Northern Virginia Center: Oral, Facial & Implant Surgery

To whom it may concernThe patient we are referring to I think is a little confused on the numbersThe patient signed an estimate the day of surgery that stated to total amount without insurance was for We estimated the patients portion to originally to be Per [redacted] We told them we would only collect 20% the day of, Bill INS and then bill them the remainder in paymentsWe adjusted our patients portion after further review (still before surgery), and they resigned stating it could be as much as not We then still collected the to honor our original agreement.We did submit for a pre estimate to their insurance; however [redacted] requires a denial from their [redacted] dental before they will give you a payment amountThey did let us know that of the charges were NOT A COVERED SERVICEWe received that on May , and Surgery was may The patient was informedoffered to file with ***, then back to [redacted] to get a more accurate estimate and mom decided to go ahead with surgeryWe always document when a patient doesn't want to wait for a pretreatment, for cases like thisAccording to our notes, mom stated dad spoke to [redacted] and found out his copay so he said to go ahead with surgery.”We performed the procedure, then billed Medical (they denied), then went to [redacted] They left the patient responsible for the denied 850, plus (with pending)They then came back and left the patient to pay for that Total due to patient was that is less than our original estimateNow the patient has a remaining balance of plus in finance charges(she also paid a payment at the time of the consult back in April that was applied to her surgery)We are Sorry for any confusion, but are very clear on any charges we provide and make sure the patient knows the amount that will be due, and what is expected of them up front.As far as the Surgery goes, We performed it in May and we heard the bracket came off in April The orthodontist uses this bracket to pull down the toothSometimes they break especially after a year of being activatedWe are willing to reperform the procedure, but the patient has not paid anything for the past year and will need to pay again for anesthesia etc.Thank you,

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because: The surgery did not help in anywayThe surgery was performed on 5/and one side of the chain fell-off in DecemberThe other side is intactOur orthodontist said the chain was not placed properlyWhen we went back to get the chain reattached they suggested we have to go through another surgery and it'll cost us ~$and insurance will not cover itWe asked if that will help pulling the affect the tooth and the Doctor said it's may or may notNo guaranteesWe spoke to insurance they suggested changing the SurgeonAs it stands now, we don't want the DrShami to redo the surgery, if Dr*** *** can take a look at it and willing to reattach the chain we can accept it otherwise we want our money back, we will consult another Surgeon as suggested by our insurance company
Regards,
*** ***

To whom it may concernThe patient we are referring to I think is a little confused on the numbers. The patient signed an estimate the day of surgery that stated to total amount without insurance was for 5925.00. We estimated the patients portion to originally to be 2566.00 Per [redacted]. We told...

them we would only collect 20% the day of, Bill INS and then bill them the remainder in payments. We adjusted our patients portion after further review (still before surgery), and they resigned stating it could be as much as 2958.00 not 2566. We then still collected the 513.20 to honor our original agreement.We did submit for a pre estimate to their insurance; however [redacted] requires a denial from their [redacted] dental before they will give you a payment amount. They did let us know that 850.00 of the charges were NOT A COVERED SERVICE. We received that on May , and Surgery was may 23. The patient was informed. offered to file with [redacted], then back to [redacted] to get a more accurate estimate and mom decided to go ahead with surgery. We always document when a patient doesn't want to wait for a pretreatment, for cases like this. According to our notes, mom stated dad spoke to [redacted] and found out his copay so he said to go ahead with surgery.”We performed the procedure, then billed Medical (they denied), then went to [redacted]. They left the patient responsible for the denied 850, plus 885.00 (with 1600 pending). They then came back and left the patient to pay 342 for that 1600. Total due to patient was 2077.00 that is less than our original estimate. Now the patient has a remaining balance of 1413.80 plus 70 in finance charges. (she also paid a 150.00 payment at the time of the consult back in April that was applied to her surgery)We are Sorry for any confusion, but are very clear on any charges we provide and make sure the patient knows the amount that will be due, and what is expected of them up front.As far as the Surgery goes, We performed it in May 2013 and we heard the bracket came off in April 2014. The orthodontist uses this bracket to pull down the tooth. Sometimes they break especially after a year of being activated. We are willing to reperform the procedure, but the patient has not paid anything for the past year and will need to pay again for anesthesia etc.Thank you,

Review: My son underwent surgery for exposing the unerupted tooth ([redacted] Surgical Access of an Unerupted Tooth) He had two of them. We went back and forth with the insurance company ([redacted]) and they came up with the estimate for $2566.00 The doctors office asked us to deposit 20% of the fee on the day of the surgery, we paid $513.20 and went through the surgery. After the surgery is done we we shocked to receive the bill of $6375. After talking to insurance over a period of time we some how managed to have them cover us $4598. As part of the Surgery they were supposed to attach a chain for pulling the tooth down looks like they did not include the codes in the estimate. Insurance said they will not cover that. Now after paying so much for the surgery, they chain fell off in couple of months, the our dentist sent us back to the Surgeon to reattach the chain, they told us they'll have to redo the surgery and it'll cost us around $4000 and they'll only do it if we settle the previous balance. This is a way too shady practice, this Surgeon needs to be accountable for the services he provided. Please do the needful.Desired Settlement: We discussed this issue with the insurance they asked us to change the Surgeon, we are planning to see a new Surgeon as insurance has already covered this they won't cover it again. We have to pay out of our pocket. We need the complete refund from this office so that we can go ahead with a different Surgeon.

Business

Response:

To whom it may concernThe patient we are referring to I think is a little confused on the numbers. The patient signed an estimate the day of surgery that stated to total amount without insurance was for 5925.00. We estimated the patients portion to originally to be 2566.00 Per [redacted]. We told them we would only collect 20% the day of, Bill INS and then bill them the remainder in payments. We adjusted our patients portion after further review (still before surgery), and they resigned stating it could be as much as 2958.00 not 2566. We then still collected the 513.20 to honor our original agreement.We did submit for a pre estimate to their insurance; however [redacted] requires a denial from their [redacted] dental before they will give you a payment amount. They did let us know that 850.00 of the charges were NOT A COVERED SERVICE. We received that on May , and Surgery was may 23. The patient was informed. offered to file with [redacted], then back to [redacted] to get a more accurate estimate and mom decided to go ahead with surgery. We always document when a patient doesn't want to wait for a pretreatment, for cases like this. According to our notes, mom stated dad spoke to [redacted] and found out his copay so he said to go ahead with surgery.”We performed the procedure, then billed Medical (they denied), then went to [redacted]. They left the patient responsible for the denied 850, plus 885.00 (with 1600 pending). They then came back and left the patient to pay 342 for that 1600. Total due to patient was 2077.00 that is less than our original estimate. Now the patient has a remaining balance of 1413.80 plus 70 in finance charges. (she also paid a 150.00 payment at the time of the consult back in April that was applied to her surgery)We are Sorry for any confusion, but are very clear on any charges we provide and make sure the patient knows the amount that will be due, and what is expected of them up front.As far as the Surgery goes, We performed it in May 2013 and we heard the bracket came off in April 2014. The orthodontist uses this bracket to pull down the tooth. Sometimes they break especially after a year of being activated. We are willing to reperform the procedure, but the patient has not paid anything for the past year and will need to pay again for anesthesia etc.Thank you,

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because: The surgery did not help in anyway. The surgery was performed on 5/23 and one side of the chain fell-off in December. The other side is intact. Our orthodontist said the chain was not placed properly. When we went back to get the chain reattached they suggested we have to go through another surgery and it'll cost us ~$3000 and insurance will not cover it. We asked if that will help pulling the affect the tooth and the Doctor said it's may or may not. No guarantees. We spoke to insurance they suggested changing the Surgeon. As it stands now, we don't want the Dr. Shami to redo the surgery, if Dr. [redacted] can take a look at it and willing to reattach the chain we can accept it otherwise we want our money back, we will consult another Surgeon as suggested by our insurance company.

Regards,