Peara Dental Practice, Inc.

Hello!We have received this complaint and we have already spoken with the customerThis customer's order was cancelled and refunded on May 2nd due to hostile behavior on the customer's behalfThe customer began to reach out to us on our social media accounts about how she believes that she
shouldn't have to purchase an item marked "PRESALE" and that the items should be ready to go as they are purchasedFor this particular item, it is fairly popular and sells out on a weekly basis so it is always sold with the label presale so that a potential buyer knows that there will be a wait time to get this item in their hands after purchaseWe explained to her the reason it is presale and we stated that due to her display of satisfaction - we would promptly cancel her order and refund the moneyUnfortunately, we do have a policy that states that shipping costs are non-refundableThe customer believes that this should only be for items already in transit, but this is not what our policy statesThe customer has been refunded the price of each item she has purchased with the exception of the shipping costsThese policies I am referring to are on our website and are readily available to be read BEFORE point of purchaseWe understand this customers complaint but we believe that we have handled it the best that we can while still sticking by the policies that we have

Review: On October 18, 2013, we visited Dr.[redacted] for extraction of 4 wisdom teeth for our Daughter [redacted].During the initial visit he was told that it is a simple and common procedure for them.After the visit I contacted the office to go over the billing responsibility and spoke to [redacted] the receptionist. She informed me that she has to wait for the insurance company to let me know what is our responsibility for this procedure. I received a call from [redacted] and was told they can only do 2 extractions since it was year-end and we had less than 1500 maximum annual available. I went over all the cost with [redacted] many times and was told that my personal out of pocket for the first two is $121.90. I agreed and again went over why I even had to pay that, and she informed me that insurance company does not cover all the cost and that there is no way to avoid paying the $121.90 for the first two.We scheduled the appt for Nov 7th 2013.I drove my daughter to her appt and paid my obligation before they performed the extractions.The procedure took 30 minutes.Our 2nd appt was for Jan 2, 2014 which was changed due to scheduling conflict to Jan, 13. I spoke to [redacted] on more than 3 occasions and this time the cost was $118.70. My sister took her to the 2nd procedure which took 30 minutes. On or about Feb 14,2014 I received a statement from [redacted] Dental asking for an additional $349.25. I was shocked and called their office and spoke to [redacted].She told me that the insurance did not pay for the additional 60 minutes of General Anesthetic so therefore we are now responsible to pay the additional fee. She even told me that they were giving us a break and were going to split the fee. The actual additional amount was $700 but their office gave us a Misc. credit of $349.25. I spoke to her in length and wanted to know why there was an additional 1 hour of General Anesthetic for all 4? She informed me that as a precaution, they normally do that.The toal time for all 4 extractions was 1 hour and not 2.Desired Settlement: The complete time for all 4 extractions was 1 hour and not 2. Office of [redacted] in my oppionion is unethical for these undisclosed fees. THE TOTAL CHARGE FOR 4 EXTRACTIONS WAS PAID BY US AND OUR INSURANCE COMPANY IS $3,366.50 AND NOW THEY WANT TO CHARGE ADDITIONAL FEE.I was never told that this is a complicated case and may require additional time for extractions.I was told by [redacted] that she didn't think she needed to send the pre-authoriza

Business

Response:

On October 18, 2013, [redacted] had a dental exam appointment with Dr. [redacted] to examine her wisdom teeth. The patient was accompanied by her father, [redacted]. I had informed the patient that I would contact their insurance carrier to find out their benefits then call them to explain their share of cost. On October 31, 2013 I was able to make contact with an insurance representative regarding [redacted]’s plan. She was covered for oral surgery at 90% with a remaining maximum of 1,059.00. Dr. [redacted]’s office is contracted with [redacted]’s insurance which is [redacted]; therefore our office accepts their contracted fee which is much lower than our regular fees. On November 4, 2013, [redacted]’s mother, [redacted], had asked me for a treatment estimate after I explained to her that her share of cost would be $505.90 for all 4 wisdom teeth to be extracted using an hour of general anesthesia. Dr. [redacted] had discounted the share of cost to $400.00 since [redacted] is a distant cousin of his. On the treatment estimate I clearly marked our contacted fees next to our regular fees so the patient and her family can see the difference. [redacted] had called me back stating due to her insurance max being low at the end of the year she wanted her daughter to have only two wisdom teeth out before the year was over then in January she would get the other two out once her insurance maximum restarted. I calculated the new share of cost and informed her of it which was estimated at $121.90 for both upper wisdom teeth.

Once the procedures were completed and billed to [redacted]’s insurance our office received the explanation of benefits back from her insurance. For each claim the insurance had only paid for 30 minutes of anesthesia and the extractions. For each individual claim the EOB stated the patient had a share of cost of $440.70 & $474.40. The patient had paid her estimated share of cost at the time of her surgery which lowered this bill to $698.50. Since this was unexpected for her insurance to not pay for the full hour of anesthesia, Dr. [redacted] had given the patient a 50% discount which lowered her share of cost to $349.25. I had sent the patient a bill for this amount with the credit already subtracted. Not long after the patient’s mother had called very upset and rude stating that this unexpected bill was my fault because I had not sent for pre-authorization. I explained to her that she never informed me to send for the authorization and that if I did the surgery wouldn’t have been able to

be done before the end of the year. I also explained how when I went over the share of cost I had stated it was just an estimate. There is no way for a receptionist to guarantee a patients share of cost. She said she would have to talk to her husband regarding the bill.

A week or so later [redacted] called our office pertaining to her bill. She stated again it was my fault for the bill and I had tried to work with her by telling her we can create a payment plan for 4 months which would have been $87.00 payments each month. She kept telling me that wouldn’t work for her and was becoming very rude and loud. I then went over how the doctor had given her 50% off which was quite a bit of a discount and I explained how he normally doesn’t do that. She kept telling me she wouldn’t pay the bill because it was my fault for not sending authorization. I then told her if she didn’t pay the bill we would have to send her to collections for the full amount. She still was yelling and being rude. The manger overheard and told me to put her on hold so she could speak to her. When I attempted to put [redacted] on hold she yelled at me “No, I don’t have time to talk to the manager!” and had hung up. The manager then called her back and [redacted] told her it was my fault for not sending pre authorization and what kind of office doesn’t send authorization. The manager let her talk then told her the reason we didn’t send the authorization was because she had wanted the surgery done in a timely manner before the year was over. [redacted] was very rude and then hung up.

We had sent her a final bill and letter stating if the bill wasn’t paid in 30 days the account would be sent to collections. A few weeks later we received a letter from Revdex.com stating she had reported Dr. [redacted]. At this time I had sent them to collections.

In March Dr. [redacted] and his wife were at a funeral where they had seen[redacted] and his wife, Mrs. [redacted] (the manager) had gone up to him to speak to him about what was going on because she didn’t want to ruin his credit with being sent to collections. [redacted] had no idea what was transpiring and could not believe it. He stated he would take care of the bill and cancel the report to Revdex.com. Dr. [redacted] called and spoke with you about how to go about dropping this report and you told him to have [redacted] e-mail you. We sent [redacted] your e-mail on April 1, 2014 and he told us he would be mailing a check to us for the amount of $349.25 as well as e-mailing you. On April 8, 2014 I had called [redacted] because we had not yet received his check. The first thing he said was “this is why you’re calling me?” He told me he ran out of checks and would have to order new ones, he asked if he could pay over the phone and I told him there was a fee for that and it would be best to come in person or send a check. He then asked if I removed him from collections. I told him I couldn’t do that without receiving payment from him. He then told me I was “playing games” with him and he didn’t like that “crap” I told him he needed to calm down cause there was no reason to speak to me in that manner and also explained I can’t remove him without payment. He began to yell and speak rudely so Dr. [redacted] got on the phone and asked him what the problem was. Dr. [redacted] explained he had already given 50% off and that was the best he could do. Eden’s manner changed entirely and Dr. [redacted] told me I could take the payment over the phone. Later that day I removed him from collections.

We have all our patients sign documentation stating they are aware if their insurance doesn’t pay they are responsible. There is no way to guarantee a patient’s share of cost, even with a preauthorization there is no guarantee. Thank you for your attention to this letter, if you have any questions, please call ###-###-#### and ask for [redacted] or [redacted].