Niantic Dental Associates

Review: I brought my son in for his regular cleaning which is a service 100% covered by my federal health insurance (which is not a true dental insurance). At that time, it was advised that he return in a couple of weeks for sealants on his molars which are also 100% covered by my health insurance. He attended the next visit, sealants were put on his molars and no payment was asked for. I later received a bill for $330 for a service for composite resin FILLINGS on his teeth. On the say of service, there was never any mention of a deviation from the plan to simply put sealants on the teeth. The dentist did not say a word about it despite the fact that my husband was present in the room and the treatment took less than 10 min. I called and asked why there was this bill, and they insisted they put fillings in his teeth. Upon multiple phone calls and consulting the nurses and office manager, it became clear that they did not do any deep fillings or drilling, but simply scrapped the tooth and filled it with a heavier coating of the same sealant material they had planned to use. They insisted that this sealant/minor filling is not covered by my health insurance. I called my health insurance who told me they do cover sealants, and do not have a differentiation between them. Ultimately, y sons appointment was for sealants, it was the treatment we were expecting him to receive, we were under the impression the service was 100% covered by health insurance, we were NEVER told of any deviation from that plan or costs that would result thereof and a costly treatment was performed on my son without my permission. I received a letter of apology from the office regarding the "miscommunication" and we were offered to pay on a payment plan, but I am not satisfied with having to pay for a service I DID NOT AUTHERIZE. I feel there is devious intent here, and possible malpractice.Desired Settlement: I would like the pending bill to be revoked as I do not feel we should be held liable for a service on our child that we neither requested, nor autherized. It should have been discussed with us, regardless of whether it costs extra or not, and especially should have been cleared with us considering the cost , as it was clear we did not have "dental" insurance.

Business

Response:

Response:

The technique used to treat the claimant's son is called "Air Abrasion". It uses a stream of air and aluminum oxide at approximately 80-100 psi to gently clean grooves of teeth prior to sealing. It is also used to remove decay from grooves in teeth in the same manner. The teeth in question were indeed treatment planned for sealants, but when the grooves were opened with the AA, they were both found to have decay beyond the enamel and into the dentin. Not deep enough to require anesthetic or drilling, but into the dentin.Once this occurs, we as dental health providers do what is in the best health interest of the patient, we removed the diseased tooth structure and restored the tooth with a "Filling" as opposed to a sealant. Does the coding officially change at that stage, yes. Does the fee change, Yes. To fee it out as a sealant at that point would be insurance fraud. Not treating the infected tooth structure could be malpractice. Had the decay been detectable without opening the groove might have been acceptable to leave until the claimants insurance was active, maybe, but in this case it was not possible to wait. The child's father was informed by myself and by my assistant that fillings were performed. Parents are always informed of the treatment we provide for their children. Whether or not he remembers is a possibility. I don't know. The statement that the claimant made about the filling material is correct, but her facts are misstated as she does not know what I used for materials. It turns out that the material that I prefer for performing sealants is actually a final filling material and not a sealant material. I find the sealant materials fail too quickly and wear out, whereas the flowable filling materials will last much longer. The original billing issue may have come back to the receptionist who checked her family out that evening. She may not have realized that the fillings were not covered under that particular plan as most plans do. She more that likely said that we would bill the insurance and follow up with them should their be a balance. Honest mistake as far as I am concerned. We have reduced our fee by 10% as a good faith gesture and have allowed the family to pay the balance over time which is not our office policy to pay all balances at the time of service. The fact that the parent feels that we were devious is only in her mind. There was no deception at all. The statement that there was possible malpractice is slanderous.

Sent on: 1/30/2014 5:47:50 PM

Consumer

Response:

Review: [redacted]

I

am rejecting this response because: In regards to : "The child's father

was informed by myself and by my assistant that fillings were performed.

Whether or not he remembers is a possibility. I don't know." This is

simply not true. My husband was NEVER informed as this is not something he

would not remember and the implication is thoroughly insulting. As a parent,

this insinuation is absurd. Neither the dentist nor the assistant informed us

as to what was going on. Regardless of what they feel is necessary, the fact is

that they performed an expensive procedure that was not approved by the

parents. The letter sent to my residence, as attached to the original

complaint, refers to the "miscommunication" in my view admits that it

was not made clear.