Perfect Teeth

Complaint: ***
I am rejecting this response because: Perfect Teeth has refused to take responsibility for horrible service and unethical business practices. There were no courtesies extended to me by Perfect Teeth. They demanded me to pay them over $on the spot, when the actual bill was $319! This was after failing to receive promised return calls, being left on hold for over minutes every time I called, being told in their office they would rather I not return, receiving harassing voicemails and mail, the dentistry failing less than a month later, and not getting me in immediately when I notified them my crown had fallen off.Clearly, this is not the forum to voice my complaints so I will be taking them out and abroad. What is really sad is I was a happy customer for over a decade and feel this is due to outstanding employees who did their jobs, were courteous and kind, so I never had to experience interfacing with Perfect Teeth corporate. Needless to say you will not only be losing me as a customer but whoever else I can reach, not to mention the many other disgusted patrons who have to deal with your self-righteous hypocritical greedy attitudes coupled with low quality dentistry, lack of professionalism, and incompetency.
Sincerely,
*** ***

Initial Business Response /* (1000, 10, 2015/06/17) */
We are initiating a refund to you today as requestedI did investigate the appointment you had with us and believe that you were not only informed prior to the treatment but agreed to itThe *** Perfect teeth will never charge patients
for treatment they did not agree to or for treatment they did not receiveI apologize for any misunderstanding

Tell us why here...First of all let me state once again that your Insurance contract is between you and your Insurance company, we are a third party and as it states in the office policy and Orthodontic treatment contract that you signed before we started treatment, we will file the claims for you as a courtesyHowever if they do not pay the claim in days, then the balance becomes your responsibilityWhat I did find out from *** was this, *** with *** stated to me that in fact it was not timely filling that held up your claim, but it was confusing when the orthodontic provider and Orthodontic office changedShe also states that the claim is currently in process and they have everything including the two appeals that our Staff has written and sent to them.The payment should be paid by the end of the month from ***We have had several of our staff working on this account and it should be resolved by the end of the monthI would urge you to call *** and verify as the contract is between you and ***If you would like a copy of all the correspondences and Appeals that we sent into *** on your behalf, we would be glad to send you a copy for your records

Due to HIPAA regulations, we are unable to post a full response online, however, we have drafted a full response and mailed it to the patient directly at the address provided

Complaint: [redacted]
I am rejecting this response because:This is not an acceptable response to me. I have spoken to Perfect Teeth on several occassions due to me calling and following up with them. They always promise to call me back but never do. I have been told that they have been reviewing my claim for the past 9 plus months with no resolution. So, the response that they are re-reviewing this is just absurd and will adjust if needed.I am not responsible for this payment and will not pay for this due to their lack of timely filing on their part. If I have to take this matter publicly, I will do that. 
Sincerely,
[redacted]

A denial letter was received from Delta Dental Tricare on October 4th 2016 stating that patient was not eligible on date of service September 28, 2016. The operations manager double checked the coverage and corrected any errors on the claim and re submitted the claim. Our A/R team did make an error...

and requested the letter per our company policy but didn't acknowledge the notes regarding the claim being re submitted. The account has received the payment from Delta Dental Tricare and now has a zero balance.  We will talk with our Accounts receivable team to ensure that this doesn’t happen again. We are sorry for the inconvenience this has caused and value you as patient in our office.

We are looking into the account and re-reviewing it. We are doing every thing we can to correct any problems with the Ins company and will adjust the account if needed. We have spoken to the patient on several occasions to try and resolve the problems.We will do are very best to get this resolved in...

a timely manner.

Good Morning. We have reviewed the complaint from [redacted]  and we are unable to locate her in our network. We would love to respond if she can provide us with the Perfect Teeth office where she saw the Dentist. If it was a perfect teeth we apologize for any pressure put on her as this is...

not how we conduct our business.

Initial Business Response /* (1000, 8, 2015/09/04) */
This letter in response to case #XXXXXXXX. In order to protect our patient's health information as outlined by HIPAA, we have responded directly to the patient via [redacted] addressing her concerns and offering her a second opinion.
Initial...

Consumer Rebuttal /* (4200, 15, 2015/09/30) */
I never received any mail communication from Perfect Teeth.
Final Business Response /* (4000, 21, 2015/10/30) */
This correspondence is in response to the Revdex.com complaint filed July 23, 2015. I would first like to apologize for any and all miscommunications between our dental offices and yourself.
On July 31, 2014 you were seen at Perfect Teeth on Speer Blvd to have a crown from a previous visit seated and have a comprehensive oral evaluation and full mouth series of radiographs. At that time it was noted that you had not had radiographs or a cleaning in over a year. It was documented by the hygienist that there was moderate plaque buildup and moderate bleeding on probing, especially in the molar areas. Oral irrigation with .12% chlorohexidine, Arestin on tooth #18, as well as fluoride varnish was recommended in conjunction with your cleaning and oral hygiene instructions explaining gingivitis, periodontal disease, decay process and etiology were also given at that time. During your evaluation with [redacted], 2 surface resin restorations were recommended on teeth # 13, 14, 12, 3, and 4, as well as crowns being recommended for teeth #18 and #19. You returned to the office on August 14, 2014 to have your cleaning, oral irrigation, Arestin, and fluoride varnish completed with the hygienist. On October 6, 2014 you returned to the office to start your restorative treatment with [redacted], and at that time informed her that your bonded retainer felt loose and that tooth #7 had moved since your cleaning being completed in August. [redacted] notated that she would contact the manager on your behalf to help resolve the situation.
On December 10, 2014, you were seen by Dr. [redacted] at the Buckley Perfect Teeth and expressed your concerns with a space that had opened up between teeth # 7 and #8, with tooth #7 being flared forward. At that time the option of limited upper orthodontic treatment for 3-4 months with the use of traditional metal braces was recommended to improve the position of tooth #8 and close the space between teeth #7 and #8, with a new bonded retainer being placed upon completion of treatment to help prevent the space from re-opening. Hilary at the Buckley location talked to corporate on your behalf and the recommended treatment was to be performed at no cost to you. You agreed to the proposed treatment plan and scheduled to begin treatment on January 14, 2015 at [redacted]'s new office Perfect Teeth on Monaco. On January 14, 2015, after treatment consents were signed, you had limited brackets placed on your upper teeth.
On May 6, 2015, you were seen to have your braces removed and a new bonded retainer placed. It is notated in your chart that at that time [redacted] asked you if you were satisfied with the esthetics; you stated you were which is why the braces were removed at that time. The bonded retainer was larger than the one you had previously to provide more support and lessen the chances of tooth movement after the braces were removed. After having the braces removed, you informed [redacted] that you were unhappy with the positioning of tooth #7, which appeared to be slightly flared forward. A radiograph was taken which showed that due to the angle of the crown of the tooth in relation to the angle of the root, the tooth does not line up completely straight with the other teeth. In order for the tooth to align perfectly, the root of the tooth would touch the root of the adjacent tooth, which may cause further dental issues. [redacted] gave you the best options in his professional opinion regarding the movement of tooth #7 and the risks and benefits for each option, and offered each option at no additional cost to you. As well, you were concerned about white spots on your teeth which appeared after having the braces removed. On occasion, there is decalcification associated with orthodontic treatment, which causes discoloration of the teeth. While good oral hygiene helps prevent this from occurring, it is a risk of treatment. This was explained on the consent form signed by you in our office on January 14, 2015 prior to treatment being rendered.
While we strive to provide excellent dental care to our patients, orthodontic treatment is not an exact science, and circumstances outside of our control can affect the outcome of treatment. We understand your concerns, and would like to offer you a second opinion with another one of our Perfect Teeth orthodontists.
Again, I apologize for any miscommunication between our offices and yourself.

I called and spoke with [redacted] today and we reviewed the information she was concerned about. We came to an agreement about the outstanding balance and resolved any issues with it. I apologized for not getting back to her in a timely manner and told her I would address this with the...

staff as this is not the customer service we want to deliver.

We contacted Ms. [redacted] today January 26,2016 and requested that we split the balance on her account with her. Ms. [redacted] agreed to this solution and will pay her portion . We would like to apologize for the misunderstanding we had with her insurance policy. Thank you Ms. [redacted] for being a patient of ours, we appreciate you very much.

Our general practicing dentist, [redacted] and our [redacted] have reviewed the patients complaint and found the following with supporting documentation-The patient has been informed since 2015 when the treatment originally started of the questionable outcome....

Each time the patient has returned to the practice the dental procedure has been redone with the communication of the questionable outcome. The patient has been informed of the more suitable option and has chosen each time the less favorable outcome. Please feel free to contact us with any further questions.

Complaint: [redacted]
I am rejecting this response because:First I would appreciate your salutation to me be Ms. rather than Mr. which is clearly stated in my file that I am a female. Secondly, I spoke with representation from [redacted] that states that after the amount of $332.50 was paid by [redacted] covered the copay in which the remainder of the bill was paid in full.  There was no rejection of a claim or that would have been stated when I spoke with them.  Although you insinuate that you did me a favor; I have spoken with both insurance parties whom clearly have stated that payment went out to your establishment in regards to the procedures.  With that stated I would recommend speaking with representatives at both primary and secondary insurance companies to clarify this "rejected" claim which is the first time I am being made aware that it was rejected for whatever reason you may beget.  I spoke with the front desk on numerous occasions trying to get a clear explanation in which I have also received numerous bills with different amounts noted that do not coincide with the amount that you stated in your response. If you could contact me personally in regards to this matter so we can actually speak I would greatly appreciate it. Thank you.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 11031901, and find that this resolution is satisfactory to me.
Sincerely,
[redacted]

In regards to consumer complaint #[redacted]. We apologize for any miscommunication received while in the office. We strive to give patients the Gold Standard and are disheartened to hear about your experience. As a courtesy, we give estimates based on the current plan information we have on...

file. In an effort to ensure we have the time to give the care needed we schedule longer appointment times, especially if the severity of the case requires it.Insurance billing upon seat date is often required by the insurance company and is sometimes delayed due to the nature of the restoration. To maintain privacy and adhere to HIPPA regulations we are unable to discuss any further detail as this is a public forum. A separate letter will follow by mail.

Ms. [redacted] I apologize for the confusion. We quote the patient the best we can with information provided to us. There are many insurance plans where the same plan will have a little change to it and can be sometimes very difficult to verify for us. your plan with in a plan has a waiting period which...

we did not identify with the information provided to us. It is always helpful when the patient knows the plan limitations because we can get many different answers when verifying due to the many different changes in the same plans. Please feel free to call me. Donna Brandenburger ###-###-####

I apologize that we have not been able to meet the need of your request. We stand firm behind our decision to require payment for services rendered by our providers.  You have a contractual obligation between you and your insurance to pay for treatment received. We normally require payment upon date of service as outlined in our office policy, signed at your initial appointment. As a courtesy, we billed your insurance prior to collecting your patient portion to correctly address the discrepancies from the previous quote. We strive to be as accurate with our quotes as possible, but sometimes pricing does change due to circumstances out of our control. For the sake of transparency and full disclosure to our patients, we would rather quote high and have a patient be pleased with the savings, rather than quote low and surprise someone with a larger bill than anticipated. The final pricing is contractually set by insurance coverage, and we are not legally able to dictate what an insurance company’s final coverage will be regarding a patient’s treatment.

Initial Business Response /* (1000, 6, 2015/11/03) */
Ms. [redacted],
First, we sincerely apologize for the inconvenience this has been for you. After reviewing your account and the explanation of benefits, we have found that we owe you an additional refund from your December 2014 date of...

service. The refund should be processed by the end of the week. To avoid this mistake again, we definitely will pay more attention to detail and stay in contact with our patients every step of the way. Again, we apologize and thank you for bringing the issue to our attention. If you have any further questions or concerns, please feel free to contact the Operations Manager, [redacted], at (XXX) XXX-XXXX.

The patient [redacted] was seen on October 07, 2016 for an evaluation with our oral surgeon; at the time of the appointment a financial estimate was presented to the patient and the patient was fully aware that his insurance was going to max out after paying the full $2000 benefit he had...

available and he would be responsible for the remaining  $3655. On the day of the surgery; November 16, 2016 the patient made a $25 payment stating he was not prepared to make a payment but never informed the staff that he needed a payment arrangement to pay off the remaining balance.  We received payment from the insurance on December 13, 2016 and a insurance paid letter was mailed. On January 02, 2017 a second attempt was mailed and then we finally received a $80 payment from the patient. On February 06, 2017 a final letter was mailed and we received another $80 payment. During this time we made three attempts to get in reach with the patient to discuss the account and possibly sent up a payment arrangement with no response from the patient. We would like to offer the patient a 30% discount if the patient can get the account paid in full within 6 months and we will remove the account from collections; we would love to work with the patient in getting the account paid off but at the patients rate of $80 a month it would take over three years to pay off and unfortunately that's not our company policy.  Respectfully, if the patient can only make the $80 payment its best to continue making the payment through the collection agency

We are responding to the question regarding the DOS 7-28-2016 on [redacted] for a crown on Tooth 15.     Patient has an HMO primary through [redacted] which denied the claim and did not pay anything. Had the patient had only [redacted] and no secondary insurance,  the...

patient would have had an out of pocket expense of $545 (the copayment under the HMO plan).     We submitted the claim to [redacted] secondary insurance carrier [redacted].   Our UCR was $1314, but our agreed upon HMO charges were $545.  According to [redacted], they actually allowed $724 due to the patient's election to have a porcelain upgrade.  However, we gave the patient the greater benefit and only charged him for the $545 for the crown - the lower HMO fee.     [redacted] paid $332.50 (50% of their covered expense).  THe patient was responsible for the remaining balance of $212.50 ($545-$332.50), of which the patient paid $100 in cash on 9/3/2016. Therefore, the patient still owes an additional $112.50 on the crown, because there was a patient co-insurance. There was a 50 cent late charge on the account, so the total amount turned to collection was $113.  The attached EOB clearly shows a 50% benefit, so the patient has a coinsurance responsibility.  Where I think there is confusion is that even though [redacted] primary may have told him they paid everything - they actually paid ZERO.  100% of the contract rate of $545 was due from the patient.  The secondary, [redacted], actually helped in defraying some of that expense by paying $332.50.  However, we are entitled to collect up to the contract rate under the lower plan; therefore even after the secondary payment, the patient had a balance due. We hope that this clears up the confusion.  It is a common misconception that when a patient has both primary and secondary insurance that there are no out of pocket expenses, which isn't always the case. Typically the secondary helps defray a part of the patient's coinsurance, which was the case in this instance.  If you have any questions, please contact the Regional Director of Operations - [redacted] at [redacted]