Revdex.com: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.The message from TransitionsDental is largely incorrect and can not justify Sagamore Meadows Family Dental’s negligence and overcharging Please see the following rebuttals (I have uploaded this letter with other supporting documents to the Revdex.com website) Allowable Amount of insuranceBased on [redacted] document, the dental office heard from my insurance company on 11/18/before my family visited the dental officeIn Exhibit 1, it indicates that” ..Based on allowable amount and the patient ” When [redacted] (Business Assistant) talked to me about proposed treatment plan for my children, I did have questions about coverageShe said I do not owe her office and she “circled” “0” on the plan (exhibit 2)This made me think $for each child is “allowable amount” which they can get from my insurance company The circle on the paper misleads everything for the treatment When I was in Hawaii for my dental treatment, I have never had any problems for billingIf necessary, I can provide the doctor’s contact informationIt had been wonderful experiences in Hawaii (out-of-state) [redacted] ’s message indicates that “He had not received a statement in the mail because our statements had not gone out in the mail due to our billing cycle This patient became very loud, upset.” I do not know who told [redacted] about billing cycle [redacted] is rude and she said “youhad the service on 11/20/2014, but you have not paid yetToday is 01/08/2015, It is almost days since you had the serviceYou must pay NOW!” (My wife heardit as well) I told her that you can not say that because I have not received the bill yet and also it is less than days since we had the servicesYou are wrongI am sure [redacted] still remembers what she said and she is very rude Why did you say “because our statements had not gone out in the mail due to our billing cycle?” This lie upsets me again[redacted] said I must pay NOW regardless of the billing cycle because it is almost days My dental treatmentI visited the doctoroffice on 12/24/after the dental office checked with my insurancecompany I told the doctor that I have “onebroken tooth” and “one missing filling” that needed to be treated.As usual, dentists normally take X-ray for the first visit for any newpatientsI did it (I thought they have already checked my insurance) In exhibit 6, Dr [redacted] commented that Icomplained “multiple broken teeth” “will like to wait for better insurancebefore proceeding..” that is incorrectand not trueAgain, I only indicated that I only have one broken tooth and Ithink they overcharge me and are dishonestyThe doctor gave me two estimatesFirstis about my # and teeth for crown with a total of $1,after $1,insuranceis applied This is much expensive thanI did my crown before (I told the dental office that I paid about $for onecrown in Alabama) Based on theestimate, each crown is $after my insurance is applied and twice expensivethan the crown I did before Due to theovercharging, I asked the doctor to see if my other teeth are needed to betreatedShe gave me the second estimate consisting of my #tooth, #3, #8, #9,and #with additional four crowns of $5,278!!!!!! Suddenly, I realized that Ishould stop talking with the doctor because I need to have a second opinionregarding my crownI came back to Alabama and visited my previous dentist (Ican release his name if necessary) on 01/13/Again, I had x-ray and thedoctor exam my teethThe conclusion is that, I only need to do one crown (#28)and one filling (#21)Rest of my teeth are ingreat shape!!!!! One crown and one filling are $after insuranceis appliedTherefore, all the evidences indicate that Sagamore Meadows FamilyDental orvercharges me and is dishonesty The similar story is posted by [redacted] on [redacted] on 09/11/http://www [redacted] Please see blow: [redacted] Upset and irritated by staffIt is true that I wasextremely upset and irritated by the staff (primarily [redacted] -office manager)due to their unprofessional attitude, incompetence,roughness, and insultsFirst, please elaborate what “definite language barrier”means in exhibit As an educator fordecades, I feel like I talked with a year-old boy when he made mistakes.Exhibit is largely wrong and inaccurate ( [redacted] should write it not ***)Italked with [redacted] first without any conflicts, but I do not know why ***suddenly jumped into our conversationNobody encouraged me to call myinsurance, but I did call my insurance The reason why I mentioned $ co-pay isthat, I realized they made mistakes, did not do much good homework, and Ishould give them a chance as I gave my students when they made mistakes (I amwilling to pay $for each child)Unfortunately, [redacted] asked me to find any discountson the bill so that she can give me some discountsI told her that I can notdo that because you are (year’s experience) an expert in the field and thisis not a discount issue and this question that you should not even ask meThen,I feel like we are forced into a rollercoaster that we started to fight unprofessional attitude, incompetence, roughness, and insultsActually, [redacted] assistant said she did check with my insurance before my familyvisited her office, but she does not understand why the insurance did not cover100% (it indicates that they did not do good homework and they have theirnegligence)[redacted] : I believe you were not in our conversationYoumade your own judgment based on what you heard from Sagamore Meadows FamilyDentalAs an educator, I understand how doctors and their staff work hard fortheir patientsHowever, people make mistakesYou should listen to your customersand fix the problemI have been using Blue Cross Blue Shield of Alabama sinceand I never had any problems with any of my doctors (etcdentists) in Alabamaand HawaiiBecause you spoke with my insurance company, you can also call themto verify whether or not I had any problems with my doctorsThe problem with SagamoreMeadows family dental is my first time of complaint and I am very upset bythem.Please get my $($for each kid) refunded and remove both $and $126from my bill (In my bill they charged me $for oral examination, $forIntra Oral Complete Series which is rejected by my insurance company becausethe company said “THIS CHARGE IS NOT COVERED WHEN A RELATED SERVICE IS RENDER.”).They also should apologize to me for their negligence and incompetence.Sincerely, [redacted] ***An educator for two decades Call Send SMS Add to Skype You'll need Skype CreditFree via Skype
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below.NOTE: attached is the same response belowMay 23, Revdex.com Indianapolis, IN Dear ***: I reviewed the response from Dr [redacted] I need you to continue to dispute the claim with Dr [redacted] for the following reasons: · I called Dr [redacted] ’s office, LifeSmiles dentistry in January, and was told that he does not own Sagamore Meadows · I called Kerri [redacted] who was also listed as an owner and my call was never returned · I have never talked to Dr [redacted] nor have I had a discussion with him about this situation His response to the Revdex.com includes quotes – implying that we have had a conversation I have never spoken to Dr [redacted] so how can he provide quotes of a conversation? His response to the Revdex.com is as deceptive as those of Sagamore Meadows implying in their insurance documentation He implied that we talked by putting words in quotes, just as his statement on his estimates implied that they talked to my insurance company“Insurance estimated based upon information from the insurance company.” · I did sign many estimates from Sagamore Meadows and all of my previous claims were paid This confirmed my belief that they did contact my insurance company · Dr [redacted] informed Sagamore Meadows in April of that he performed the work that they referred me to him for a charge of $ Carol, the office manager, made a big point that I did not inform them of Dr [redacted] work and that was why I no longer had benefits, even though DrHeart informed Sagamore Meadows of the work and charges back in April of So Dr [redacted] ’s response “It is a moot point that Mr [redacted] said that he had services rendered elsewhere” is incorrect Further proof that I have never had a conversation with Dr [redacted] and I’m not sure where he is getting his information This information was available to them prior to their “estimate” and they should’ve known that my benefits were used up for the year without even calling my insurance company They never should’ve suggested that I have this elective procedure until I trusted that they knew my information, because they were correct all the previous times and they referred me to Dr [redacted] and he shared my information with them I also was in the chair with gauze in my mouth, prepped for the procedure and not in a position to call my insurance company · Dr [redacted] did not address the $charge to my Sagamore Meadows account on 10/19/without my signature I was never told about this charge, never signed an estimate So I did not agree to this charge! · Based on Dr [redacted] ’s response I should not be charged $since I did not get an estimate for this charge or sign for it Their business practices are not consistent I need the Revdex.com to continue to dispute these charges because Dr [redacted] has not acknowledged his ownership of Sagamore Meadows, addressed all the issues and I have no other way to dispute these charges Thank you, Steven [redacted] Regards, [redacted]
Revdex.com:I had great conversations with *** *** who the Regional Manager Assistant at Transitions Dental CompanyWe have reached an agreement that I paid my children’ s expense ($323.10) and Transitions Dental Company removes $and $on my billMy bill balance is 0.The above is our settlement.Thank you ***’s hard work for correcting the mistakesRegards,
*** *** %
I am [redacted] and the Regional Manager Assistant at Transitions Dental Company. I am writing in
0.6in 0pt">response to a complaint made by patient [redacted], whose children were seen at our satellite office Sagamore Meadows Family Dental in November 2014.
First, I would like to address the patient's complaint of negligence and overcharging. After much investigation into the patient's account I found that Sagamore Meadows Family Dental did not overcharge. The office is an in-network provider, however, after speaking to a representative, [redacted], at Blue Cross Blue Shield of Alabama myself, she stated that benefits for out-of-state dentist will be based on usual and customary fees with the patient being responsible for the difference between bill charged and the actual payment. I have included a faxback of benefits from the patient's insurance company stating this fact (Exhibit 1). The fees we presented to the patient were correct. The patient signed the treatment plans stating the fees( Exhibit 2). I have also included the insurance EOB which states the portion that the patient owes (Exhibit 3). I also verified over that phone with the BCBS of Alabama representative and that portion of $323.10 is correct and the responsibility of the patient.
The patient signed a Financial Policy stating that he understood that all charges incurred are his responsibility (Exhibit 4) and an Insurance Estimate form (Exhibit 5) which states he understands that our insurance estimates are based in information given to us by his insurance company.
The patient was informed of the portion on his children's accounts when he arrived for his own appointment on 1/8/2015. He had not received a statement in the mail because our statements had not gone out in the mail due to our billing cycle. This patient became very loud, upset, and aggressive when our staff of Sagamore Meadows tried to explain why he had a balance on his account. Please read the chart notes made by employees at Sagamore Meadows (Exhibit 6).
Unfortunately, we cannot accommodate Mr. [redacted]'s request of a refund of $323.10. This is his portion for the services his children recieved based upon his insurance plan and owed to our office.
Thank you for your time and consideration. Should you have further questions, please contact me at 765-807-0580 or email [redacted]@transitionsdental.com
Sincerely,
[redacted] Regional Manager Assistant
%3%3
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.NOTE: attached is the same response below.
May 23, 2016
Revdex.com
Indianapolis, IN
Dear [redacted]:
I reviewed the response from Dr. [redacted]. I need you to continue to dispute the claim
with Dr. [redacted] for the following reasons:
·
I called Dr. [redacted]’s office, LifeSmiles
dentistry in January, 2016 and was told that he does not own Sagamore Meadows.
·
I called
Kerri [redacted] who was also listed
as an owner and my call was never returned.
·
I have never talked to Dr. [redacted] nor have I
had a discussion with him about this situation.
His response to the Revdex.com includes quotes – implying that we have had a
conversation. I have never spoken to Dr.
[redacted] so how can he provide quotes of a conversation? His response to the Revdex.com is as deceptive as
those of Sagamore Meadows implying in their insurance documentation. He implied that we talked by putting words in
quotes, just as his statement on his estimates implied that they talked to my
insurance company. “Insurance estimated
based upon information from the insurance company.”
·
I did sign many estimates from Sagamore Meadows
and all of my previous claims were paid.
This confirmed my belief that they did contact my insurance
company.
·
Dr. [redacted] informed Sagamore Meadows in April of 2015
that he performed the work that they referred me to him for a charge of
$700.00. Carol, the office manager, made
a big point that I did not inform them of Dr. [redacted] work and that was why I no
longer had benefits, even though Dr. Heart informed Sagamore Meadows of the
work and charges back in April of 2015. So Dr. [redacted]’s response “It is a moot
point that Mr. [redacted] said that he had services rendered elsewhere” is
incorrect. Further proof that I have
never had a conversation with Dr. [redacted] and I’m not sure where he is getting
his information. This information was
available to them prior to their “estimate” and they should’ve known that my
benefits were used up for the year without even calling my insurance
company. They never should’ve suggested
that I have this elective procedure until 2016.
I trusted that they knew my information, because they were correct all
the previous times and they referred me to Dr. [redacted] and he shared my
information with them. I also was in the
chair with gauze in my mouth, prepped for the procedure and not in a position
to call my insurance company.
·
Dr. [redacted] did not address the $119.00 charge
to my Sagamore Meadows account on 10/19/15 without my signature. I was never told about this charge, never
signed an estimate. So I did not agree
to this charge!
·
Based on Dr. [redacted]’s response I should not be
charged $119.00 since I did not get an estimate for this charge or sign for
it. Their business practices are not
consistent.
I need the Revdex.com to continue to dispute these charges because
Dr. [redacted] has not acknowledged his ownership of Sagamore Meadows, addressed
all the issues and I have no other way
to dispute these charges.
Thank you,
Steven [redacted]
Regards,
[redacted]
I am writing in response the patient's rebuttal to my previous letter.
While it is true that I was not present when the issue arose at our satellite office, Sagamore Meadows Family Dental, my determination of whether or not patient balances are correct Is based upon facts which include signed documents and insurance EOB's , which I will address again.
All charges incurred are patient responsibility. Between the insurance company and the patient, the total fee must be paid. Our PPO fee schedules are determined by insurance companies based upon zip codes. In other words, the patient's PPO insurance company tells us what fees to charge based upon our geographical area. All collectable fees are determined by the patient's insurance company. The office receives an EOB (Explanation of Benefits) stating how much they have paid and how much the patient owes. See Exhibit 1, it clearly states the patient responsibility for each child is $107.70 for a total amount due of $323.10.
It clearly states on our treatment plan the total fee for services that the patient and his family received. The patient signed the treatment plans. Our treatment plans also state that they are estimates only. We cannot guarantee what the patient's insurance company will pay. It even states on the insurance faxback on the breakdown of covered services that it is not a guarantee of payment. The patient signed our Financial Policy (Exhibit 2) that states he understands that all fees are his responsibility regardless of what insurance pays. He also signed the Insurance Estimate form (Exhibit 3) stating that our treatment plans are just that, estimates. We try to come as close as we can to determining what a patient's insurance will pay based upon what their insurance company tells us, however, that information is NOT a guarantee of payment and you may still have a balance after the insurance has paid. The signed treatment plans and insurance faxback were previously submitted as supporting documents.
Like I stated before, I personally called the patient's insurance company to find out if the patient portion
was correct. I was told that the patient does indeed owe Sagamore Meadows Family Dental $323.10 (for his children). The EOB from the patient's insurance company also states this fact.
Thank you for taking the time to address the concerns for both Mr [redacted] and Sagamore Meadows. Mr. [redacted] presented to Sagamore Meadows on 10-05-2015 for a crown. Mr [redacted] was presented a treatment plan (Exhibit 1) for the estimated patient portion. Mr. [redacted] signed the treatment plan that...
explicitly states that the treatment plan is "only an estimate and that the patient is financially responsible for all work". Mr [redacted] has been a patient with Sagamore Meadows since 04-03-2014, at which time, he signed a financial agreement (exhibit 2) that states that the patient is financially responsible for all work. In the year and a half that Mr. [redacted] was a patient with Sagamore Meadows, Mr [redacted] signed approximately 10 treatment plans agreeing to pay for our expertise and services.Mr. [redacted] has said, on multiple occasions, because the treatment plan was "off", even though it was an estimate, he absolved himself of any financial responsibility and that we would have to "eat the difference", or he would spread a lot of bad reviews on social media. It is a moot point that Mr. [redacted] says that he told us of the service rendered elsewhere. It is Mr [redacted]'s responsibility to know his insurance benefit plan, its maximum benefits, and the approximate amounts used.It appears that Mr. [redacted] desires for us to take responsibility for his insurance utilization decisions. It is our opinion that Mr [redacted] knew and accepted all financial responsibility work that he received. We ask that this case be dropped and that Mr [redacted] pay his bill, as he committed to both in word and in writing.
We have very solid processes for presenting fees to our patients. We educate consistently that our fees are separate from any insurance estimates. We educate patients consistently that the insurance policies purchased by the patient are their own responsibility and any amounts their insurance chooses not to pay is their responsibility. As an added service to them we don't ask for final payment of estimated amounts until the insurance either pays or denies their claim.
Regards,
Dr. Daniel W. [redacted], DDS
Revdex.com: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.The message from TransitionsDental is largely incorrect and can not justify Sagamore Meadows Family Dental’s negligence and overcharging. Please see the following rebuttals (I have uploaded this letter with other supporting documents to the Revdex.com website).1. Allowable Amount of insuranceBased on [redacted] document, the dental office heard from my insurance company on 11/18/2014 before my family visited the dental office. In Exhibit 1, it indicates that”…..Based on allowable amount and the patient…” When [redacted] (Business Assistant) talked to me about proposed treatment plan for my children, I did have questions about coverage. She said I do not owe her office and she “circled” “0” on the plan (exhibit 2). This made me think $341 for each child is “allowable amount” which they can get from my insurance company. The circle on the paper misleads everything for the treatment. When I was in Hawaii for my dental treatment, I have never had any problems for billing. If necessary, I can provide the doctor’s contact information. It had been wonderful experiences in Hawaii (out-of-state). [redacted]’s message indicates that “He had not received a statement in the mail because our statements had not gone out in the mail due to our billing cycle…. This patient became very loud, upset.” I do not know who told [redacted] about billing cycle. [redacted] is rude and she said “youhad the service on 11/20/2014, but you have not paid yet. Today is 01/08/2015, It is almost 60 days since you had the service. You must pay NOW!” (My wife heardit as well). I told her that you can not say that because I have not received the bill yet and also it is less than 50 days since we had the services. You are wrong. I am sure [redacted] still remembers what she said and she is very rude. Why did you say “because our statements had not gone out in the mail due to our billing cycle?” This lie upsets me again.[redacted] said I must pay NOW regardless of the billing cycle because it is almost 60 days.2. My dental treatmentI visited the doctoroffice on 12/24/2014 after the dental office checked with my insurancecompany. I told the doctor that I have “onebroken tooth” and “one missing filling” that needed to be treated.As usual, dentists normally take X-ray for the first visit for any newpatients. I did it (I thought they have already checked my insurance). In exhibit 6, Dr. [redacted] commented that Icomplained “multiple broken teeth”…. “will like to wait for better insurancebefore proceeding..” that is incorrectand not true. Again, I only indicated that I only have one broken tooth and Ithink they overcharge me and are dishonesty. The doctor gave me two estimates. Firstis about my # 21 and 28 teeth for crown with a total of $1,682 after $1,000 insuranceis applied. This is much expensive thanI did my crown before (I told the dental office that I paid about $375 for onecrown in Alabama). Based on theestimate, each crown is $841 after my insurance is applied and twice expensivethan the crown I did before. Due to theovercharging, I asked the doctor to see if my other teeth are needed to betreated. She gave me the second estimate consisting of my #2 tooth, #3, #8, #9,and #14 with additional four crowns of $5,278!!!!!! Suddenly, I realized that Ishould stop talking with the doctor because I need to have a second opinionregarding my crown. I came back to Alabama and visited my previous dentist (Ican release his name if necessary) on 01/13/15. Again, I had x-ray and thedoctor exam my teeth. The conclusion is that, I only need to do one crown (#28)and one filling (#21). Rest of my teeth are ingreat shape!!!!! One crown and one filling are $392.90 after insuranceis applied. Therefore, all the evidences indicate that Sagamore Meadows FamilyDental orvercharges me and is dishonesty. The similar story is posted by [redacted] on [redacted]on 09/11/2013 http://www[redacted]Please see blow:[redacted] 3. Upset and irritated by staffIt is true that I wasextremely upset and irritated by the staff (primarily [redacted]-office manager)due to their unprofessional attitude, incompetence,roughness, and insults. First, please elaborate what “definite language barrier”means in exhibit 6. As an educator fordecades, I feel like I talked with a 4 year-old boy when he made mistakes.Exhibit 6 is largely wrong and inaccurate ([redacted] should write it not [redacted]). Italked with [redacted] first without any conflicts, but I do not know why [redacted]suddenly jumped into our conversation. Nobody encouraged me to call myinsurance, but I did call my insurance. The reason why I mentioned $ 30 co-pay isthat, I realized they made mistakes, did not do much good homework, and Ishould give them a chance as I gave my students when they made mistakes (I amwilling to pay $30 for each child). Unfortunately, [redacted] asked me to find any discountson the bill so that she can give me some discounts. I told her that I can notdo that because you are (30 year’s experience) an expert in the field and thisis not a discount issue and this question that you should not even ask me. Then,I feel like we are forced into a rollercoaster that we started to fight unprofessional attitude, incompetence, roughness, and insults. Actually,[redacted] assistant said she did check with my insurance before my familyvisited her office, but she does not understand why the insurance did not cover100% (it indicates that they did not do good homework and they have theirnegligence).[redacted]: I believe you were not in our conversation. Youmade your own judgment based on what you heard from Sagamore Meadows FamilyDental. As an educator, I understand how doctors and their staff work hard fortheir patients. However, people make mistakes. You should listen to your customersand fix the problem. I have been using Blue Cross Blue Shield of Alabama since2008 and I never had any problems with any of my doctors (etc. dentists) in Alabamaand Hawaii. Because you spoke with my insurance company, you can also call themto verify whether or not I had any problems with my doctors. The problem with SagamoreMeadows family dental is my first time of complaint and I am very upset bythem.Please get my $323.10 ($107.70 for each kid) refunded and remove both $85 and $126from my bill (In my bill they charged me $85 for oral examination, $126 forIntra Oral Complete Series which is rejected by my insurance company becausethe company said “THIS CHARGE IS NOT COVERED WHEN A RELATED SERVICE IS RENDER.”).They also should apologize to me for their negligence and incompetence.Sincerely,[redacted]An educator for two decades
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Revdex.com: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.The message from TransitionsDental is largely incorrect and can not justify Sagamore Meadows Family Dental’s negligence and overcharging Please see the following rebuttals (I have uploaded this letter with other supporting documents to the Revdex.com website) Allowable Amount of insuranceBased on [redacted] document, the dental office heard from my insurance company on 11/18/before my family visited the dental officeIn Exhibit 1, it indicates that” ..Based on allowable amount and the patient ” When [redacted] (Business Assistant) talked to me about proposed treatment plan for my children, I did have questions about coverageShe said I do not owe her office and she “circled” “0” on the plan (exhibit 2)This made me think $for each child is “allowable amount” which they can get from my insurance company The circle on the paper misleads everything for the treatment When I was in Hawaii for my dental treatment, I have never had any problems for billingIf necessary, I can provide the doctor’s contact informationIt had been wonderful experiences in Hawaii (out-of-state) [redacted] ’s message indicates that “He had not received a statement in the mail because our statements had not gone out in the mail due to our billing cycle This patient became very loud, upset.” I do not know who told [redacted] about billing cycle [redacted] is rude and she said “youhad the service on 11/20/2014, but you have not paid yetToday is 01/08/2015, It is almost days since you had the serviceYou must pay NOW!” (My wife heardit as well) I told her that you can not say that because I have not received the bill yet and also it is less than days since we had the servicesYou are wrongI am sure [redacted] still remembers what she said and she is very rude Why did you say “because our statements had not gone out in the mail due to our billing cycle?” This lie upsets me again[redacted] said I must pay NOW regardless of the billing cycle because it is almost days My dental treatmentI visited the doctoroffice on 12/24/after the dental office checked with my insurancecompany I told the doctor that I have “onebroken tooth” and “one missing filling” that needed to be treated.As usual, dentists normally take X-ray for the first visit for any newpatientsI did it (I thought they have already checked my insurance) In exhibit 6, Dr [redacted] commented that Icomplained “multiple broken teeth” “will like to wait for better insurancebefore proceeding..” that is incorrectand not trueAgain, I only indicated that I only have one broken tooth and Ithink they overcharge me and are dishonestyThe doctor gave me two estimatesFirstis about my # and teeth for crown with a total of $1,after $1,insuranceis applied This is much expensive thanI did my crown before (I told the dental office that I paid about $for onecrown in Alabama) Based on theestimate, each crown is $after my insurance is applied and twice expensivethan the crown I did before Due to theovercharging, I asked the doctor to see if my other teeth are needed to betreatedShe gave me the second estimate consisting of my #tooth, #3, #8, #9,and #with additional four crowns of $5,278!!!!!! Suddenly, I realized that Ishould stop talking with the doctor because I need to have a second opinionregarding my crownI came back to Alabama and visited my previous dentist (Ican release his name if necessary) on 01/13/Again, I had x-ray and thedoctor exam my teethThe conclusion is that, I only need to do one crown (#28)and one filling (#21)Rest of my teeth are ingreat shape!!!!! One crown and one filling are $after insuranceis appliedTherefore, all the evidences indicate that Sagamore Meadows FamilyDental orvercharges me and is dishonesty The similar story is posted by [redacted] on [redacted] on 09/11/http://www [redacted] Please see blow: [redacted] Upset and irritated by staffIt is true that I wasextremely upset and irritated by the staff (primarily [redacted] -office manager)due to their unprofessional attitude, incompetence,roughness, and insultsFirst, please elaborate what “definite language barrier”means in exhibit As an educator fordecades, I feel like I talked with a year-old boy when he made mistakes.Exhibit is largely wrong and inaccurate ( [redacted] should write it not ***)Italked with [redacted] first without any conflicts, but I do not know why ***suddenly jumped into our conversationNobody encouraged me to call myinsurance, but I did call my insurance The reason why I mentioned $ co-pay isthat, I realized they made mistakes, did not do much good homework, and Ishould give them a chance as I gave my students when they made mistakes (I amwilling to pay $for each child)Unfortunately, [redacted] asked me to find any discountson the bill so that she can give me some discountsI told her that I can notdo that because you are (year’s experience) an expert in the field and thisis not a discount issue and this question that you should not even ask meThen,I feel like we are forced into a rollercoaster that we started to fight unprofessional attitude, incompetence, roughness, and insultsActually, [redacted] assistant said she did check with my insurance before my familyvisited her office, but she does not understand why the insurance did not cover100% (it indicates that they did not do good homework and they have theirnegligence)[redacted] : I believe you were not in our conversationYoumade your own judgment based on what you heard from Sagamore Meadows FamilyDentalAs an educator, I understand how doctors and their staff work hard fortheir patientsHowever, people make mistakesYou should listen to your customersand fix the problemI have been using Blue Cross Blue Shield of Alabama sinceand I never had any problems with any of my doctors (etcdentists) in Alabamaand HawaiiBecause you spoke with my insurance company, you can also call themto verify whether or not I had any problems with my doctorsThe problem with SagamoreMeadows family dental is my first time of complaint and I am very upset bythem.Please get my $($for each kid) refunded and remove both $and $126from my bill (In my bill they charged me $for oral examination, $forIntra Oral Complete Series which is rejected by my insurance company becausethe company said “THIS CHARGE IS NOT COVERED WHEN A RELATED SERVICE IS RENDER.”).They also should apologize to me for their negligence and incompetence.Sincerely, [redacted] ***An educator for two decades Call Send SMS Add to Skype You'll need Skype CreditFree via Skype
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below.NOTE: attached is the same response belowMay 23, Revdex.com Indianapolis, IN Dear ***: I reviewed the response from Dr [redacted] I need you to continue to dispute the claim with Dr [redacted] for the following reasons: · I called Dr [redacted] ’s office, LifeSmiles dentistry in January, and was told that he does not own Sagamore Meadows · I called Kerri [redacted] who was also listed as an owner and my call was never returned · I have never talked to Dr [redacted] nor have I had a discussion with him about this situation His response to the Revdex.com includes quotes – implying that we have had a conversation I have never spoken to Dr [redacted] so how can he provide quotes of a conversation? His response to the Revdex.com is as deceptive as those of Sagamore Meadows implying in their insurance documentation He implied that we talked by putting words in quotes, just as his statement on his estimates implied that they talked to my insurance company“Insurance estimated based upon information from the insurance company.” · I did sign many estimates from Sagamore Meadows and all of my previous claims were paid This confirmed my belief that they did contact my insurance company · Dr [redacted] informed Sagamore Meadows in April of that he performed the work that they referred me to him for a charge of $ Carol, the office manager, made a big point that I did not inform them of Dr [redacted] work and that was why I no longer had benefits, even though DrHeart informed Sagamore Meadows of the work and charges back in April of So Dr [redacted] ’s response “It is a moot point that Mr [redacted] said that he had services rendered elsewhere” is incorrect Further proof that I have never had a conversation with Dr [redacted] and I’m not sure where he is getting his information This information was available to them prior to their “estimate” and they should’ve known that my benefits were used up for the year without even calling my insurance company They never should’ve suggested that I have this elective procedure until I trusted that they knew my information, because they were correct all the previous times and they referred me to Dr [redacted] and he shared my information with them I also was in the chair with gauze in my mouth, prepped for the procedure and not in a position to call my insurance company · Dr [redacted] did not address the $charge to my Sagamore Meadows account on 10/19/without my signature I was never told about this charge, never signed an estimate So I did not agree to this charge! · Based on Dr [redacted] ’s response I should not be charged $since I did not get an estimate for this charge or sign for it Their business practices are not consistent I need the Revdex.com to continue to dispute these charges because Dr [redacted] has not acknowledged his ownership of Sagamore Meadows, addressed all the issues and I have no other way to dispute these charges Thank you, Steven [redacted] Regards, [redacted]
Revdex.com:I had great conversations with *** *** who the Regional Manager Assistant at Transitions Dental CompanyWe have reached an agreement that I paid my children’ s expense ($323.10) and Transitions Dental Company removes $and $on my billMy bill balance is 0.The above is our settlement.Thank you ***’s hard work for correcting the mistakesRegards,
*** *** %
I am [redacted] and the Regional Manager Assistant at Transitions Dental Company. I am writing in
0.6in 0pt">response to a complaint made by patient [redacted], whose children were seen at our satellite office Sagamore Meadows Family Dental in November 2014.
First, I would like to address the patient's complaint of negligence and overcharging. After much investigation into the patient's account I found that Sagamore Meadows Family Dental did not overcharge. The office is an in-network provider, however, after speaking to a representative, [redacted], at Blue Cross Blue Shield of Alabama myself, she stated that benefits for out-of-state dentist will be based on usual and customary fees with the patient being responsible for the difference between bill charged and the actual payment. I have included a faxback of benefits from the patient's insurance company stating this fact (Exhibit 1). The fees we presented to the patient were correct. The patient signed the treatment plans stating the fees( Exhibit 2). I have also included the insurance EOB which states the portion that the patient owes (Exhibit 3). I also verified over that phone with the BCBS of Alabama representative and that portion of $323.10 is correct and the responsibility of the patient.
The patient signed a Financial Policy stating that he understood that all charges incurred are his responsibility (Exhibit 4) and an Insurance Estimate form (Exhibit 5) which states he understands that our insurance estimates are based in information given to us by his insurance company.
The patient was informed of the portion on his children's accounts when he arrived for his own appointment on 1/8/2015. He had not received a statement in the mail because our statements had not gone out in the mail due to our billing cycle. This patient became very loud, upset, and aggressive when our staff of Sagamore Meadows tried to explain why he had a balance on his account. Please read the chart notes made by employees at Sagamore Meadows (Exhibit 6).
Unfortunately, we cannot accommodate Mr. [redacted]'s request of a refund of $323.10. This is his portion for the services his children recieved based upon his insurance plan and owed to our office.
Thank you for your time and consideration. Should you have further questions, please contact me at 765-807-0580 or email [redacted]@transitionsdental.com
Sincerely,
[redacted] Regional Manager Assistant
%3%3
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.NOTE: attached is the same response below.
May 23, 2016
Revdex.com
Indianapolis, IN
Dear [redacted]:
I reviewed the response from Dr. [redacted]. I need you to continue to dispute the claim
with Dr. [redacted] for the following reasons:
·
I called Dr. [redacted]’s office, LifeSmiles
dentistry in January, 2016 and was told that he does not own Sagamore Meadows.
·
I called
Kerri [redacted] who was also listed
as an owner and my call was never returned.
·
I have never talked to Dr. [redacted] nor have I
had a discussion with him about this situation.
His response to the Revdex.com includes quotes – implying that we have had a
conversation. I have never spoken to Dr.
[redacted] so how can he provide quotes of a conversation? His response to the Revdex.com is as deceptive as
those of Sagamore Meadows implying in their insurance documentation. He implied that we talked by putting words in
quotes, just as his statement on his estimates implied that they talked to my
insurance company. “Insurance estimated
based upon information from the insurance company.”
·
I did sign many estimates from Sagamore Meadows
and all of my previous claims were paid.
This confirmed my belief that they did contact my insurance
company.
·
Dr. [redacted] informed Sagamore Meadows in April of 2015
that he performed the work that they referred me to him for a charge of
$700.00. Carol, the office manager, made
a big point that I did not inform them of Dr. [redacted] work and that was why I no
longer had benefits, even though Dr. Heart informed Sagamore Meadows of the
work and charges back in April of 2015. So Dr. [redacted]’s response “It is a moot
point that Mr. [redacted] said that he had services rendered elsewhere” is
incorrect. Further proof that I have
never had a conversation with Dr. [redacted] and I’m not sure where he is getting
his information. This information was
available to them prior to their “estimate” and they should’ve known that my
benefits were used up for the year without even calling my insurance
company. They never should’ve suggested
that I have this elective procedure until 2016.
I trusted that they knew my information, because they were correct all
the previous times and they referred me to Dr. [redacted] and he shared my
information with them. I also was in the
chair with gauze in my mouth, prepped for the procedure and not in a position
to call my insurance company.
·
Dr. [redacted] did not address the $119.00 charge
to my Sagamore Meadows account on 10/19/15 without my signature. I was never told about this charge, never
signed an estimate. So I did not agree
to this charge!
·
Based on Dr. [redacted]’s response I should not be
charged $119.00 since I did not get an estimate for this charge or sign for
it. Their business practices are not
consistent.
I need the Revdex.com to continue to dispute these charges because
Dr. [redacted] has not acknowledged his ownership of Sagamore Meadows, addressed
all the issues and I have no other way
to dispute these charges.
Thank you,
Steven [redacted]
Regards,
[redacted]
I am writing in response the patient's rebuttal to my previous letter.
While it is true that I was not present when the issue arose at our satellite office, Sagamore Meadows Family Dental, my determination of whether or not patient balances are correct Is based upon facts which include signed documents and insurance EOB's , which I will address again.
All charges incurred are patient responsibility. Between the insurance company and the patient, the total fee must be paid. Our PPO fee schedules are determined by insurance companies based upon zip codes. In other words, the patient's PPO insurance company tells us what fees to charge based upon our geographical area. All collectable fees are determined by the patient's insurance company. The office receives an EOB (Explanation of Benefits) stating how much they have paid and how much the patient owes. See Exhibit 1, it clearly states the patient responsibility for each child is $107.70 for a total amount due of $323.10.
It clearly states on our treatment plan the total fee for services that the patient and his family received. The patient signed the treatment plans. Our treatment plans also state that they are estimates only. We cannot guarantee what the patient's insurance company will pay. It even states on the insurance faxback on the breakdown of covered services that it is not a guarantee of payment. The patient signed our Financial Policy (Exhibit 2) that states he understands that all fees are his responsibility regardless of what insurance pays. He also signed the Insurance Estimate form (Exhibit 3) stating that our treatment plans are just that, estimates. We try to come as close as we can to determining what a patient's insurance will pay based upon what their insurance company tells us, however, that information is NOT a guarantee of payment and you may still have a balance after the insurance has paid. The signed treatment plans and insurance faxback were previously submitted as supporting documents.
Like I stated before, I personally called the patient's insurance company to find out if the patient portion
was correct. I was told that the patient does indeed owe Sagamore Meadows Family Dental $323.10 (for his children). The EOB from the patient's insurance company also states this fact.
Thank you for taking the time to address the concerns for both Mr [redacted] and Sagamore Meadows. Mr. [redacted] presented to Sagamore Meadows on 10-05-2015 for a crown. Mr [redacted] was presented a treatment plan (Exhibit 1) for the estimated patient portion. Mr. [redacted] signed the treatment plan that...
explicitly states that the treatment plan is "only an estimate and that the patient is financially responsible for all work". Mr [redacted] has been a patient with Sagamore Meadows since 04-03-2014, at which time, he signed a financial agreement (exhibit 2) that states that the patient is financially responsible for all work. In the year and a half that Mr. [redacted] was a patient with Sagamore Meadows, Mr [redacted] signed approximately 10 treatment plans agreeing to pay for our expertise and services.Mr. [redacted] has said, on multiple occasions, because the treatment plan was "off", even though it was an estimate, he absolved himself of any financial responsibility and that we would have to "eat the difference", or he would spread a lot of bad reviews on social media. It is a moot point that Mr. [redacted] says that he told us of the service rendered elsewhere. It is Mr [redacted]'s responsibility to know his insurance benefit plan, its maximum benefits, and the approximate amounts used.It appears that Mr. [redacted] desires for us to take responsibility for his insurance utilization decisions. It is our opinion that Mr [redacted] knew and accepted all financial responsibility work that he received. We ask that this case be dropped and that Mr [redacted] pay his bill, as he committed to both in word and in writing.
We have very solid processes for presenting fees to our patients. We educate consistently that our fees are separate from any insurance estimates. We educate patients consistently that the insurance policies purchased by the patient are their own responsibility and any amounts their insurance chooses not to pay is their responsibility. As an added service to them we don't ask for final payment of estimated amounts until the insurance either pays or denies their claim.
Regards,
Dr. Daniel W. [redacted], DDS
Revdex.com: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.The message from TransitionsDental is largely incorrect and can not justify Sagamore Meadows Family Dental’s negligence and overcharging. Please see the following rebuttals (I have uploaded this letter with other supporting documents to the Revdex.com website).1. Allowable Amount of insuranceBased on [redacted] document, the dental office heard from my insurance company on 11/18/2014 before my family visited the dental office. In Exhibit 1, it indicates that”…..Based on allowable amount and the patient…” When [redacted] (Business Assistant) talked to me about proposed treatment plan for my children, I did have questions about coverage. She said I do not owe her office and she “circled” “0” on the plan (exhibit 2). This made me think $341 for each child is “allowable amount” which they can get from my insurance company. The circle on the paper misleads everything for the treatment. When I was in Hawaii for my dental treatment, I have never had any problems for billing. If necessary, I can provide the doctor’s contact information. It had been wonderful experiences in Hawaii (out-of-state). [redacted]’s message indicates that “He had not received a statement in the mail because our statements had not gone out in the mail due to our billing cycle…. This patient became very loud, upset.” I do not know who told [redacted] about billing cycle. [redacted] is rude and she said “youhad the service on 11/20/2014, but you have not paid yet. Today is 01/08/2015, It is almost 60 days since you had the service. You must pay NOW!” (My wife heardit as well). I told her that you can not say that because I have not received the bill yet and also it is less than 50 days since we had the services. You are wrong. I am sure [redacted] still remembers what she said and she is very rude. Why did you say “because our statements had not gone out in the mail due to our billing cycle?” This lie upsets me again.[redacted] said I must pay NOW regardless of the billing cycle because it is almost 60 days.2. My dental treatmentI visited the doctoroffice on 12/24/2014 after the dental office checked with my insurancecompany. I told the doctor that I have “onebroken tooth” and “one missing filling” that needed to be treated.As usual, dentists normally take X-ray for the first visit for any newpatients. I did it (I thought they have already checked my insurance). In exhibit 6, Dr. [redacted] commented that Icomplained “multiple broken teeth”…. “will like to wait for better insurancebefore proceeding..” that is incorrectand not true. Again, I only indicated that I only have one broken tooth and Ithink they overcharge me and are dishonesty. The doctor gave me two estimates. Firstis about my # 21 and 28 teeth for crown with a total of $1,682 after $1,000 insuranceis applied. This is much expensive thanI did my crown before (I told the dental office that I paid about $375 for onecrown in Alabama). Based on theestimate, each crown is $841 after my insurance is applied and twice expensivethan the crown I did before. Due to theovercharging, I asked the doctor to see if my other teeth are needed to betreated. She gave me the second estimate consisting of my #2 tooth, #3, #8, #9,and #14 with additional four crowns of $5,278!!!!!! Suddenly, I realized that Ishould stop talking with the doctor because I need to have a second opinionregarding my crown. I came back to Alabama and visited my previous dentist (Ican release his name if necessary) on 01/13/15. Again, I had x-ray and thedoctor exam my teeth. The conclusion is that, I only need to do one crown (#28)and one filling (#21). Rest of my teeth are ingreat shape!!!!! One crown and one filling are $392.90 after insuranceis applied. Therefore, all the evidences indicate that Sagamore Meadows FamilyDental orvercharges me and is dishonesty. The similar story is posted by [redacted] on [redacted]on 09/11/2013 http://www[redacted]Please see blow:[redacted] 3. Upset and irritated by staffIt is true that I wasextremely upset and irritated by the staff (primarily [redacted]-office manager)due to their unprofessional attitude, incompetence,roughness, and insults. First, please elaborate what “definite language barrier”means in exhibit 6. As an educator fordecades, I feel like I talked with a 4 year-old boy when he made mistakes.Exhibit 6 is largely wrong and inaccurate ([redacted] should write it not [redacted]). Italked with [redacted] first without any conflicts, but I do not know why [redacted]suddenly jumped into our conversation. Nobody encouraged me to call myinsurance, but I did call my insurance. The reason why I mentioned $ 30 co-pay isthat, I realized they made mistakes, did not do much good homework, and Ishould give them a chance as I gave my students when they made mistakes (I amwilling to pay $30 for each child). Unfortunately, [redacted] asked me to find any discountson the bill so that she can give me some discounts. I told her that I can notdo that because you are (30 year’s experience) an expert in the field and thisis not a discount issue and this question that you should not even ask me. Then,I feel like we are forced into a rollercoaster that we started to fight unprofessional attitude, incompetence, roughness, and insults. Actually,[redacted] assistant said she did check with my insurance before my familyvisited her office, but she does not understand why the insurance did not cover100% (it indicates that they did not do good homework and they have theirnegligence).[redacted]: I believe you were not in our conversation. Youmade your own judgment based on what you heard from Sagamore Meadows FamilyDental. As an educator, I understand how doctors and their staff work hard fortheir patients. However, people make mistakes. You should listen to your customersand fix the problem. I have been using Blue Cross Blue Shield of Alabama since2008 and I never had any problems with any of my doctors (etc. dentists) in Alabamaand Hawaii. Because you spoke with my insurance company, you can also call themto verify whether or not I had any problems with my doctors. The problem with SagamoreMeadows family dental is my first time of complaint and I am very upset bythem.Please get my $323.10 ($107.70 for each kid) refunded and remove both $85 and $126from my bill (In my bill they charged me $85 for oral examination, $126 forIntra Oral Complete Series which is rejected by my insurance company becausethe company said “THIS CHARGE IS NOT COVERED WHEN A RELATED SERVICE IS RENDER.”).They also should apologize to me for their negligence and incompetence.Sincerely,[redacted]An educator for two decades
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