Potomac Dental Center

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted] I am rejecting this response for the time being because: First, the matter is still pending, while [redacted] and the practice (hopefully) sort out their misunderstanding.Second, some of the figures noted in the practice's response are inaccurate; namely, my initial visit was fully covered, minus one optional procedure of which I was informed and for which I paid; also, I was told on three occasions by practice personnel - before the procedures were agreed to and performed - that the coverage of the procedures was 100%Third, the note from the practice makes no mention of the poor handling of my account - specifically that my issue was forwarded to a collection agency without adequate effort to resolve the issue with me or my insurance company, without prior notice to me, and with an indication to the collection agency that the issue was not in dispute, when clearly it was Although the practice's staff members with whom I have spoken have been courteous and generally helpful, they have not resolved the issue yet I have not been in direct contact with the person or people who chose to deal with a collection agency rather than with their inconvenienced customer.Fourth, the reason for this dispute is not made clear in the practice's response It appears as though the confusion resulted from the fact that my insurance company covers the procedures in question 100% at a different office of the same practice, but only 80% at the office where I have had all my interactions with the practice I only learned this after repeated phone calls to both [redacted] and the practice I fully expect [redacted] to cover the expense, as clearly they played some role in the misinformation, and clearly they do cover the procedures completely in some contexts However, I am still disappointed that the management of the practice has handled this issue so poorly, including threats of legal action and to my credit rating.I do not intend to pursue this matter further currently; I intend to wait until one of three things happens: (1) the matter is resolved either by the practice waiving the owed balance on my account out of courtesy (ideally with an apology for my anxiety and inconvenience) or by [redacted] paying the outstanding amount in full; (2) the practice or collection agency attempts to carry out any further action to collect the disputed amount from me; or (3) I reach some other agreement with the practice for the settlement of my account.It should here be noted that I was given incorrect information by [redacted] that the issue would be resolved within working days When this time had elapsed - and I received another notice from the collection agency, despite having been told that the practice would contact me before any further action was taken - I called [redacted] again, at which time I was told the actual time needed can be up to working days, or more (It has crossed my mind to file a complaint against ***, as well, but I do not choose to do so at this time.)Thank you for your support in this matter Regards, [redacted]

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

To
whom it may concern:The
patient, ***
***,
called our office and scheduled an appointment to be seen by the
doctor for a routine cleaning and examWhen we initially scheduled
the appointment, we told the patient we did take the insurance but
did not mention to her that instead of the
fee schedule we give all
*** patient’s 25% off the total amount of the bill since Dr
*** is a Prosthodontist (Specialist)The receptionist that
helped Ms*** with scheduling her appointment is new to the office
and is in training so forgot to give that piece of information to her
over the phoneAt the end of the day, we realized that Ms*** was
under charged so we called to explain the mistakeWe apologized for
any inconvenience and tried to explain why she still had a balanceOn
June 15, Ms*** received an exam, cleaning, and fluoride
which she paid $Since it was a mistake in our part, Dr
*** is willing to adjust off the remaining balance of $
Part of our financial policy that Ms*** signed when she first
came to the office explains to patients that payment is due at the
time of serviceSince she received the services she scheduled, we
cannot refund any money backOur
staff is in transition at the moment and mistakes will be madeIt is
unfortunate that we were not able to provide the type of experience
Ms*** was looking for but, as an office, we will work harder to
prevent situations like this from happening againWe hope that
adjusting off the balance will settle all and any complaints.Thank
you and if you have any questions or concerns please feel free to
contact me or Dr*** at the office ###-###-####Best
Regards,Fernanda

To Whom It May Concern:We are writing in response to a patient's' complaint made about her services and treatmentThe patient's' first visit to our office was in March 2014, At this visit the patient came in concerned about a crick on tooth #We consulted with the patient and took xrays to see
what could be done to help with her toothWe recommended that the patient replace the veneer on tooth #or she could wait until it broke off completely and then replace itThe patient chose to wait to replace the veneerThe patient returned to the office weeks later to have an evaluation with the periodontistThe patient was seen January for her regular cleaning and exam and she returned in July for a regular cleaning and examAt this visit the veneer for tooth #had broken off We informed the patient that she needed to replace the veneer but again she opted not to replace itWe recommended to re-cement the veneer as a temporary fix and informed the patient that she would need to have the veneer replacedAgain, she chose to have it re-cemented instead of replaced due to financial reasonsThe patient returned August for an emergency exam because her veneer broke on tooth #At this visit the veneer was completely broken and the part that came off was lostWe explained again to the patient that we needed to replace the veneer in Order for it to stayThe patient asked to just repair the veneer againWe informed her again that his is a temporary fix and it wouldn't lastAfter explaining to the patient again that this was a temporary solution she decided to have it repaired again due to financial ReasonsAt the patient request we repaired the veneerThe patient had two insurances, *** and AetnaBoth insurances paid for the exams the patient had in January and JuneHer emergency exam in August was denied by both insurances due to frequency*** and Aetna allow exams in a yearThe doctor cannot treat a patient without first examining them to determine what treatment is necessary for their condition.Statements began going out to the patient in March as we were waiting for both insurances to pay before we billed the patientWe reached out to the patient in April via emailThe bill was explained in detail to the patientA detailed bill was sent to the patient to show where her balance was coming fromThe patient was disputing the amount for the exam that was denied by her insurance companyThe patient paid $on April 29, for her portion due for the re-cementation of the veneer on date of service 6/25/The patients remaining balance was $As a courtesy to the patient, we contacted both her insurances and submitted the claims to try to maximize her benefitsWhile we were waiting for the insurance to reconsider her claims, we did not send statements to the patientOnce we received the denial from both companie, we sent a statement to the patientWe contacted the patient via email in September, after sending her two statements the prior two monthsShe replied that she didn't understand what the bill was forWe explained to the patient the reason for the bill and informed her we submitted the claims to her insurance company as a courtesyWe went back and forth with the patient no understanding and refusing to pay to us explaining why she has a bill, Our accounts are reviewed monthly and sent to collections on a monthly basisWe had been holding the patient's account from going to collections to try to work something out with the patientWe informed her we were willing to accept $a month until the account is paid off.December 8, the patient called with her mother on the lineWe informed the patient due to HIPPA laws we are unable to discuss anything with her momThe patient stated that she gives us permission to speak with her mom about her accountThe patient and her mom were both irate and upsetI (Michelle) explained the balance again to the patientThe patient's' mom stated that they don't agree with the bill because it's the doctor's' fault and they should not be responsible:, I explained that the doctor was not at fault and the patient agreed to everything we informed her concerning her toothThe mom told me since I was not in the office at the time she felt I didn't': know anythingThe patient's' mom demanded to speak with the doctor, I informed her the doctor was busy and that I am the person to handle the financesShe stated she didn't care and expected to hear from the doctor that dayI informed them once again I am the person to speak to and they still insisted to speak with the doctorI said Okay to end the conversationI gave the doctor the message and the doctor informed me I am the person who needs to handle the situation, reviewed the events with the doctor and left a message for the patientDecember 13, the patient called upset that she was sent to collections and demanded I explain to her what happenedI informed the patient that I have explained to her several times and that we finally decided to send her account to collections, The patient stated that I didn't do my job properly and that I had poor customer service as she was upset and irateThe patient was yelling and cursing and belittling meI had to put the patient on hold several times as I was the only front desk staff person to answer phones, check inpatients and check patients outThe patient stated she paid her balance with the collections agency and I informed her than it's nothing more I can do since it has been paidShe stated she wanted to know why the doctor didn’t call her motherI informed the patient that the doctor is not the one who handles the finances and that I had explained everything to herThe patient continued to fuss, yell, cuss and belittle meI informed the patient that I will not continue to go back and forth with her as she is yelling and cursing at meThe patient stated that she was never going to return to the office and to remove her name from our list, I said thank you and have a great day and hung up the phoneI informed the doctor that I had to hang up on the patient because she was going back and forth with me while cussing, fussing and yelling all the while I was trying to answer phones and handle patients.At this time we do not feel the patient is due a refundThe patient was informed of the veneer needing to be replaced for long term satisfactionThe patient continued to choose the temporary fixThe doctor never broke the patients veneerThe patient came into our office in complaining of the broken veneer as her concernThe doctor has always treated the patient fair, with respect and kindness, I felt bad as I had to hang up on the patient because my customer Service supersedes meAs the patient was speaking I felt attacked and like I was in danger as I didn't know what the patient was capable of doingWe treat all patients with kindness and with the upnosrespect, We have several patients that can attest to nine and the doctors' professionalism and customer service.Michelle H***Office Manager

To
whom it may concern:The
patient, ***
***,
called our office and scheduled an appointment to be seen by the
doctor for a routine cleaning and examWhen we initially scheduled
the appointment, we told the patient we did take the insurance but
did not mention to her
that instead of the fee schedule we give all
*** patient’s 25% off the total amount of the bill since Dr
*** is a Prosthodontist (Specialist)The receptionist that
helped Ms*** with scheduling her appointment is new to the office
and is in training so forgot to give that piece of information to her
over the phoneAt the end of the day, we realized that Ms*** was
under charged so we called to explain the mistakeWe apologized for
any inconvenience and tried to explain why she still had a balanceOn
June 15, Ms*** received an exam, cleaning, and fluoride
which she paid $Since it was a mistake in our part, Dr
*** is willing to adjust off the remaining balance of $
Part of our financial policy that Ms*** signed when she first
came to the office explains to patients that payment is due at the
time of serviceSince she received the services she scheduled, we
cannot refund any money backOur
staff is in transition at the moment and mistakes will be madeIt is
unfortunate that we were not able to provide the type of experience
Ms*** was looking for but, as an office, we will work harder to
prevent situations like this from happening againWe hope that
adjusting off the balance will settle all and any complaints.Thank
you and if you have any questions or concerns please feel free to
contact me or Dr*** at the office ###-###-####Best
Regards,Fernanda

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response for the time being
because: First, the matter is still pending, while *** and the practice (hopefully) sort out their misunderstanding.Second, some of the figures noted in the practice's response are inaccurate; namely, my initial visit was fully covered, minus one optional procedure of which I was informed and for which I paid; also, I was told on three occasions by practice personnel - before the procedures were agreed to and performed - that the coverage of the procedures was 100%
Third, the note from the practice makes no mention of the poor handling of my account - specifically that my issue was forwarded to a collection agency without adequate effort to resolve the issue with me or my insurance company, without prior notice to me, and with an indication to the collection agency that the issue was not in dispute, when clearly it was Although the practice's staff members with whom I have spoken have been courteous and generally helpful, they have not resolved the issue yet I have not been in direct contact with the person or people who chose to deal with a collection agency rather than with their inconvenienced customerFourth, the reason for this dispute is not made clear in the practice's response It appears as though the confusion resulted from the fact that my insurance company covers the procedures in question 100% at a different office of the same practice, but only 80% at the office where I have had all my interactions with the practice I only learned this after repeated phone calls to both *** and the practice I fully expect *** to cover the expense, as clearly they played some role in the misinformation, and clearly they do cover the procedures completely in some contexts However, I am still disappointed that the management of the practice has handled this issue so poorly, including threats of legal action and to my credit ratingI do not intend to pursue this matter further currently; I intend to wait until one of three things happens: (1) the matter is resolved either by the practice waiving the owed balance on my account out of courtesy (ideally with an apology for my anxiety and inconvenience) or by *** paying the outstanding amount in full; (2) the practice or collection agency attempts to carry out any further action to collect the disputed amount from me; or (3) I reach some other agreement with the practice for the settlement of my accountIt should here be noted that I was given incorrect information by *** that the issue would be resolved within working days When this time had elapsed - and I received another notice from the collection agency, despite having been told that the practice would contact me before any further action was taken - I called *** again, at which time I was told the actual time needed can be up to working days, or more (It has crossed my mind to file a complaint against ***, as well, but I do not choose to do so at this time.)
Thank you for your support in this matter
Regards,
*** ***

To whom it may concern,As [redacted] says on his letter to you, he was waiting for a long time to have the crowns on his 6 upper front teeth crowned, it was his choice to have them treated at that time. He never asked about the amount of his remaining benefits for that calendar year. The pat is...

the one that know for example if he had any treatment somewhere else, and that of course would reduce the amount left on his insurance for future treatments As a matter of fact, I believe the insurance holder, and who will pay for the treatment would be the one best informed on how his insurance works- We recommend a dental treatment based on the patient needs, not on the insurance benefits. If a patient wants to know for sure how much their co -payment will be he can always contact the insurance himself and find out.He says that I had access to his insurance account, but he also had access to the same information, so why he never called the insurance himself? He is a very intelligent man, I really believe he could do it. He also states that after the work was done and he paid his final bill he was informed that he owes another $1,000,00. Well that is not exactly what happened. He knew that when the treatment was completed it should already be paid in full. When we tried to collect the balance from him, he said that his wife would make the payment. She paid $1000 few days after the treatment was complete, 4 statements were sent to him from Feb.08th 2015 to June, 04th 2015. However, he never called us to discuss the charges, he only wrote to you now because, since we never heard from him, his account was referred to a collection agency.I am sure I didn’t make a mistake, as he says I did. and want him to pay for my mistake. As he said, it is his insurance, and he understands very well how it works. If he didn't know that he was going to max out, that is his fault. As an insurance holder, he could get any information he needed from his insurance before starting a major dental treatment and, of course, he could wait few more months or maybe never have them done but he chose to have them done at that time.Dr. Elenir B

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response for the time being because: First, the matter...

is still pending, while [redacted] and the practice (hopefully) sort out their misunderstanding.Second, some of the figures noted in the practice's response are inaccurate; namely, my initial visit was fully covered, minus one optional procedure of which I was informed and for which I paid; also, I was told on three occasions by practice personnel - before the procedures were agreed to and performed - that the coverage of the procedures was 100%. Third, the note from the practice makes no mention of the poor handling of my account - specifically that my issue was forwarded to a collection agency without adequate effort to resolve the issue with me or my insurance company, without prior notice to me, and with an indication to the collection agency that the issue was not in dispute, when clearly it was.  Although the practice's staff members with whom I have spoken have been courteous and generally helpful, they have not resolved the issue yet.  I have not been in direct contact with the person or people who chose to deal with a collection agency rather than with their inconvenienced customer.Fourth, the reason for this dispute is not made clear in the practice's response.  It appears as though the confusion resulted from the fact that my insurance company covers the procedures in question 100% at a different office of the same practice, but only 80% at the office where I have had all my interactions with the practice.  I only learned this after repeated phone calls to both [redacted] and the practice.  I fully expect [redacted] to cover the expense, as clearly they played some role in the misinformation, and clearly they do cover the procedures completely in some contexts.  However, I am still disappointed that the management of the practice has handled this issue so poorly, including threats of legal action and to my credit rating.I do not intend to pursue this matter further currently; I intend to wait until one of three things happens: (1) the matter is resolved either by the practice waiving the owed balance on my account out of courtesy (ideally with an apology for my anxiety and inconvenience) or by [redacted] paying the outstanding amount in full; (2) the practice or collection agency attempts to carry out any further action to collect the disputed amount from me; or (3) I reach some other agreement with the practice for the settlement of my account.It should here be noted that I was given incorrect information by [redacted] that the issue would be resolved within 15 working days.  When this time had elapsed - and I received another notice from the collection agency, despite having been told that the practice would contact me before any further action was taken - I called [redacted] again, at which time I was told the actual time needed can be up to 42 working days, or more.  (It has crossed my mind to file a complaint against [redacted], as well, but I do not choose to do so at this time.)Thank you for your support in this matter.
Regards,
[redacted]

Review: I received three fillings, from the office and was originally told that the co-pay was going to be $110.00. They did not pre-authorize the service and my insurance company only paid a portion of the original service. At the time of the original appointment I asked if I would have to pay anything else at any point and they stated no. I received a bill 1 month later stating I owed them an additional $309.00. I spoke with the account manager afterwards and and asked her why the procedure was not pre-authorized, and she stated that they don't pre-authorize all procedures. I also asked why I wasn't originally offered the cheaper alternative that my insurance covered and she stated no offices use that particular type of filling anymore. I researched this and found most dental offices still use both types of fillings.

After refusing to adjust my bill, we were discussing a payment plan to which an agreement could not be established. After several minutes, she stated that the bill was in fact already sent to collections and I would need to negotiate with the collection agency. I immediately called CLX Systems, the collection agency, and spoke with representative [redacted], who stated they have not receive any account under my name. I called the dentist's office again to speak with the accounts manager again, but a receptionist stated she has left for the day.Desired Settlement: I would like my bill to be adjusted to reflect no additional charges or to have the additional fees adjusted partially.

Business

Response:

August 19, 2013

Dear **. [redacted],

Enclosed you will find a copy of **, [redacted]'s transactions, his explanation of benefits, 2 letters we sent him and our financial policy, signed by **. [redacted] on his first visit to our office. With all this information we will be able to prove that **, [redacted]’s allegations are untrue.

**. [redacted] was given a write off, on his first to our office. In the included explanation of benefits you will see that his insurance calculated the discount amount for his first visit, on his second visit there was, according to the explanation of benefits, no write off. Our financial policy states clearly that the patient is responsible for any unpaid balance and is also suggested that the patients should be aware of his insurance's benefits . As the policy bolder for his insurance, it is **. [redacted]'s responsibility to know I he benefits associated with his policy.

On this patient's first visit he was informed of the treatment recommended to him, he only needed some basic procedures, we are not required to request pre authorization for basic procedures , **. [redacted] requested neither a preauthorization, nor an alternative form of treatment. Because of this the composite resin restoration was preformed.

On March 31, 2013, we sent **. [redacted] a statement with his balance; due to a lack of response from **. [redacted] we resent the statement with his balance, including a finance charge and a letter explaining that his payment was overdue on June 6, 2013. **, [redacted] failed once more to reply to the letters, On July 29, 2013, we sent another statement with a finance charge and a letter of delinquency. Copies of both letters have also been included, **. [redacted] once again failed to contact us, as a result on August 9, 2013; we referred his account to a collection agency and a collection fee was added to his transactions. The collection fee, as stated on our financial policy, was added to bis account total, only after the collection agency contacted him **. [redacted], called us to discuss his account and was told that, after having his account referred to collection agency, he should contact the collection agency with any questions regarding his balance . **. [redacted] should have contacted us when he received his first statement in March, and later in June and July, instead he chose to ignore the statements. We hope that **. [redacted] pays for the treatment provided and for the additional fee the collection agency charges us.

Please do not hesitate to contact us if you require more information to resolve this matter.

Best Regards,