Northern Smiles Dentistry & Orthodontics

In regards to complaint  ID# [redacted] from [redacted].  We researched his file from his previous dentist Dr. [redacted] and the lab slip stated all porcelain crowns for teeth #6-11dated  October 21,2009.  We have enclosed copies of previous lab slip,preterm nation of...

dental benefits. We replaced #8 on April1, 2015 with an all porcelain crown, which was previous a porcelain crown. This is the same type of crown that was placed by previous dentist. Due to replacing the same type of crown,no discussion was to be made as a different type of crown would have not looked the same and not matched the other crowns that were placed by Dr [redacted]. His complaint should be with his dental insurance company due to them giving an alternative downgrade to porcelain fused to high noble metal crown and paying less thus causing his portion to be higher.  When treatment was diagnosed the complainant asked for us to do a predetermination for the crown which we did and a copy from the insurance company is sent to patient and provider.  When we received the predetermination the patient was called and it was discussed and the patient proceeded to schedule the treatment. It was agreed that the patient would pay !It of his patient estimate at prep appointment and the balance at his seat appointment. After the crown was cemented and in collecting his balance is when the patient informed us of his concern of us not coding correctly and not doing the same crown that was previously done. His balance at the time was $266.90 which we had decided to adjust off 50% ($133.45} to make the patient happy which we thought was more than fair and a courtesy that did not need to be made but was made in good faith to establish a better doctor  patient relationship.  This was unsuccessful and he stated he was not happy and will not be returning and would be contacting the Revdex.com walking out of the office. He did pay his balance of $133.45 in full and his account has a zero balance. We strive to provide great customer service to all our patients and feel that this patient was handled in a professional and courtesy way. We feel that we explained and answered all questions that were asked. We will not be giving any more of a refund or discount that has already been offered due to the complaint of different crown was false and shown with the lab slip, and that the predetermination of benefit that the patient received from insurance company and gone over prior to treatment being started and completed clearly shows the patient financial responsibility of cost of the crown and the patient was happy and satisfied with the crown itself,not the cost which is set by the insurance and his dental benefits.Sincerely,[redacted], DDS

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

You said that my old dentist has ordered the same cap type before, I see your attachment of the [redacted] code, and now I understand what happened. Even my Insurance gave me bad information. Your form I signed, said I will owe $433.80 see attached it's is circled so I believed that was the price (estimated give or take 5 or 10 dollars). When I talked to the financial person she asked how long did I have the old cap in my mouth.  I told her I didn't know and she would check in her files to verify (assumming to get length of time the insurance would pay the 50% which your attached form said $433.80 owe by me). The code [redacted] error says [redacted] would pay only $347 because this was an alternative benefit.  In other words they wouldn't have paid anything, because the original cap wasn't in my mouth long enough for them  to pay the 50% payment.  I believe that your financial person never verified with my insurace company on the length of time before they would pay the 50% of the new cap cost. I would have no problem waiting a year or so for the cap. Her error puts me out $217 bucks after your patient courtesy adjustment of $133.  She never told me that my Insurance wouldn't pick up 50% of the caps cost, probably because she never verified the time constraints for the old cap. I still believe you owe me $217 bucks because of your financial person not doing her job verifying with my insurance company for the 50% payment on the new cap. We can agree to disagree, in your response you said you wouldn't pay the $217 dollars difference OK don't.  But is it worth having a nice big complaint with the Revdex.com for the next 3 years.  How many future patients will you lose?  Is it worth $217 bucks?

Regards,

In regards to complaint  ID# [redacted] from [redacted].  We researched his file from his previous dentist Dr. [redacted] and the lab slip stated all porcelain crowns for teeth #6-11dated  October 21,2009.  We have enclosed copies of previous lab slip,preterm nation of dental benefits. We replaced #8 on April1, 2015 with an all porcelain crown, which was previous a porcelain crown. This is the same type of crown that was placed by previous dentist. Due to replacing the same type of crown,no discussion was to be made as a different type of crown would have not looked the same and not matched the other crowns that were placed by Dr [redacted]. His complaint should be with his dental insurance company due to them giving an alternative downgrade to porcelain fused to high noble metal crown and paying less thus causing his portion to be higher.  When treatment was diagnosed the complainant asked for us to do a predetermination for the crown which we did and a copy from the insurance company is sent to patient and provider.  When we received the predetermination the patient was called and it was discussed and the patient proceeded to schedule the treatment. It was agreed that the patient would pay !It of his patient estimate at prep appointment and the balance at his seat appointment. After the crown was cemented and in collecting his balance is when the patient informed us of his concern of us not coding correctly and not doing the same crown that was previously done. His balance at the time was $266.90 which we had decided to adjust off 50% ($133.45} to make the patient happy which we thought was more than fair and a courtesy that did not need to be made but was made in good faith to establish a better doctor  patient relationship.  This was unsuccessful and he stated he was not happy and will not be returning and would be contacting the Revdex.com walking out of the office. He did pay his balance of $133.45 in full and his account has a zero balance. We strive to provide great customer service to all our patients and feel that this patient was handled in a professional and courtesy way. We feel that we explained and answered all questions that were asked. We will not be giving any more of a refund or discount that has already been offered due to the complaint of different crown was false and shown with the lab slip, and that the predetermination of benefit that the patient received from insurance company and gone over prior to treatment being started and completed clearly shows the patient financial responsibility of cost of the crown and the patient was happy and satisfied with the crown itself,not the cost which is set by the insurance and his dental benefits.Sincerely,[redacted], DDS