Mountain View Oral Surgery & Implaint

Review: Went in for a consultation on wisdom teeth removal. So after the consultation we spoke figures of course, I requested to have a different type of anesthesia sine I knew it would bring the bill down, because I don't have a lot of money but needed the procedure since my wisdoms are causing some sensitivity issues. Well Dr. [redacted] adjusted it accordingly for me and brought the price down, which I appreciated.

On to the issue, in the next room they take your insurance and basically give you the break down of what you'll owe and what insurance will cover, so along with that I request that everything be PRE APPROVED with my insurance because I have been burned before with the Dentist office next door (ya know, tell what ya want then screw you later), before I commit to the surgery. Within about 5 minutes I was told the break down and I specifically asked if everything was covered, while thinking that was a fast determination. The answer was yes, so I commit the the surgery for a march appt and give them half of my deposit . Showed up to the appt, payed my other half which squared my bill up and went along with the surgery which went well.

Well low and behold about a month later or so I get a bill for $900 + dollars. So I call and the lady behind the desk said they will run it through since they tried dental, which I don't have!!!!! So that immediately tells me someone didn't do what I SPECIFICALLY REQUESTED, but I gave the benefit of the doubt and waited to see the outcome..

Well another bill shows up, so I call again , once again the lady behind the desk tells me they keep trying not to worry about it.!!!!!

At this point I am worried, like I said before I dont have $900+ lying around like they must think, I am in a single income home with a child and just don't have it, which is why I made a specific request to have everything PRE APPROVED!!!!

Well turns out the didn't do [redacted] but feed me what I wanted to hear for 5+ months and now the lady behind the desk is telling me that the Dr. said "the bill is what it is". Ive requested to speak with him, because I am sure he's not getting ALL the FACTs, just what someone thinks they know at the receptionist desk. So I call again today after receiving another bill 8/21/15, and try to bypass the RECEPTIONIST by asking to speak to the Dr himself, and im told it would be best to write him!?!?!?! Are you serious, this is 2015 who the hell writes letters anymore, do your [redacted] job and pick a phone up and admit to your mistake instead of [redacted] over people who made specific requests while trusting you to do your jobs!!!!!!Desired Settlement: I would like my bill wiped clean, because I feel I did everything I could to cover my own by requesting pre approval and was basically told what I wanted to hear to get my $$$$$.

I work in the automotive field, and if I were to give a bad estimate or tell someone something when its not true then get caught, id make it right instead of hiding behind a receptionist who dos nothing but answer phones.

Got knows Doctors in this area are known for gouging there customers already!!!!

Business

Response:

This patient came to our office initially 2/13/2003 for a consult for wisdom teeth. The patient was given a treatment plan which included general anesthesia and the removal of four wisdom teeth. The patient at the initial presentation was given a treatment estimate and had a predetermination of benefits sent to his dental and medical insurance. The patient never had the surgery completed. The patient presented back to my office two years later on 3/13/2015 in pain with his wisdom teeth and now wanted the teeth removed as soon as possible. The patient was given a prescription for pain medication and antibiotics to help calm down the infection and pain. At the second consultation the patient was given a revised treatment plan and the general anesthesia was removed and replaced with nitrous oxide analgesia to lower his costs. The patient presented to our office with a new insurance card which listed his medical and dental benefits on the same card. The patient was given an estimate of payment required to schedule the surgery. The patient was interested in proceeding with the surgery as soon as possible and did not want to wait the two weeks for the treatment estimate. The patient was told that a predetermination would take two weeks for insurance to respond. The patient proceeded with surgery four days later. The treatment estimate clearly states “your signature below means that you and your doctor have reviewed this plan of treatment and you agree that you approve and understand it and agree to the fees and terms. All efforts are made to determine your surgical costs, however; this treatment plan is an estimate and may be subject to changes based on insurance coverages and findings at the time of your surgery.” Furthermore the financial policy of the practice which Mr. [redacted] signed states the office will help assist the patient with receiving the maximum allowable benefits under their insurance policy. The patient is ultimately responsible for their account.

In the case of Mr. [redacted] it turned out the patient had no dental benefits and his medical insurance did not cover any of the procedure. [redacted] medical insurance has not covered wisdom teeth removal for two years and my staff would never tell a patient that his medical insurance would cover this procedure since [redacted] has changed their benefits and most of the time does not cover the surgery. Of course there are always exception to these rules which our office cannot have knowledge of for all patient encounters. The patient was quoted a copay based on an anticipated insurance reimbursement from [redacted] dental which when billed came back as showing the patient had no coverage.

No one attempted to mislead Mr. [redacted] but rather help facilitate his care since he was in pain and wanted definitive relief of the problem after putting off the procedure for two years. Furthermore, attempts were made to reduce the healthcare costs to the patient by developing an alternative treatment plan which was less costly.

It is unfortunate that Mr. [redacted] is upset that he received no coverage from his insurance plan. In today’s rapidly changing insurance environment the patient has to assume some responsibility in checking their benefits. Mr. [redacted] had his benefits preauthorized the first time he came in to our practice. At the second consult visit it would not be feasible to get a preauthorization back in time for his surgery scheduled in 4 days from his consult visit. The patient had the option of waiting for a estimate of benefits to be returned back before proceeding with the surgery. At this juncture I would be more than willing to have the patient set up a payment plan with our office to settle his account, but the balance will not be written off since the services have been rendered.