In response to Mr***'s complaint, I have attached all documents we have on file that support our billing and collection policy, which clearly states that the patient is always ultimately responsible for their treatment fees As a courtesy to our patients, we do agree to assist the patient
with submitting their insurance claim and we attempt to help them maximize their insurance benefits However, the dental insurance is a contract between the insurance company, the employer and the employee We can only estimate what the insurance will pay on the treatment, based on the information we receive when we contact them to confirm eligibility and benefits The insurance claim is submitted with the appropriate ADA code that is determined best matches the treatment provided However, we cannot control what the insurance claims adjuster will decide once they process the claim We do not agree that the "pre-approval insurance coding error" was a mistake on our part It was the opinion of our insurance billing manager, on behalf of the doctor, based on our experience with appropriately submitting standard dental claims on a daily basisAgain, we attempt to do our best to help the patient maximize their dental insurance benefits, but we never know precisely what the fee determination will be until the insurance company processes our claim and/or pays or denies benefits to be paid We can submit a pre-estimate on behalf of the patient, if they request us to do that However, it does delay treatment, and in this case, the patient did not request one be submitted.
I hope this appropriately explains the situation on our partOur goal is to always support our patient and provide the best treatment possible We want our patients to have a happy experience with the Periodontal Associates of Jackson
Please feel free to contact me with further questions or comments
Best regards,
*** ***
I was very impressed with Dr [redacted] and his staffThey were friendly, professional and very helpfulI highly recommend them
In response to Mr***'s complaint, I have attached all documents we have on file that support our billing and collection policy, which clearly states that the patient is always ultimately responsible for their treatment fees As a courtesy to our patients, we do agree to assist the patient
with submitting their insurance claim and we attempt to help them maximize their insurance benefits However, the dental insurance is a contract between the insurance company, the employer and the employee We can only estimate what the insurance will pay on the treatment, based on the information we receive when we contact them to confirm eligibility and benefits The insurance claim is submitted with the appropriate ADA code that is determined best matches the treatment provided However, we cannot control what the insurance claims adjuster will decide once they process the claim We do not agree that the "pre-approval insurance coding error" was a mistake on our part It was the opinion of our insurance billing manager, on behalf of the doctor, based on our experience with appropriately submitting standard dental claims on a daily basisAgain, we attempt to do our best to help the patient maximize their dental insurance benefits, but we never know precisely what the fee determination will be until the insurance company processes our claim and/or pays or denies benefits to be paid We can submit a pre-estimate on behalf of the patient, if they request us to do that However, it does delay treatment, and in this case, the patient did not request one be submitted.
I hope this appropriately explains the situation on our partOur goal is to always support our patient and provide the best treatment possible We want our patients to have a happy experience with the Periodontal Associates of Jackson
Please feel free to contact me with further questions or comments
Best regards,
*** ***
I was very impressed with Dr. [redacted] and his staff. They were friendly, professional and very helpful. I highly recommend them.