Oral Surgery Center

Before the patient is taken back for a consultation there is a Financial Disclosure Statement that they are asked to read and sign In this disclosure it states the insurance companies that we are providers for(WEA is not listed) This allows the opportunity for questions regarding insurance coverage ***, as parent/guardian, signed the form and continued with the consultation After completion of the consultation the patient has an estimate reviewed with them This estimate is explained to them and again at this time there is the opportunity for any insurance coverage questions The patient is informed of total cost of surgery, deposit required and they are told that if the insurance should pay less than anticipated they will receive a statement; if the insurance pays better than anticipated they could receive a refund ***, as parent/guardian, read the disclosure on the estimate form which also states that if there is a dispute with payments made by your insurance company you agree to pay Oral Surgery Center, S.Cin full and work with your insurance company regarding the dispute It also states that you have read and had the estimate explained Again, this form was signed by *** The Oral Surgery Center, S.Chas apologized for any misunderstandings in the matter It is very important that anyone having insurance coverage understand their role and responsibility in knowing their coverage and where that coverage is Insurance companies even state in their policy manual and materials sent to the insured party that it is their responsibility to know their coverageThey even send a list of providers The Oral Surgery Center, S.Cdoes everything it can to provide the most current information we have available to patients regarding their specific insuranceHealthcare facilities deal with hundreds of different insurance companies and policies, there is a point where the patient/insured party does have to accept responsibility [redacted] Office ManagerOral Surgery Center, S.C8th StreetBaraboo, WI

1.
normal;">      Before the patient is taken back for a consultation there is a Financial Disclosure Statement that they are asked to read and sign.  In this disclosure it states the insurance companies that we are providers for. (WEA is not listed)  This allows the opportunity for questions regarding insurance coverage.  [redacted], as parent/guardian, signed the form and continued with the consultation.
2.      After completion of the consultation the patient has an estimate reviewed with them.  This estimate is explained to them and again at this time there is the opportunity for any insurance coverage questions.  The patient is informed of total cost of surgery, deposit required and they are told that if the insurance should pay less than anticipated they will receive a statement; if the insurance pays better than anticipated they could receive a refund.  [redacted], as parent/guardian, read the disclosure on the estimate form which also states that if there is a dispute with payments made by your insurance company you agree to pay Oral Surgery Center, S.C. in full and work with your insurance company regarding the dispute.  It also states that you have read and had the estimate explained.  Again, this form was signed by [redacted].
3.      The Oral Surgery Center, S.C. has apologized for any misunderstandings in the matter.
4.       It is very important that anyone having insurance coverage understand their role and responsibility in knowing their coverage and where that coverage is.  Insurance companies even state in their policy manual and materials sent to the insured party that it is their responsibility to know their coverage. They even send a list of providers.  The Oral Surgery Center, S.C. does everything it can to provide the most current information we have available to patients regarding their specific insurance. Healthcare facilities deal with hundreds of different insurance companies and policies, there is a point where the patient/insured party does have to accept responsibility.   
[redacted]
Office Manager
Oral Surgery Center, S.C.
1203 8th Street
Baraboo, WI  53913

1.      Before the patient is taken back for a consultation there is a Financial Disclosure Statement that they are asked to read and sign.  In this disclosure it states the insurance companies that we are providers for. (WEA is not listed)  This allows the...

opportunity for questions regarding insurance coverage.  [redacted], as parent/guardian, signed the form and continued with the consultation.2.      After completion of the consultation the patient has an estimate reviewed with them.  This estimate is explained to them and again at this time there is the opportunity for any insurance coverage questions.  The patient is informed of total cost of surgery, deposit required and they are told that if the insurance should pay less than anticipated they will receive a statement; if the insurance pays better than anticipated they could receive a refund.  [redacted], as parent/guardian, read the disclosure on the estimate form which also states that if there is a dispute with payments made by your insurance company you agree to pay Oral Surgery Center, S.C. in full and work with your insurance company regarding the dispute.  It also states that you have read and had the estimate explained.  Again, this form was signed by [redacted].3.      The Oral Surgery Center, S.C. has apologized for any misunderstandings in the matter.4.       It is very important that anyone having insurance coverage understand their role and responsibility in knowing their coverage and where that coverage is.  Insurance companies even state in their policy manual and materials sent to the insured party that it is their responsibility to know their coverage. They even send a list of providers.  The Oral Surgery Center, S.C. does everything it can to provide the most current information we have available to patients regarding their specific insurance. Healthcare facilities deal with hundreds of different insurance companies and policies, there is a point where the patient/insured party does have to accept responsibility.   [redacted]Office ManagerOral Surgery Center, S.C.1203 8th StreetBaraboo, WI  53913

Review: I first called the Oral Surgery Center in early July after being advised by our dentist that my son needed his wisdom teeth removed. I was actually referred to another oral surgeon in the Madison area, but as I had done business previously with this clinic for my other sons a few years prior, I contacted them first. At that time, I specifically stated that my insurance had changed from Dean to WEA Trust, and I asked if their clinic was a provider. I was told yes, so I proceeded with scheduling the first consult.

When I arrived for the consult, I provided a copy of my insurance card and paid the initial payment. Again, I stated that we had changed insurance companies. The fee schedule was explained, and I was told that I would receive a check as reimbursement after my insurance paid the claim.

After paying over $2000 in July, instead of a reimbursement, I received a bill in October for an additional charge of over $650. I immediately contacted both the surgery center and my insurance, who told me that the Oral Surgery Center was not a provider. I did not receive a call back from the surgery center.

In December, I received a second notice, to which I responded in writing, explaining how their employees gave me incorrect information regarding insurance coverage, and I would have never had the surgery done there if I'd been told WEA was not in their network. I asked that the additional charges of $657.91 be removed from my account.

To this I received a written response apologizing for my misunderstanding and explaining that since I had signed a form assuming responsibility for payment, I still owed the balance. This blanket form shouldn't cover erroneous information provided by clinic staff.Desired Settlement: The clinic should remove the final charges from my account. Given that my deductible was met and I should have gotten reimbursement for the money I have already paid, having them eliminate these charges seems fair. Their employee's mistakes have already cost me significantly.

Business

Response:

1. Before the patient is taken back for a consultation there is a Financial Disclosure Statement that they are asked to read and sign. In this disclosure it states the insurance companies that we are providers for. (WEA is not listed) This allows the opportunity for questions regarding insurance coverage. [redacted], as parent/guardian, signed the form and continued with the consultation.2. After completion of the consultation the patient has an estimate reviewed with them. This estimate is explained to them and again at this time there is the opportunity for any insurance coverage questions. The patient is informed of total cost of surgery, deposit required and they are told that if the insurance should pay less than anticipated they will receive a statement; if the insurance pays better than anticipated they could receive a refund. [redacted], as parent/guardian, read the disclosure on the estimate form which also states that if there is a dispute with payments made by your insurance company you agree to pay Oral Surgery Center, S.C. in full and work with your insurance company regarding the dispute. It also states that you have read and had the estimate explained. Again, this form was signed by [redacted].3. The Oral Surgery Center, S.C. has apologized for any misunderstandings in the matter.4. It is very important that anyone having insurance coverage understand their role and responsibility in knowing their coverage and where that coverage is. Insurance companies even state in their policy manual and materials sent to the insured party that it is their responsibility to know their coverage. They even send a list of providers. The Oral Surgery Center, S.C. does everything it can to provide the most current information we have available to patients regarding their specific insurance. Healthcare facilities deal with hundreds of different insurance companies and policies, there is a point where the patient/insured party does have to accept responsibility. [redacted]Office ManagerOral Surgery Center, S.C.1203 8th StreetBaraboo, WI 53913