worry however I did make them call before I would have my work done and verify. It was determined I didn't have enough money left to have all my work done and my appointments were modified and one was cancelled. Their office manager admitted to me she submitted the insurance wrong and nothing was covered!

The billing practices of this company are very underhanded and are fraud. They give an "estimate" of the cost of services but fail to inform the patient that the services being performed are not covered by the insurance company. Any complaints are responded to with the same generic letter that the patients signed the consent forms, and all costs are that of the patient; however telling patients something is covered then to find out not $1.00 of it was covered is misrepresentation and fraud! The company has an obligation to give an accurate representation of costs involved, this company did not under the guise of an "estimate". They had every opportunity to verify my dental insurance coverage but did not and point the blame back at the patients since we are suppose to call and verify coverage. It even states in their "Patient Treatment" policy that "we will do all we can to ensure your estimate is as accurate as possible". I would not have agreed to the services had I known the true cost of the service.

I was at my old dentist for 20 years (which now we have gone back) and never ONCE was their estimate wrong for a crown, filling, root canal, anything. Never $1.00 over so how can their insurance billing practices be so wrong? You can read the other complaints around the web; Midwest Dental takes no responsibility for messing up patient bills and sends the same generic response to everyone.Desired Settlement: I believe they should comprise on our bill! We should have known the day we had our cleanings the actual amount left in our dental plans. Their office manager admitted to me she messed up our insurance. We were told we would have a very minimal and now we have over a $2,000 bill which we would have never agreed too. No one in their right mind would agree to have that much non-emergency work done!

Please don't waste your or my time by responding with your generic letter - I already have a copy of it from the Wisconsin Department of Agriculture, Trade and Consumer Protection. Something showing you care and are willing to comprise on your mistake would be nice!

Business

Response:

Dear

Sir or Madam,

Midwest

Dental responded to [redacted] @ the Department of Agriculture, Trade and

Consumer Protection on May 20, 2015, regarding a complaint from [redacted]. Enclosed

is a copy of that response.Midwest

Dental has not changed their position, as the Treatment plans were presented

in advance of dental treatment.

The patient had the opportunity to reach out to their dental insurance carrier

to verify coverage, as the treatment estimate lists the specific ADA codes. The

Midwest Dental Baldwin office was contacted for comment on the complaint and below is their

response:“The family had immediate dental needs

and none of the services provided were cosmetic in nature. The husband’s

chart notes indicate that he was in urgent need of dental care and was also

working with an oral surgeon for implants. The family members had

significant active decay.

Patients presented with two insurance

plans. Both were DD of MN plans. We did caution them at their first

appointment that there may be a coordination of benefits or non-duplicating

clause. The conversation regarding the insurance that the patient had

referenced in the complaint was a primary/secondary assignment issue for the

children. The husband had only one insurance

plan, but had presented with two. He was not included on his wife’s

plan. When [redacted] had quoted him at the desk, she stated “now with your

two insurance plans . . .” and the patient did not deny secondary insurance

coverage. The

maximum was shared for the family which was a new limitation of the plan. “Patients have an obligation and assume

responsibility of their insurance benefits and provider panel. We certainly are available to assist in the

process, but it is ultimately the patient’s responsibility to consent to care

and accept financial responsibility. The service was rendered and the

balance stands at $2358.20. Regards,[redacted]Collections

ManagerMidwest

Dental, Inc.

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

I have reviewed the response made by the business in reference to complaint ID [redacted]. I was finally able to speak with [redacted] from Midwest Dental and she was beyond awesome! We were able to talk through what happened for both sides to understand where each was coming from. We were able to come up with a presentable offer which she submitted to her team. The offer was accepted and our bill is paid. This resolution is beyond satisfactory to me.

Regards,

Review: For my daughter's visit on 4/14/14 patient responsibility was $103.60 but we paid our $50 credit (from being overcharged the previous visit) plus $106.00 via Mastercard, an overage of $52.40. When I called their office on 5/5/14 I was promised a refund within 2 weeks. Then I called on 5/27/14 because our card was still not credited and at first was informed I had no credit coming, but later in the day [redacted] replied to my email & told me I did and that I should call the next day with my credit card number. I gave them that number on 5/28/14 and was told I would see the credit within 24-48 hours. Then on 6/3/14 I called & informed them we had not yet received the credit. [redacted] left me a message stating it was not processed until 6/2 (with no explanation why) so we would see it within 24-48 hours from that date. I again emailed on 6/5/14 to let [redacted] know there has been no credit. It is now 6/6/14 and we STILL have not received the credit.Desired Settlement: Credit my card and mail me the receipt as proof. An apology would also be nice.

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

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

The credit has now been received.

Review: Was charged for an expense that I was not notified about ahead of time. Thought my entire service was covered by my insurance and and didn't know it was not. The clinic claimed to have informed me of the issue but in fact they did not.Desired Settlement: Refund of the amount paid and removal of the service from my insurance deductible.

Business

Response:

Dear Sir or M[redacted] presented to our Midwest Dental Appleton practice on 12/14/15 and 12/23/15.As of this date, insurance is pending on both of these dates of service and no co pay/co insurance was collected.His complaint states the DOS was 12/17/15. Enclosed is a detailed copy of his ledger, signed patient treatment and financial policy and signed treatment plan for your review. Thank you.[redacted]Collections ManagerMidwest Dental, Inc.

Consumer

Response:

Review: I have been a patient of Dr.[redacted] of Sullivan, Mo. office for over 10 years. Recently it was taken over by Midwest dental. My issue began with a loose crown that at the time of service I was assured it lasted a lifetime if taken care of, and Dr. [redacted] would warranty it as long as my dental maintenance was kept by him. It was, when my crown became loose I contacted the office and was immediately told it had no warranty that it was done prior to Midwest dental taking over. I was upset, and concerned because at my last cleaning I was told I had 4 cavities on top that had apparently developed from 6 months prior when all I needed was lower partials. I went to establish with another dentist for an estimate to help with my loose crown. The dentist took xrays and examined my teeth and could only find 1 small cavity, after double checking.?? Quite suspect on my end. I afterwards spoke with Michelle from Midwest dental and she offered my loose crown removed, and a flipper for a discounted price of $415.00 and her and everyone in the office stated insurance covered no portion of it. Later I received notice my insurance covered $279.00. I was promised a refund as soon as all insurance payments posted. My flipper came in and was very tight, the assistant could hardly get it off the mold, and Dr.[redacted] had to use tools to take it out of my mouth to adjust, at that time I heard a crack, and Dr.[redacted] looked at the assistant obviously it broke, and the corner was cracked, and he smoothed it over. The tooth on the flipper fit and Dr.[redacted] kept shaving more and more off, commenting on how thin it was. Just weeks later the tooth broke off. I contacted Michelle to inquire on getting my refund for the $279.00 insurance overpayment ,and a full refund on the flipper. She called back and said I would need to sign a paper to receive my check for the $279.00 and that Dr.[redacted] would replace a flipper free of any charges. When I went in for another impression I signed a paper that had free of charge per Dr.[redacted] circled and in the corner my refund amount being only $245.00. I questioned and was told she would have Michelle contact me about the other $34.00. I never received any notification other than my check was mailed out of Wisconsin on 8-19-14. When I received my refund check it was only $110.70. The free flipper was picked up by my husband no office visit or adjustments needed to be made, this is unacceptable and needs to be made right. I now want a full refund and Dr.[redacted] can have both flippers back.Desired Settlement: I want my $415.00 paid initially, and $168.30 balance from my refund I was suppose to get. Total of $583.30

Business

Response:

Dr. [redacted] reviewed Ms. [redacted]'s complaint and responded with the following:

[redacted] was a patient of Dr. [redacted] and Associates beginning May 1, 2006 (not for over 10

years as she stated). On July 7,2008, [redacted] presented to Dr. [redacted]'s office and saw Dr. [redacted] for

endodondict treatment on tooth #7 and crown preparation with post and core buildup. That crown was

seated on July 28, 2008. At this time, Dr. [redacted] had a warranty that stated; that if a crown needs

replacement and the "TOOTH IS STILL SAVABLE ... AS LONG AS DR. [redacted] AND ASSOCIATES MAINTAINS

A PRACTICE OF DENTISTRY and YOU DO YOUR PART" Dr. [redacted] will replace any crown with a new

crown of the same type at no charge.

Ms. [redacted] states that she had a "loose crown" when in reality she had a loose tooth, likely as a result

of a root fracture and subsequent bone loss around that tooth ( therefore rendering the tooth not

savable). The warranty does not apply to the tooth, only the crown. In any event, when Dr. [redacted] sold his

practice to Midwest Dental on October 1, 2012, this warranty was rendered terminated, since he no

longer "maintains a practice of dentistry" in Sullivan. In addition, she did not "do her part" by having the

required minimum of 2 visits per calendar year, as specified in the warranty. She claims that her dental

maintenance was "kept", but clearly it was not. During one span she wentfrom December 23,2011 to

April 16, 2013 with not visits. She also had several no show appointments which also renders the

warranty void.

[redacted] also states "that she had 4 cavities on top that had apparently developed from 6 month prior

when aliI needed was lower partials". She was informed several times that there were smaller fillings

that needed to be done at some point if she opted not to do the bridges that I recommended for the

missing teeth on the upper. They are clearly listed on her treatment plan sheets from December 23, 2011

and from April 16, 2013. The only changes were additional surfaces on 2 teeth, a filling no longer being

an option on tooth #14 and new decay evident on tooth #6 that became noticeable after 15 months.

What another dentist interprets as necessary treatment is not in my control. My diagnosis was

consistent all along. In fact, I had to remove two surfaces from the recommended treatment on #3 that

looked decalcified and needing restoration in 2011, that were possibly more related to stain and had

been cleaned off after the exam in 2011 or had some re-mineralization since.

We offered her a 25% courtesy discount on her flipper that was done on 5/27/14 for $538.00, as she was

upset about the warranty (although I was not obligated to offer this discount). That made the fee

charged to the patient $403.50. We told her that very rarely will insurance pay benefits on an interim

partial, but the service was submitted to her insurance. As it turns out, her insurance provider paid 50%

($269.00).

Since we charged her a discounted amount and insurance paid base on the full amount, we had to make

an adjustment to the amount that she could be refunded. Either we accept the insurance payment and

reverse the discount (charge her the full fee) or keep the discount and return the payment to her

insurance provider. She can't have both the payment and the discount. Since it was better for her to

accept the payment, the Midwest Dental Support Center adjusted the amount by $134.50 and refunded

Ms. [redacted] $110.70.

[redacted] has given us no indication of any problem with the second flipper. When contacted, after her

husband picked it up for her (a practice I do not recommend), she reported that it fit perfectly and had no

problems. She had never contacted us with a complaint about the second flipper. She had some issues

with her first flipper, we made a second one at no charge and I feel that we have done our part to satisfy

her concerns.

Dr. [redacted] asked to have the original 25% be applied to her account. Since then a refund check was

mailed to her on 9/11/2014for $134.50.

Enclosed for your review are:

o A copy of [redacted]'s history file, showing that the original crown was done tooth #7 on 7/7/08, by

Dr. [redacted].

o Proof of her of her last appointment 12/23/11 as indicated on her history file copy.

o A copy of the "Our Last Time Warranty".

o Treatment plans from 7/7/08, 12/23/11 and 4/16/13.

o A copy of [redacted]'s "worked ledger" indicating her next date of service was from 4/16/13 to

8/7/14.

o The work sheet used to calculate her refund.

o The treatment plan dated 5/27/14 that indicates the cost of her first flipper and reflecting no

insurance benefit- but also shows $402.50 out of pocket. (s/b $403.50- 25% off $538.00).

o The signed informed consent for dentures dated 5/27/14.

o The write off request from Dr. [redacted] to allow the courtesy 25% discount.

o The refund request cover sheet.

o A copy of the refund check for $134.50 issued and mailed to [redacted] on 9/11/14.

Ms. [redacted] received the services and Dr. [redacted] made every effort to satisfy her needs and that the

refund total of $245.20 is correct.

Thank you for your time.

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

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