Piedmont Pediatric Dentistry

To Whom It May Concern: To begin our response to this complaint submitted by Mr [redacted] , we would like to state that we are very sorry for any misunderstanding and any role we may have played as it was not our intent.It is however to important to note that Mr [redacted] (step-dad of the patient) has never been to our office and was not present on the date in questionDue to his relationship to the patient (not verified to be legal guardian) and our attempts to protect patient confidentiality (HIPAA), our staff has not had any communication with himHe did email our office, but our response was sent directly to [redacted] (mother and legal guardian of the patient)To give some context, the patient was not a patient-of-record and was coming to our office as recommended by another local dentistMr [redacted] indicated in this complaint that DrP [redacted] was "rude and verbally abusive.” Mr [redacted] has never met DrP [redacted] and according to our records and collective memories, Mr [redacted] ’s report was not accurateUpon check out, [redacted] was speaking with the patient at the check-out desk, she was overheard byour office manager and other members of our staff saying, “Now see, that was nothing to get upset about, it didn’t hurtThe doctor was trying to help you, he was very patient and nice to you”During the course of treatment the patient and mother were treated withrespectWe are having difficulty understanding the claim of rudeness and verbal abuseMr [redacted] indicated later in his complaint that DrP [redacted] “refused service and tried to remove our child after inducing laughing gas, but before starting the procedure (and bill us for this), because child was crying about having a tooth pulled.” During the explanation of the treatment to the patient, DrP [redacted] used the Tell-Shand positive reinforcement behavior guidance techniques to assist the patientWhen the nitrous oxide mask was placed, the patient kept it on until local anesthesia was about to be administered, then thepatientdefiantlyremoved the mask, got out of the chair and attempted to leave the operatoryAt this point, DrP [redacted] asked the patient to please sit down so they could discussDrP [redacted] presented to the patient options of: 1) returning to chair to proceed with treatment, 2) getting patients mother and have her speak with patient, or 3) refer to different practice for completion of dental workThe patient chose option #Mom was requested into operatory at which time she appeared disappointed with patient for his defiance and instructed him to return to the chair to have treatment initiated and completedMom encouraged DrP [redacted] to complete the necessary extractions that were causing symptomsDrP [redacted] stated that he would be happy to address symptomatic teeth, but for all further dental work the patient would require to be referred out for sedation in order to achieve necessary compliance (as the patient has additional and more complex dental needs) and ensure patient safetyDental work was rendered with nitrous oxide while mother held patients hands and encouraged DrP [redacted] to continue with the procedure to alleviate patient symptomsTo clarify, 1)DrP [redacted] did not refuse service or remove the laughing gas,the patient removed the mask himself; 2) laughing gas (nitrous oxide) was charged because it was used to render treatment.Regarding the charges mentioned in Mr [redacted] 's complaint, [redacted] signed a treatment plan prior to treatment indicating she consented to treatment and understood that nitrous oxide and the Limited Evaluation were not covered benefits by her insurance and the cost was $ [redacted] and $**respectivelyOn the treatment plan the cost for the extractions was also listedUpon checkout $ [redacted] was collected for the treatment and nitrous.Shawn D [redacted] (our office manager) did fail to collect for the “Limited Evaluation” of $**Shawn informed [redacted] via email on 5/24/and during a phone call on 5/25/(prior to the complaint) that she did fail to collect for the Limited Evaluation andapologizedfor overlooking collecting that fee at checkout.To clarify, 1) There were no “extra” charges for nitrous as stated in the complaint, only forthe nitrous used to render treatment;2)Shawn wasn’t asked about any additional charges at check out and Shawn statedwould never tell a Responsible Party and she quotes “Under no uncertain terms that these charges would not be processed and that they were ***% paid in full”.3) It is our office policy toalways use the word “estimate” when speaking to a responsible party because we don't know exactly what the insurance will pay once the claim is processedThe signed treatment plan clearly states that [redacted] understood that the treatment plan was only an estimate.To clarify, a limited exam is required to determine treatment and diagnosis for a focused problem,especially for a non-patient-of-record Mr [redacted] stated in his complaint that once “we” complained to the office, Shawn added additional charges.This is not correct, as stated above, as Shawn forgot tocollect the Limited Exam fee at checkout and it was not added inresponse to any complaintDue topatientconfidentiality,Shawn was unable to speak with Mr [redacted] about treatment or finances regarding his step-child.The only charge not discussed with [redacted] was the “Behavior Management” charge as there were no signs of adversebehaviorprior to treatmentThis charge is only reserved for patients that take an inordinate amount of time/effortdue to poor behavior/non-complianeabove the usual and customary fortheir age and medical condition(s) and is almost always added after treatment is renderedIn this instance this charge was fully-justified by the standards set forth in the profession.During a phone conversation with [redacted] on 5/25/2017, she confirmed her son was not cooperative and had never heard of this chargeShawn explained the meaning of thebehaviormanagementcharge and referred [redacted] to the American Dental Association to confirm it was a valid codeHowever, Shawn did inform her the behavior management charge would be reversed and it was reversed ontheir account [redacted] then inquired about the Limited EvaluationShawn explained the evaluation had to be completed to determine treatment and diagnosis and that this it is the standard of careShawn explained it was a Limited Evaluation because the patient was being seen for a specific problem and the exam was limited to the area in which was causing symptomsIn summary, the balance due on the account is $ [redacted] for theLimited EvaluationThe services provided and charged are as follows; Limited Evaluation $**.**, Nitirous $***.**, 1st Extraction $***, 2nd Extraction $***The estimate given the patient was exactly correct once processed by the insurance companyWe are so sorry for anymiscommunication; have apologized for our failure to collect for the Limited Evaluation fee; and have reversed the Behavior Management feeWe desire to treat all our families with respect and compassion and we want people to know we have good intentionsThis complaint, along with an online [redacted] review, do not accurately represent our practice or this eventThis is due in part to Mr [redacted] ’s absence at the appointment in question, as well as a missunderstandingWe are grateful to have the opportunity to share our side of this event in more depth.We hope our explanation above helps clarify the events of theappointment in questionSummary: We are grateful to have the opportunity to share our side of this event in more depth and request that Mr [redacted] consider removing his online review and dropping all current and future reviews/complaints in exchange for a reversal of the Limited Exam fee.We hope our explanation above helps clarify the events of theappointment in question Shawn AD [redacted] Office / Financial Coordinator Piedmont Pediatric Dentistry T [redacted] *** *** www[redacted] .com

To Whom It May Concern: To begin our response to this complaint submitted by Mr. [redacted], we would like to state that we are very sorry for any misunderstanding and any role we may have played as it was not our intent.It is however to important to note that Mr. [redacted] (step-dad of the...

patient) has never been to our office and was not present on the date in question. Due to his relationship to the patient (not verified to be legal guardian) and our attempts to protect patient confidentiality (HIPAA), our staff has not had any communication with him. He did email our office, but our response was sent directly to [redacted] (mother and legal guardian of the patient). To give some context, the patient was not a patient-of-record and was coming to our office as recommended by another local dentist. Mr. [redacted] indicated in this complaint that Dr. P[redacted] was "rude and verbally abusive.” Mr. [redacted] has never met Dr. P[redacted] and according to our records and collective memories, Mr. [redacted]’s report was not accurate. Upon check out, [redacted] was speaking with the patient at the check-out desk, she was overheard byour office manager and other members of our staff saying, “Now see, that was nothing to get upset about, it didn’t hurt. The doctor was trying to help you, he was very patient and nice to you”. During the course of treatment the patient and mother were treated withrespect. We are having difficulty understanding the claim of rudeness and verbal abuse. Mr. [redacted] indicated later in his complaint that Dr. P[redacted] “refused service and tried to remove our child after inducing laughing gas, but before starting the procedure (and bill us for this), because child was crying about having a tooth pulled.” During the explanation of the treatment to the patient, Dr. P[redacted] used the Tell-Show-Do and positive reinforcement behavior guidance techniques to assist the patient. When the nitrous oxide mask was placed, the patient kept it on until local anesthesia was about to be administered, then thepatientdefiantlyremoved the mask, got out of the chair and attempted to leave the operatory. At this point, Dr. P[redacted] asked the patient to please sit down so they could discuss. Dr. P[redacted] presented to the patient options of: 1) returning to chair to proceed with treatment, 2) getting patients mother and have her speak with patient, or 3) refer to different practice for completion of dental work. The patient chose option #2. Mom was requested into operatory at which time she appeared disappointed with patient for his defiance and instructed him to return to the chair to have treatment initiated and completed. Mom encouraged Dr. P[redacted] to complete the necessary extractions that were causing symptoms. Dr. P[redacted] stated that he would be happy to address symptomatic teeth, but for all further dental work the patient would require to be referred out for sedation in order to achieve necessary compliance (as the patient has additional and more complex dental needs) and ensure patient safety. Dental work was rendered with nitrous oxide while mother held patients hands and encouraged Dr. P[redacted] to continue with the procedure to alleviate patient symptoms. To clarify, 1)Dr. P[redacted] did not refuse service or remove the laughing gas,the patient removed the mask himself; 2) laughing gas (nitrous oxide) was charged because it was used to render treatment.Regarding the charges mentioned in Mr. [redacted]'s complaint, [redacted] signed a treatment plan prior to treatment indicating she consented to treatment and understood that nitrous oxide and the Limited Evaluation were not covered benefits by her insurance and the cost was $[redacted] and $**respectively. On the treatment plan the cost for the extractions was also listed. Upon checkout $[redacted] was collected for the treatment and nitrous.Shawn D[redacted] (our office manager) did fail to collect for the “Limited Evaluation” of $**. Shawn informed [redacted] via email on 5/24/2017 and during a phone call on 5/25/2017 (prior to the complaint) that she did fail to collect for the Limited Evaluation andapologizedfor overlooking collecting that fee at checkout.To clarify, 1) There were no “extra” charges for nitrous as stated in the complaint, only forthe nitrous used to render treatment;2)Shawn wasn’t asked about any additional charges at check out and Shawn statedwould never tell a Responsible Party and she quotes “Under no uncertain terms that these charges would not be processed and that they were [redacted]% paid in full”.3) It is our office policy toalways use the word “estimate” when speaking to a responsible party because we don't know exactly what the insurance will pay once the claim is processed. The signed treatment plan clearly states that [redacted] understood that the treatment plan was only an estimate.To clarify, a limited exam is required to determine treatment and diagnosis for a focused problem,especially for a non-patient-of-record.   Mr. [redacted] stated in his complaint that once “we” complained to the office, Shawn added additional charges.This is not correct, as stated above, as Shawn forgot tocollect the Limited Exam fee at checkout and it was not added inresponse to any complaint. Due topatientconfidentiality,Shawn was unable to speak with Mr. [redacted] about treatment or finances regarding his step-child.The only charge not discussed with [redacted] was the “Behavior Management” charge as there were no signs of adversebehaviorprior to treatment. This charge is only reserved for patients that take an inordinate amount of time/effortdue to poor behavior/non-complianeabove the usual and customary fortheir age and medical condition(s) and is almost always added after treatment is rendered. In this instance this charge was fully-justified by the standards set forth in the profession.During a phone conversation with [redacted] on 5/25/2017, she confirmed her son was not cooperative and had never heard of this charge. Shawn explained the meaning of thebehaviormanagementcharge and referred [redacted] to the American Dental Association to confirm it was a valid code. However, Shawn did inform her the behavior management charge would be reversed and it was reversed ontheir account. [redacted] then inquired about the Limited Evaluation. Shawn explained the evaluation had to be completed to determine treatment and diagnosis and that this it is the standard of care. Shawn explained it was a Limited Evaluation because the patient was being seen for a specific problem and the exam was limited to the area in which was causing symptoms. In summary, the balance due on the account is $** for theLimited Evaluation. The services provided and charged are as follows; Limited Evaluation $**.**, Nitirous $[redacted].**, 1st Extraction $[redacted], 2nd Extraction $[redacted]. The estimate given the patient was exactly correct once processed by the insurance company. We are so sorry for anymiscommunication; have apologized for our failure to collect for the Limited Evaluation fee; and have reversed the Behavior Management fee. We desire to treat all our families with respect and compassion and we want people to know we have good intentions. This complaint, along with an online [redacted] review, do not accurately represent our practice or this event. This is due in part to Mr. [redacted]’s absence at the appointment in question, as well as a missunderstanding. We are grateful to have the opportunity to share our side of this event in more depth.We hope our explanation above helps clarify the events of theappointment in question. Summary: We are grateful to have the opportunity to share our side of this event in more depth and request that Mr. [redacted] consider removing his online review and dropping all current and future reviews/complaints in exchange for a reversal of the Limited Exam fee.We hope our explanation above helps clarify the events of theappointment in question.      Shawn A. D[redacted] Office / Financial Coordinator Piedmont Pediatric Dentistry T [redacted] www.[redacted].com