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Prime Dental Care Reviews (2)

Re: [redacted] (id# [redacted])
To whom it may concern,
In response to the complaint filed by [redacted] on 09/19/14,the purpose of dual Insurance coverage is
to help cover services not covered by one policy or to assist in the payment of copays. Having dual
insurance...

coverage is not for the patient to choose which insurance to use for services. All claims and if
an hmo an encounter form is sent to both insurance companies, as we are required to notify the
insurance company of all services rendered to the patient. As we are an electronic office it is not
possible to select what insurance company will be sent a claim, it automatically is sent to both
companies.
 After consulting with the office manager and the billing personnel it has been determined
that the insurance company will not be refunded as both insurance companies received the claim and as
previously stated the policy holder/patient is not able decide what services are billed or notified of
rendered services as it Is required that all services be reported. None of these funds are considered
stolen by either insurance company. In regards to the refund of $22.50 to "[redacted]" credit card, the
patient was informed that she needed to come to the office with the credit card to be refunded and sign
for the refund. We are at the office 6 days a week from 10 am to 7:30 pm. The patient has yet to come to
the office to receive the refund.
These issues to which she stated were attempted to be resolved by the office, the patient was not asked to
continue her treatment at another practice due to not letting "these issues drop
or compromising regarding this; but rather due to her aggressive verbal behaviors/
statements as well as lack of respect for those attempting to assist her in resolving this matter.

Review: I visited Dr. [redacted] twice this year - in May for my cleaning and in June for a couple fillings. I have two dental insurance policies, an HMO for my free cleanings and to keep copays low, and an indemnity policy to cover those copays. In May, I specifically requested she use the HMO to cover my cleaning, which should be free per her contract with the HMO. In return, the HMO provides her money every month for me having selected her as my Primary Care Dentist. She went behind my back and billed my indemnity policy for the full possible amount of $100 for cleanings, so she has essentially been paid twice for the same cleaning. In June, she said there was a hole in one of my bottom teeth when she had located and filled all cavities in my bottom jaw the previous winter (2013). When I pointed this out, she said the filling might have fallen out and needed to be redone. I specifically asked if there was any charge for this, and she said no. I later found out she also billed my indemnity policy for this filling in the full amount of $75 payable by the policy. She has now overbilled my indemnity policy $175 when I have a $1500 annual limit. I have contacted her office numerous times from June-September, but she is refusing to refund the amount to my insurance. She also owes me a refund of $22.50 for another filling I had done in June. My HMO copay was $90, but the indemnity policy would only pay $75, so I really only owed $15. However, she didn't trust my policy, so she charged me half of the $75 upfront and promised a refund that I have yet to receive. She has declared that I am no longer welcome in her office because I am refusing to let this drop or compromise and let her keep some of the essentially stolen funds, so I don't know how I am going to get it back. If she had been up front about a cost for the filling, I would have gladly paid, but she said it was at no charge. I can't abide a liar or stealing, whether it be from me or my insurance.Desired Settlement: I would like the overcharged $175 reimbursed to my Indemnity insurance policy, and I would like the overcharged $22.50 reimbursed directly to my card or sent to me in the mail via check. I would also think it a good idea she re-read the terms of her contract with my HMO carrier so she is clear on what services she is to provide for what price so this doesn't happen again.

Business

Response:

Re: [redacted] (id# [redacted])

To whom it may concern,

In response to the complaint filed by [redacted] on 09/19/14,the purpose of dual Insurance coverage is

to help cover services not covered by one policy or to assist in the payment of copays. Having dual

insurance coverage is not for the patient to choose which insurance to use for services. All claims and if

an hmo an encounter form is sent to both insurance companies, as we are required to notify the

insurance company of all services rendered to the patient. As we are an electronic office it is not

possible to select what insurance company will be sent a claim, it automatically is sent to both

companies.

After consulting with the office manager and the billing personnel it has been determined

that the insurance company will not be refunded as both insurance companies received the claim and as

previously stated the policy holder/patient is not able decide what services are billed or notified of

rendered services as it Is required that all services be reported. None of these funds are considered

stolen by either insurance company. In regards to the refund of $22.50 to "[redacted]" credit card, the

patient was informed that she needed to come to the office with the credit card to be refunded and sign

for the refund. We are at the office 6 days a week from 10 am to 7:30 pm. The patient has yet to come to

the office to receive the refund.

These issues to which she stated were attempted to be resolved by the office, the patient was not asked to

continue her treatment at another practice due to not letting "these issues drop

or compromising regarding this; but rather due to her aggressive verbal behaviors/

statements as well as lack of respect for those attempting to assist her in resolving this matter.

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Description: Dental Laboratories, Dentists, Dentist - Orthodontist, Dentistry - Cosmetic

Address: 10717 Camino Ruiz #170, San Diego, California, United States, 92126

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Shady, yet now dead: once upon a time this website was reported to be associated with Prime Dental Care, but after several inspections we’ve come to the conclusion that this domain is no longer active.



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