Pediatric & Teenage Dentistry

To Whom It May Concern,We were previously informed by DHHR the patient must have their card in hand and active coverage on the date of service in order for Medicaid to pay for a procedure, if not we could collect from the parent and were not obligated to reimburse them at a later timeWe would like
to know who she spoke with, name, title, and contact number, so we can make sure we are receiving the same informationThis method she is speaking of makes for unnecessary accounting work on the provider when they do not keep up with their coverageWe should not be held responsible for that.Medicaid and therefore our office policy, has always been that the patient must have active coverage on the date of appointment for the state to pay or the parents are given the option of rescheduling until they meet with their caseworker and give them the needed information to reinstate their coverage or paying out of pocket*** was given this option and chose to pay out of pocket.As stated above, If *** can provide the name, title, and number of the Medicaid representative she spoke with, with a signed letter from them stating *** has active coverage for 02-21-and that they will pay for this date of service we will reimburse her for this date.Sincerely,***Account Representative

I spoke to *** at the phone number provided by *** *** and gave her the reference # ***I questioned whether *** was told we were legally obligated to reimburse her and bill MedicaidShe put me on hold and spoke to her team lead, ***, which informed her the members were informed if they DO NOT have coverage on a date of service they should reschedule until their coverage has been reinstatedIf they choose to pay out of pocket and have treatment then the Provider is NOT required to reimburse the member and bill Medicaid as *** is stating*** also took the time to walk me through the Bureau for Medical Services website and show me the page that clearly outlines the member's responsibilities, please see the attached policy.We will stand as we previously stated, we will not reimburse *** for date of service, February 21, 2017, for *** as she did not have coverage on the date of service and mother chose to pay for treatment knowing our office policy and we do not back date.I do want this to be the last correspondence to this matter, as my office staff has spent entirely too much time on this matter just to prove she did not have her facts straight

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.
I find the response completely unacceptable. They asked me to provide proof of coverage for the date of appointment. I did so. I stand firm in that at absolutely no point during my appointment or the moment leading up to the actual exam, did ANYONE EVER say they would not reimburse me. I was assured I would be getting reimbursed once I could prove my daughter's coverage. I was told by the DHHR customer service line that it is the doctors offices responsibility to issue reimbursement. After all, that is who I gave my money to. This is a simple billing process that has been completely dragged out and turned into an over exaggerated ordeal. I am so disappointed in this "family" business!  
Regards,
[redacted]